Implant System, Secondary Fixation with PEEK SwiveLock Anchor 4.75 x 19.1 mm

Finished Product

AR-1593-P

Knee

Product

The ACL Backup Fixation System includes the implants and instruments needed to back up the fixation sutures of an ACL graft, or the InternalBrace™ ligament augmentation of an ACL reconstruction or primary repair. The kit contains a 4.75 mm SwiveLock® implant, as well as a spade-tipped drill and disposable tap. One factor of successful ACL reconstruction is strong tibial fixation. This system provides a reliable and reproducible augment to ACL tibial fixation.

ACL Backup Fixation System

Child (D)

Orthobiologics

Procedure

Harnessing the power of biologics to provide all necessary components of healing, the BioACL technique uses the patient’s own bone collected using the GraftNet™ device and mixed with autologous bioactive fluid. Using the Angel® system or Arthrex ACP® double-syringe system, concentrated platelet-rich plasma (cPRP) is obtained from bone marrow aspirate (BMA) or whole blood. The autologous mixture is then 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

Ruptures of the quadriceps and patellar tendons are common in elite and recreational athletes. Most surgeons treat these injuries surgically to lessen the risk of long-term disability and morbidity. Historically, open techniques have been used for rupture repairs, but these techniques may be complicated by wound-healing issues and infection. The minimally invasive Percutaneous Achilles Repair System (PARS) technique can be used to treat quadriceps, patellar, and Achilles tendon ruptures.

Patellar Tendon Repair

PARS, für die Quadrizepssehnenrefixierung

Fully threaded knotless SwiveLock anchors are designed for use with SutureTape, FiberWire®, FiberTape®, and soft-tissue grafts in repair and reconstruction techniques. Tension is visualized, adjusted, and locked into position with the SwiveLock anchor body. Available in biocomposite or PEEK material, SwiveLock anchors are cannulated and vented to minimize material.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

SwiveLock®

The SwiveLock fixation kit includes the implants and instruments needed to back up the fixation sutures of an ACL graft or FiberTape® suture for the InternalBrace™ technique in an ACL reconstruction or primary repair. The kit contains a 4.75 mm SwiveLock implant as well as a spade-tipped drill and two sizes of disposable taps (4.75 mm and 5.2 mm). Because successful ACL reconstruction requires strong tibial fixation, this system provides a reliable and reproducible augment to ACL tibial 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.

SwiveLock® Fixation Kit

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

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 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 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.
<ul>
 <li>Anatomic:&nbsp;Independent tibial and femoral socket preparation with FlipCutter III reamer and/or low-profile reamers facilitate unconstrained placement of the ACL graft.</li>
 <li>Minimally Invasive:&nbsp;Socket preparation with the FlipCutter III reamer limits soft-tissue dissection and helps preserve bone and periosteum.&nbsp;</li>
 <li>Reproducible:&nbsp;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.</li>
</ul>

GraftLink® Technique

Arthroscopic-assisted surgical reconstruction of the PCL using the FlipCutter® drill with RetroConstruction™ technology allows for more anatomic placement and safer drilling in the posterior aspect of the knee. Anterograde drilling can also be performed using low-profile reamers in a far lateral portal to avoid iatrogenic injury. Allograft fixation is accomplished with biocomposite, PEEK, or titanium interference screws. Either a single- or double-bundle allograft reconstruction can be performed using these techniques. Some surgeons may elect to use backup, extracortical 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
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.

Implant System, Secondary Fixation with PEEK SwiveLock Anchor 4.75 x 19.1 mm

AR-1593-P

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