Finished Product

AR-1204FF

Knee

Product

The new, innovative FlipCutter III drill is an adjustable, variable-size, all-in-one guide pin and reamer that allows minimally invasive socket creation from the inside out. Proprietary technology gives the FlipCutter drill unconstrained freedom of socket positioning and is ideal for difficult-to-reach applications such as tibial socket creation for PCL reconstruction, anatomic femoral socket creation for ACL reconstruction, and socket creation for meniscal allograft transplantation or meniscal root repair. With an adjustable design, the FlipCutter III drill can accommodate sizes 6 mm to 12 mm, including half sizes.

FlipCutter® III Drill

Child (D)

Orthobiologics

Procedure

Soft-tissue meniscal allograft transplantation techniques continue to evolve with the advancement of fixation devices. Using common meniscal repair devices allows for greater flexibility while ensuring anatomic graft placement. Soft–tissue-only meniscal allograft surgical techniques and clinical outcomes are well documented and have good clinical efficacy.1-4
References
1. Kim SH, Lipinski L, Pujol N. Meniscal allograft transplantation with soft-tissue fixation including the anterior intermeniscal ligament. Arthrosc Tech. 2019;9(1):e137-e142. doi:10.1016/j.eats.2019.09.015
2. Spalding T, Parkinson B, Smith NA, Verdonk P. Arthroscopic meniscal allograft transplantation with soft-tissue fixation through bone tunnels. Arthrosc Tech. 2015;4(5):e559-e563. doi:10.1016/j.eats.2015.06.001
3. Elattar M, Dhollander A, Verdonk R, Almqvist KF, Verdonk P. Twenty-six years of meniscal allograft transplantation: is it still experimental? A meta-analysis of 44 trials. Knee Surg Sports Traumatol Arthrosc. 2011;19(2):147-157. doi:10.1007/s00167-010-1351-6
4. Myers P, Tudor F. Meniscal allograft transplantation: how should we be doing it? A systematic review. Arthroscopy. 2015;31(5):911-925. doi:10.1016/j.arthro.2014.11.020

Soft Tissue Meniscal Allograft Transplantation Technique

There has been a renewed interest in ACL primary repairs as the treatment for Sherman Type I and Type II ACL ruptures. Careful analysis of historical data has revealed that certain ACL tear subgroups, especially proximal tears with good tissue quality, have positive clinical outcomes with primary ACL repair.1
Studies reporting outcomes of remnant-preserving ACL surgeries have shown encouraging results and a greater potential for early healing and better functional outcomes compared with remnant-resecting surgeries.2 Preservation of the native ACL using the primary repair technique can achieve short-term clinical success and result in good clinical outcomes at 3-year follow-up in this carefully selected patient population.3
Arthroscopic primary repair is minimally invasive in that no grafts need to be harvested, no tunnels need to be drilled, and revision surgery, if necessary, is more analogous to primary reconstructions.4 The goal of the procedure is to preserve the remnant native ligament. By doing this, the native nerve endings and blood supply are preserved.5
References
1. van der List JP, DiFelice GS. Role of tear location on outcomes of open primary repair of the anterior cruciate ligament: a systematic review of historical studies. Knee. 2017;24(5):898-908. doi:10.1016/j.knee.2017.05.009
2. van der List JP, DiFelice GS. Successful arthroscopic primary repair of a chronic anterior cruciate ligament tear 11 years following injury. HSS J. 2017;13(1):90-95. doi:10.1007/s11420-016-9530-8
3. Jonkergouw A, van der List JP, DiFelice GS. Arthroscopic primary repair of proximal anterior cruciate ligament tears: outcomes of the first 56 consecutive patients and the role of additional internal bracing. Knee Surg Sports Traumatol Arthrosc. 2019;27(1):21-28. doi:10.1007/s00167-018-5338-z
4. DiFelice GS, Villegas C, Taylor S. Anterior cruciate ligament preservation: early results of a novel arthroscopic technique for suture anchor primary anterior cruciate ligament repair. Arthroscopy. 2015;31(11):2162-2171. doi:10.1016/j.arthro.2015.08.010
5. DiFelice GS, van der List JP. Arthroscopic primary repair of proximal anterior cruciate ligament tears. Arthrosc Tech. 2016;5(5):e1057-e1061. doi:10.1016/j.eats.2016.05.009

ACL Repair

An innovative approach to ACL preservation, the ACL Repair TightRope implant allows precise, incremental repair tensioning and retensioning. Additionally, the new FiberRing suture allows for simplified and reproducible suture passing and implant loading. Careful analysis of historical data has revealed that certain ACL tear subgroups, especially proximal tears with good tissue quality, have positive clinical outcomes with primary ACL repair.1
Reference
1. Arthrex, Inc. DOC1-000178-en-US_B. Naples, FL; 2020.

ACL Repair TightRope® Implant With FiberRing™ Sutures

Replicate the anatomical footprint advantage of outside-in guide pin placement without transosseous tunnels. The ACL RetroConstruction system and FlipCutter III drill enable anatomic drill placement of ACL and PCL sockets or tunnels.
Create minimally invasive inside-out sockets with the FlipCutter III drill, an innovative variable-size, all-in-one guide pin and reamer. The FlipCutter III drill provides a whole new level of freedom in socket positioning and is ideal for hard-to-reach areas such as tibial socket creation for PCLR, anatomic femoral socket creation for ACLR, socket creation for meniscal allograft, meniscal root avulsion repair, and retrograde OATS® procedures of the patella.

