Finished Product

AR-1204FF

Human

Knee

Product

The 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

Arthrex offers a comprehensive selection of fixation devices for a variety of bone-patellar tendon-bone (BTB) graft techniques. These options include adjustable, continuous-loop suspensory fixation, and interference screws in a variety of materials. The TightRope® implant, which has been used in 2 million procedures globally,1 was designed to simplify ACL reconstruction and facilitate advanced techniques, such as the GraftLink® technique. BioComposite FastThread™ interference screws, which are composed of time-tested material with more than a decade of clinical success and implantation, allow for faster screw insertion and better graft protection.2
References
1. Arthrex, Inc. Data on file (sales data as of September 18, 2018). Naples, FL; 2018.
2. Arthrex, Inc. LA1-0199-EN_E. Naples, FL; 2018.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

BTB Autograft ACL Reconstruction 

Arthrex offers the most advanced techniques and instruments for hamstring harvesting and preparation for ACL reconstruction. A reproducible harvest can be performed through a traditional anterior or posterior approach using the minimally invasive hamstring harvest technique and specialized tendon strippers.
The GraftLink®&nbsp;technique provides an anatomic, minimally invasive, and reproducible ACL reconstruction procedure. When used in combination with anatomic guides, the FlipCutter® III drill allows independent femoral and tibial "retrodrilling" to create sockets while maintaining the cortices to maximize fixation. Femoral and tibial TightRope® II implants, with a proprietary 5-point locking system, make the GraftLink technique the most reproducible ACL reconstruction available.
Anatomic: Independent tibial and femoral socket preparation with FlipCutter III reamer and/or low-profile reamers facilitate unconstrained placement of the ACL graft.
Minimally Invasive: Socket preparation with the FlipCutter III reamer limits soft-tissue dissection and helps preserve bone and periosteum.
Reproducible: The GraftPro® graft prep system simplifies graft preparation; the tapered graft and adjustable ACL TightRope II buttons facilitate graft passing, fine tuning of graft depth, and graft tensioning from the femoral and tibial sides.

Hamstring Autograft ACL Reconstruction

For more than a decade, Arthrex has offered multiple collateral ligament reconstruction techniques, ranging from socket- and tunnel-based aperture fixation with FastThread™ interference screws to suspensory fixation using TightRope® technology.&nbsp;
 
 
The newest addition to our anchor portfolio, Knee FiberTak® anchors allow surgeons to perform minimally invasive collateral ligament reconstruction techniques to restore stability while preserving native anatomy. This versatile line supports both hybrid and all-onlay reconstruction, using both knotted and knotless SutureTape technology in conjunction with the InternalBrace™ technique.
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.&nbsp;

Lateral Collateral Ligament (LCL) and Posterolateral Corner (PLC) Reconstruction 

PCL injuries occur during sports-related activities or high-velocity, traumatic accidents. Indications for operative treatment of PCL tears include acute injuries, active young patients, and either isolated grade 3 tears or combined injuries, such as a grade 2 injury with posterolateral corner instability. 

Arthrex has several techniques for isolated PCL injuries—including PCL inlay reconstruction, double-bundle PCL reconstruction, and the transtibial PCL RetroConstruction™ procedure—that can be combined with multiligament or posterolateral corner (PLC) reconstruction.
Additionally, a comprehensive line of PCL reconstruction instrumentation is available for a variety of PCL reconstruction techniques, as well as autografts and allografts and single- or double-bundle options.

Posterior Cruciate Ligament (PCL) Reconstruction

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 harvest a quadriceps or patellar tendon graft using a minimally invasive technique.2-4 The sharp tip cores out an approximate cylindrical graft. The harvester's 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 quadriceps 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 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

