Name: Quad Tendon Graft Preparation Using the FiberTag® TightRope® Implant
Uploaded: 2019-11-11T00:00:00Z
Channel: Arthrex
Description: John W. Xerogeanes, MD (Atlanta, GA), prepares a quadriceps tendon graft using the FiberTag ® TightRope ® implant system.

John W. Xerogeanes, MD (Atlanta, GA), prepares a quadriceps tendon graft using the FiberTag® TightRope® implant system.

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VID1-000368-en-US | B | Quad Tendon Graft Preparation Using the FiberTag® TightRope® Implant

John W. Xerogeanes

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

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Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

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Quad Tendon Graft Preparation Using the FiberTag® TightRope® Implant

We have several new devices here. One is a GraftPro board, which makes it very easy to prepare a graft. We have multiple clamps which could hold the buttons and the graft as well. We have our quad tendon graft. All soft tissue graft right there. Here we have the FiberTag TightRope dt. You can see the button and then the FiberTag as well. And it's all combined in one. We have a nice stout needle which could pierce the graft very easily. Over on this side we have the FiberTag abs and this is all attached together again making it very easy to use and eliminating steps. Here we have the Graf clamp. This is specially designed to hold the graft and also the FiberTag system. These slots are used to hold the card and the FiberTag while we're applying it to the graft. This is a notch which will help hold the FiberTag. So again making this very easy. So it comes in a nice package. We can easily unwrap it. And it's self-contained. So we can slide it into the clamp. And then we'll take the sharp tip of it. And you can see the length is perfect. And it can pierce the end of the FiberTag that's hooked on to the TightRope loop. This will fit in that notch so it doesn't move and it's locked in place. We then place this on the graft about 2 to 3mm from the end, and it pierces and holds it very well. The FiberTag portion of the implant is between 18 and 20mm in length. Notice that we pull when we pull these sutures, we pull them together. And that is so we don't split the graph. Then we loop around. We're holding tension. Obviously this could be easier if you have someone else to help, it can be easily done by yourself. And then we go about almost halfway up the graft. Pierce the FiberTag. And this causes a rip lock type system. And watch here we'll pull with two hands on this and that will tighten it down. So we pull hard, it tightens it down. Then we take the loop. Go around. We then put the needle through at the junction of the FiberTag and the TightRope. Again we're pulling these strings together to tubular eyes. The graft you can see it's very nicely tubular eyes there. We then flip the paper over, put the needle through the hole, pull it through, and then this reinforces that junction between FiberTag and TightRope. We then pierce the location between the previously thrown stitches and tighten it. When we throw the next stitch here, you can see it rises it, we pull hard. We then cut one limb of the suture so the needle remains on one part of the suture. You'll see where that's important. Right here. We then make a simple tie, tighten it down, throw another loop to lock it. Then we cut the end without the needle, and we take the needle and bury the knot. This is important so it does not get caught on the aperture of the tunnel when you're placing the graft. We then go to the other side. Cut it. And the nice thing about this is we can take the very proximal end of the graft and trim it. You don't want to get your cut your graft stuck at the aperture of the tunnel when you're pulling it in. You don't want that binding in the tunnel. So this will allow us to get the whole graft well seated in the tunnel. And this process is not only stronger than any construct we've previously described, but it's a much faster technique. We then placed it in the button holder. This eliminates the need to have another set of hands. This is the FiberTag abs TightRope. We use this on the tibial side. It comes without the button, which we add later for tibial fixation. Again, it works exactly the same way. We lock the card in. We pierce the FiberTag and we're ready to place it on the end of the quad graft. The FiberTag portion of the implant is between 18 and 20mm in length. We go up about halfway. Place a second throw and notice again how we're pulling it. This is key. We come through. We go around. And again, if wanted you could stop right here and tie it off. We want to show you the technique during this video. So we're throwing multiple multiple sutures. Then again we bury the knot. And you're done. You have a completed graft. Quad grafts tend to be rectangular in shape. Then we used a graph compression tubes to take the rectangular quad graft and make it circumferential. So we tubular it here. This makes it very easy to pass into the tunnels we created with round drills. You can see we can size the graft as well. We can see both distance and the circumferential measurement. Now this graph is ready to place.

Quad Tendon Graft Preparation Using the FiberTag® TightRope® Implant

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