ACL RetroConstruction™ System / FlipCutter® III Drill

The GraftLink® technique provides the ultimate in anatomic, minimally invasive, and reproducible ACL reconstruction. Used in combination with anatomic guides, the FlipCutter III drill allows independent femoral and tibial "retrodrilling" to create sockets while maintaining the cortices to potentially maximize fixation. ACL TightRope® II implants feature an exclusive flat SutureTape design and a new proprietary fifth locking point used for fixation, making the GraftLink technique the most reproducible ACL reconstruction system available.
 
• Anatomic: Independent tibial and femoral socket preparation with the FlipCutter III reamer and/or low-profile reamers facilitate unconstrained placement of the ACL graft.
• Minimally Invasive: The FlipCutter III reamer is designed to limit soft-tissue dissection and help preserve bone and periosteum during socket preparation.
• Reproducible: The GraftLink technique workstation simplifies graft preparation. The tapered graft and adjustable ACL TightRope buttons facilitate graft passing, fine tuning of graft depth, and graft tensioning from the femoral and tibial sides.

All-Inside ACL Reconstruction / FlipCutter® III Reamer

Create minimally invasive inside-out sockets with the FlipCutter drill, an innovative all-in-one guide pin and reamer. The FlipCutter drill provides a whole new level of freedom in socket positioning and is ideal for hard-to-reach areas, such as tibial socket creation for PCLR, anatomic femoral socket creation for ACLR, socket creation for meniscal allograft, and meniscal root avulsion. Retrograde sockets may be accurately placed in diameters ranging from 6 mm to 13 mm using the RetroConstruction drill guide system.
Femoral and tibial RetroConstruction marking hooks allow reproducible placement of pins and drills into the anatomic footprints. Also included in the set are double-bundle femoral drill guides, curved instruments for tibial preparation, a knee obturator for safe and easy posterior portal placement, the curving suture passer, tunnel plugs, drills, screwdrivers, notchers, and other accessories. This toolbox facilitates standard transtibial PCL reconstruction as well as modern techniques, such as the arthroscopic inlay and GraftLink® all-inside PCL technique.

PCL RetroConstruction™ System / FlipCutter® III Drill

Quadriceps tendon grafts offer unique benefits for cruciate ligament reconstruction, such as a predictably large diameter, low morbidity,1 and a preferable stiffness profile for knee ligament reconstruction.
The QuadPro™ tendon harvester is designed to safely, easily, and quickly harvest a quadriceps or patellar tendon graft using a minimally invasive technique.2-4 The sharp tip cores out an approximate cylindrical graft. Its ergonomically designed handle features graduations on the clear shaft to allow visualization of approximate graft length during harvesting. Available in four sizes (8 mm to 11 mm), the QuadPro tendon harvester can accommodate each patient’s unique needs as well as the surgeon’s preference for graft diameter.
The FiberTag® TightRope® implant facilitates attachment of single-ended grafts, such as quad tendon grafts, to the ACL TightRope RT and ABS implants. FiberTag suture is integrated into the TightRope implant for a strong, consistent connection between the suture and TightRope loop. A simplified suturing technique, along with innovative packaging and the new GraftClamp graft preparation instrument, make preparing quadriceps tendon grafts faster and more reproducible than ever.
References
1. Arthrex, Inc. LA1-00100-EN_K. Naples, FL; 2021.
2. Xerogeanes JW, Mitchell PM, Karasev PA, Kolesov IA, Romine SE. Anatomic and morphological evaluation of the quadriceps tendon using 3-dimensional magnetic resonance imaging reconstruction: applications for anterior cruciate ligament autograft choice and procurement. Am J Sports Med. 2013;41(10):2392-2399. doi:10.1177/0363546513496626
3. Hadjicostas PT, Soucacos PN, Berger I, Koleganova N, Paessler HH. Comparative analysis of the morphologic structure of quadriceps and patellar tendon: a descriptive laboratory study. Arthroscopy. 2007;23(7):744-750. doi:10.1016/j.arthro.2007.01.032
4. Krebs N, Yaish A, O’Neill N. Anatomic evaluation of the quadriceps tendon in cadaveric specimens: application for anterior cruciate ligament reconstruction graft choice. SMRJ. 2019;4(1):7961. doi:10.51894/001c.7961
InternalBrace surgical technique is intended only to support the primary repair and is not intended as a replacement for the standard of care using biologic augmentation in a primary repair.&nbsp;InternalBrace surgical technique is intended only for soft-tissue-to-bone fixation and is not cleared for bone-to-bone fixation.

Quad Tendon Graft ACL Reconstruction

Arthrex pioneered quadriceps tendon (QT) autograft harvesting in 2014 with the minimally invasive QT harvest instrument set for a much easier and more reproducible harvest of the quad tendon. The QuadPro™ tendon harvester is the next evolution in graft harvesting for ACL reconstruction (ACLR). It was specifically engineered to allow for efficient, safe graft harvesting while reducing the morbidity and challenges associated with traditional quad harvesting techniques.

FlipCutter III Drill

AR-1204FF

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