Quad Tendon Autograft ACL Reconstruction

It is estimated that between 1.8% and 10.4% of patients who undergo an ACL reconstruction will require a revision.1 Restoring a previously malpositioned ACL tunnel or widened tunnels can be challenging, sometimes requiring a two-stage approach.2 The Cannulated Bone Dowel Kit offers surgeons a simplified solution to effectively address these issues. Allograft bone dowels act as a biologic scaffold to provide an immediate structural architecture and promote osseous integration. The bone dowels can be soaked in platelet-rich plasma (PRP) or bone marrow concentrate to provide autologous cells and growth factors that facilitate graft incorporation.
Additionally, press-fit nature and structural integrity of the bone dowels provides surgeons the option to take a single-stage approach in cases where no more than half of the failed tunnel is violated. Favorable outcomes have been reported for patients undergoing single-stage ACL reconstruction using allograft bone dowels.3 &nbsp;
Along with allograft bone dowels, the FlipCutter® III drill is particularly advantageous in setting a revision ACL reconstruction. The all-in-one adjustable guide pin and reamer allows surgeons to precisely debride remnant tissue and maximize residual bone stock during tunnel preparation.
References&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
1. MARS Group, Ding DY, Zhang AL, et al. Subsequent surgery after revision anterior cruciate ligament reconstruction: rates and risk factors from a multicenter cohort. Am J Sports Med. 2017;45(9):2068-2076. doi:10.1177/0363546517707207
2. Richter DL, Werner BC, Miller MD. Surgical pearls in revision anterior cruciate ligament surgery. when must I stage? Clin Sports Med. 2017;36(1):173-187. doi:10.1016/j.csm.2016.08.008&nbsp;
3. Werner BC, Gilmore CJ, Hamann JC, et al. Revision anterior cruciate ligament reconstruction: results of a single-stage approach using allograft dowel bone grafting for femoral defects. J Am Acad Orthop Surg. 2016;24(8):581-587. doi:10.5435/JAAOS-D-15-00572
<ul>
 <li>Revising Two-Stage BioACL Technique
 <ul>
 <li><a href="https://www.arthrex.com/orthobiologics/bioacl-technique">Arthrex - BioACL™ Technique</a></li>
 </ul>
 </li>
 <li>Revising Two-Stage Quad Tendon Autograft
 <ul>
 <li><a href="https://www.arthrex.com/knee/quad-tendon-graft-acl-reconstruction">Arthrex - Quad Tendon Graft ACL Reconstruction</a></li>
 </ul>
 </li>
 <li>Revising Two-Stage BTB Autograft
 <ul>
 <li><a href="https://www.arthrex.com/knee/acl-btb-graft-fixation">Arthrex - BTB Autograft ACL Reconstruction</a></li>
 </ul>
 </li>
 <li>Revising Two-Stage HT Autograft
 <ul>
 <li><a href="https://www.arthrex.com/knee/hamstring-autograft-acl-reconstruction">Arthrex - Hamstring Autograft ACL Reconstruction</a></li>
 </ul>
 </li>
 <li>Revising Two-Stage Allograft
 <ul>
 <li><a href="https://www.arthrex.com/knee/allograft-acl-reconstruction">Arthrex - Allograft ACL Reconstruction</a></li>
 </ul>
 </li>
 <li>Allograft Bone
 <ul>
 <li><a href="https://www.arthrex.com/orthobiologics/allograft-bone?objectID=human.taxonomy_item.en.e41edfe6-c0f7-445f-91b9-930ee54d242b&amp;queryID=7c33852b43f7f746d4376f56bca1f901">Bone Grafting with Revision Bone Dowels 
Arthrex - Cannulated Revision Bone Dowels</a></li>
 </ul>
 </li>
</ul>

Revision ACL Reconstruction

Relatively uncommon knee injuries, tibial spine avulsion fractures typically occur in children and adolescents.1 Despite the low incidence of tibial spine avulsion fractures, they deserve ample attention to ensure knee function and stability are correctly restored.
Innovative FiberRing™ sutures provide a simple and reproducible technique for securing the distal remnant to achieve anatomic reduction. The ACL Repair TightRope® implant offers titratable knotless fixation to ensure ACL length is appropriately restored and maintained.
Finally, the ACL InternalBrace™ ligament augmentation button accommodates the InternalBrace technique to help prevent excess range of motion during the healing phase and potentially reduce the chances of secondary injury.2,3
References
1. Williams NR, Yin S, Guzman AJ, et al. Tibial spine avulsion repair with FiberRing suture and anterior cruciate ligament repair TightRope.&nbsp;Arthrosc Tech. 2023;12(12):e2381-e2385. doi:10.1016/j.eats.2023.08.008
2. Mackay GM, Blyth MJ, Anthony I, Hopper GP, Ribbans WJ. A review of ligament augmentation with the InternalBrace™ the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented. Surg Technol Int. 2015;26:239-255.
3. Smith PA, Bley JA. Allograft anterior cruciate ligament reconstruction utilizing internal Brace augmentation. Arthrosc Tech. 2016;5(5):e1143-e1147. doi:10.1016/j.eats.2016.06.007

FlipCutter III Drill

AR-1204FF

Related Pages

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FlipCutter^® III Drill

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Soft Tissue Meniscal Allograft Transplantation Technique

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BTB Autograft ACL Reconstruction

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Hamstring Autograft ACL Reconstruction

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Lateral Collateral Ligament (LCL) and Posterolateral Corner (PLC) Reconstruction

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Quad Tendon Autograft ACL Reconstruction

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Revision ACL Reconstruction

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