#2 FiberSnare suture, 26" length with 2” closed loop (White/Blue)

#2 FiberSnare mit FiberWire #2, Geflochtener Polyblend Faden, Blau/Weiß mit Schlaufe, ca. 66.0 cm und 30.0 cm versteiftem Ende

#2 FiberSnare with #2 FiberWire Braided Polyblend Suture, White/Blue with Closed Loop, 66 cm, One End Stiffened, 30 cm

Finished Product

AR-7209SNL

Knee

Product

FiberSnare® is a #2 FiberWire® with a small loop on one end while the opposite end is stiffened 12 inches. This provides an easy one step approach to creating a FiberWire® loop on the tip of the Bio-Tenodesis Driver. Instead of using a nitinol wire, insert the stiff non-looped end retrograde through the tip of the Bio-Tenodesis Screwdriver. Place the tip of the tendon or tendon graft into the FiberWire® loop and cinch the other end around the suture cleat on the back end of the blue Tear Drop Handle.

FiberSnare®

Child (D)

FiberStick™ is blue FiberWire® with the first 12 inches stiffened to allow convenient andeasy advancement through most cannulated instruments, alleviating the need fora monofilament suture or wire suture shuttle. FiberSticks come with a thinplastic tube which protects the stiffened suture until use. TigerStick® is similar to FiberStick but whitewith a black stripe in the suture, making suture identification easier.

FiberStick™ and TigerStick®

Procedure

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 a 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

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 offer a comprehensive line of anchor fixation devices, including FiberTak® soft anchors or biocomposite suture anchors, which come preloaded with needles.

Collateral Ligament Graft Fixation

The Collateral Ligament Reconstruction Set is based upon over a decade of international scientific research to improve the safety, accuracy and efficiency of posterolateral and medial/posteromedial knee reconstructions. This unique instrument set has been designed to accommodate all anatomic and isometric-based ligament reconstructions on the outside of the knee.

Collateral Ligament Reconstruction Set

Orthobiologics

For meniscal allograft transplant, the double bone plug technique involves medially implanting the meniscal allograft with rigid fixation at both horn attachments. The technique can also correct meniscal deficiency using bone plugs and minimally invasive suspensory fixation and allows the meniscal allograft to maintain functional hoop stress.

Double Bone Plug

The Double Bone Plug technique for meniscal tear/deficiency utilizes bone plugs that can either be prepared freehand or by using a coring reamer. The freehand technique is performed using rongeurs and a high speed burr. For detailed information about this technique and/or Arthrex products utilized in this technique, visit the educational resources tab or products tab below. The double bone plug technique for meniscal allograft reconstruction provides a method for implanting the meniscal allograft medially with rigid fixation at both horn attachments. It has been demonstrated that bony fixation and bony healing at the attachment site allows for the maintenance of functional hoop stress by the meniscal allograft.

Double Bone Plug Meniscal Transplant

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 preparation 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 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

The streamlined PCL ToolBox contains all the necessary instruments for performing a variety of modern PCL reconstruction techniques. The set includes the RetroConstruction™ Drill Guide System with drill sleeves for use with the FlipCutter® reamer, RetroDrill® reamer, and standard 2.4 mm guide pins.
 
 
Femoral and tibial RetroConstruction marking hooks allow safe, 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, 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 ToolBox

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

#2 FiberSnare suture, 26" length with 2” closed loop (White/Blue)

AR-7209SNL

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