TightRope ABS Button, Round, Concave 11 mm

TightRope ABS, Button, Round, Concave, Ø 11 mm

Finished Product

AR-1588TB-3

Orthobiologics

Procedure

The BioACL™ technique harnesses the power of biologics to provide all necessary components of healing. In this procedure, AlloSync™ Pure demineralized bone matrix, autologous tissue collected using the GraftNet™ device, and Angel® system concentrated platelet-rich plasma from BMA delivered into the bone tunnels created during ACL reconstruction. In conjunction with the GraftLink® technique, this provides the ultimate anatomic, minimally invasive, and reproducible approach for biologically augmented ACL reconstructions.

BioACL™ Technique

Child (D)

Knee

Product

The TightRope® Attachable Button System (ABS) is a 2-piece implant that can be passed through narrow bone tunnels, while allowing increased cortical fixation with the assembly of a large button over the cortical bone. The TightRope ABS may be used for tibial fixation of the GraftLink® technique for all-inside ACL reconstruction technique or for fixation of the graft over small bone tunnels created during transtibial ACL reconstruction. The slotted button can be loaded over the TightRope implant and locked into place. The large 12 mm x 7.5 mm footprint maximizes button-to-bone contact against the cortex. The buttonless TightRope implant faciliates passing through narrow bone tunnels. Four-point, knotless locking system provides strong, stiff graft fixation. The oblong button is another option that provides the same 3.4 mm x 11 mm profile as the TightRope button. An additional option is the 14 mm round button. This button provides a larger footprint to maximize button-to-bone contact.

TightRope® ABS Implant and Button

Arthrex offers a comprehensive selection of soft-tissue fixation devices for a variety of techniques. Innovative designs and cutting-edge materials allow surgeons to achieve strong, less invasive anatomic ACL reconstructions with soft-tissue grafts.

ACL Soft-Tissue Graft Fixation

The TightRope Attachable Button System (ABS) revolutionized minimally invasive, adjustable loop suspensory fixation grafts used in knee ligament surgery. Suitable for all graft types, the TightRope II ABS implant loops can be attached to a variety of button configurations for fixation over sockets created with a FlipCutter® drill or full tunnels with concave buttons. The new flat-tape TightRope II ABS implant loop improves handling characteristics and can reduce graft abrasion.1 Able to easily pass through narrow bone tunnels, the two-piece TightRope II ABS implant allows increased cortical fixation with the assembly of a large button over the cortical bone. During all-inside ACL reconstruction, use the TightRope II ABS implant for tibial fixation in QuadLink™ and GraftLink® techniques or graft fixation over small bone tunnels created during transtibial ACL reconstruction.
Reference
1. Arthrex, Inc. Data on file (LA1-00038-EN_B). Naples, FL; 2017.

ACL TightRope® II Attachable Button System

As the first adjustable-loop cortical suspensory fixation implant to use a flat SutureTape design, the new ACL TightRope® II implant offers better handling characteristics and is more resistant to graft abrasion or tissue pull-through than traditional round sutures.1 Engineered for precise graft tensioning, the adjustable-loop mechanism allows for incremental retensioning of the graft construct after the implants have been secured on the cortex. The redesigned cortical button now incorporates a proprietary knotless fifth locking mechanism, increasing strength and resistance to cyclic displacement.2 To accommodate various graft types and techniques, TightRope II implants are available in RT and BTB configurations loaded with an additional flipping suture or preloaded with a FiberTape® suture for the InternalBrace™ technique. Available options for the ABS implant include standard or open.
References
1. Arthrex, Inc. LA1-00038-EN_B. Naples, FL; 2017.
2. Arthrex, Inc. Data on file (APT-G01155). Munich, Germany; 2020.

ACL TightRope® II Implant

Once the minimally invasive or open incision is made and proper soft tissue windows are established, the Fibular, Tibial, and/or Femoral Collateral Marking Hooks are used for anatomic precision and osseous measurements when drilling the appropriate reconstruction tunnels. Using the Femoral Collateral Marking Hook in conjunction with the Parallel Drill Guide will increase the efficiency of anatomic femoral drilling by significantly reducing convergent tunnels and allowing for accurate guide pin placement at multiple incremental distances. During tunnel creation the spooned ends of the Collateral Ligament Retractor are used to protect the neurovascular structures and the Collateral ligament rasp is used to chamfer the aperture of the completed reconstruction tunnels. The prepared grafts are then passed with the use of FiberWire or FiberSticks and tensioned into the desire position prior to graft fixation.
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.

Anatomic Collateral Ligament Reconstruction

Collateral Ligament Reconstruction Set

Multiple collateral ligament reconstruction techniques are available ranging from aperture fixation using the BioComposite SwiveLock® tenodesis system with biocomposite interference screws to suspensory fixation with TightRope® technology.
For primary or hybrid collateral ligament repair techniques, Arthrex offers a comprehensive line of anchor fixation devices, including FiberTak® soft anchors or biocomposite suture anchors, which come preloaded with needles.

Collateral Ligament Graft Fixation

Multiple collateral ligament reconstruction techniques are available and range from aperture fixation using the BioComposite SwiveLock® tenodesis system with biocomposite interference screws to suspensory fixation with TightRope® technology. 
 
For primary or hybrid collateral ligament repair techniques, choose from a comprehensive line of anchor fixation devices, including FiberTak® soft anchors or biocomposite suture anchors, which come preloaded with needles.

Collateral Ligament Reconstruction Set

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 strong1, 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. LA1-000023-EN_A. Naples, FL; 2020.

FiberTag® TightRope® Implant

Arthroscopic-assisted surgical reconstruction of the PCL using the FlipCutter RetroConstruction technology allows for more anatomic placement and safer drilling in the posterior aspect of the knee. Antergrade drilling can also be performed using low profile reamers in a far lateral portal to avoid iatrogenic injury. Allograft fixation is accomplished with Interference Screws (BioComposite, Titanium). Either a single bundle or double-bundle allograft reconstruction can be performed using these techniques. Some surgeons may elect to use back-up, extra-cortical fixation with a staple, PushLock or SwiveLock.
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.

PCL Soft Tissue Graft Fixation

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

TightRope ABS Button, Round, Concave 11 mm

AR-1588TB-3

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