Driving innovation with the latest technological products and procedures to treat a variety of shoulder conditions.

The Knotless 1.8 FiberTak® soft anchor, Gen2 is the latest in knotless tensionable technology for instability. This design combines trusted knotless technology with the latest in suture innovation. The updates help improve implant insertion, help improve handling characteristics, and provide premium instrumentation with additional stability.

Knotless 1.8 FiberTak® Soft Anchor

As the next evolution of knotless rotator cuff repair, the FiberTak SpeedBridge™ technique is completed with 2.6 FiberTak RC soft anchors on the medial row and FiberTape® sutures fixated laterally with trusted SwiveLock® anchors.
This knotless repair creates a quick, secure construct in as few as three suture-passing steps. The small size of the 2.6 FiberTak RC anchors allows for three points of medial-row fixation where previously only two fixation points could be achieved.
Knotless 2.6 FiberTak RC anchors are adaptable and can conform to traditional repair techniques while providing the additional benefits of tensionable knotless technology for incorporating biologics or increasing medial-row compression.

FiberTak® SpeedBridge™ Rotator Cuff Repair

The tensionable Knotless FiberTak soft anchor combines the benefits of soft anchors with knotless soft-tissue fixation. Curved- and straight-guide delivery systems are available with 1.8 mm drills, making this the smallest knotless anchor on the market.

Knotless FiberTak® Soft Anchor Technique

The TensionTight™ button is used to perform a knotless onlay biceps tenodesis with an arthroscopic suprapectoral or open subpectoral approach. A locking jaw in the button allows for a knotless biceps tenodesis. Securing the biceps tendon repair with a Loop 'N' Tack™ stitch enables an all-arthroscopic suprapectoral onlay tenodesis.

Knotless TensionTight™ Tenodesis Technique

FiberTape® cerclage is a strong, simple, and reproducibly effective solution for replacing metal cables and wires traditionally used for fracture management. The low-profile, broad footprint of the FiberTape cerclage suture provides superior compression and ultimate load compared to traditional metal cables and wires.1 The system includes FiberTape and TigerTape™ cerclage sutures, a tensioner, an instrument tray, and various passing instruments.
Reference
1. Arthrex, Inc. Data on file (APT 3197). Naples, FL; 2017.

FiberTape® Cerclage Technique

Shoulder

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Knotless rotator cuff repair gives surgeons the ability to save time and eliminate the possibility of ongoing shoulder pain due to knot impingement. Arthrex offers many knotless anchor and surgical technique options that provide robust repairs with comparable fixation strength to traditional knotted techniques.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Knotless Rotator Cuff Repair

Arthrex offers many anchor and surgical technique options for surgeons who prefer to tie knots. Repair of the rotator cuff requires reattachment of the rotator cuff tendon back to the humerus. This can be performed in many different ways ranging from open to all arthroscopic procedures and single or double row repair techniques.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Knotted Rotator Cuff Repair

The PASTA Bridge technique allows for the transtendon repair of partial, articular-sided supraspinatus tendon avulsions. This technique simplifies PASTA repair, while providing a secure bridging technique that enhances footprint compression to maximize contact between tendon and bone. The technique allows for percutaneous transtendon anchor insertion through a 3.25 mm incision with no arthroscopic suture passing or knot tying, creating a simple, reproducible technique.

PASTA

The SCR technique was pioneered by Dr. Teruhisa Mihata in 2007 for patients with irreparable rotator cuff tears. In the SCR study, a 24- to 51-month follow-up on 23 patients shows outstanding outcomes in pain, ASES scores, and acromiohumeral distance measurements.1 The SCR technique reinforces the superior capsule, keeping the humeral head reduced in the glenoid by attaching tissue from the glenoid to the greater tuberosity.
Reference
1. Mihata T, Lee TQ, Watanabe C, et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy. 2013;29(3):459-470. doi:10.1016/j.arthro.2012.10.022

Superior Capsular Reconstruction (SCR)

CuffMend™ Rotator Cuff Augmentation Technique

Rotator Cuff Tear

Tears of the rotator cuff are a common source of pain, weakness, and loss of function of the shoulder affecting the ability to perform even the simplest of daily activities. Most commonly rotator cuff tears are degenerative in nature however acute tears are also seen with shoulder injuries. Tears of the rotator cuff can get larger over time therefore early treatment can prevent tear propagation and significant reduction in pain and weakness.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Primary (B)

The knotless SutureTak®, PushLock® and SwiveLock® anchors are knotless suture anchors designed for arthroscopic glenohumeral joint instability and SLAP repair. The knotless SutureTak anchor is inserted through a guide. The suture is passed through the labrum and then it is passed through the locking mechanism and sequentially tensioned to create a low-profile knotless repair. The PushLock and SwiveLock anchors provide the ability to independently pass the suture through a desired amount of tissue prior to anchor implantation allowing for proper visualization and adjustment of tissue tension prior to final implant insertion.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Knotless Labral, Instability, ALPSA and HAGL Lesion Repair

Traumatic glenohumeral dislocation or chronic glenohumeral dislocation/subluxation can cause damage to or fracture the glenoid rim. The resulting bone loss leads to anterior instability that cannot be corrected with soft tissue/labral repair alone. Thus, a Latarjet/Coracoid Process Transfer is performed based on pre-operative diagnostic imaging and arthroscopic evaluation of the percentage of bone loss. The increase in bone area by securing the coracoid to the glenoid and resultant soft tissue sling from tendon attachments on the coracoid leads to a stabilized glenohumeral joint.

Latarjet/Coracoid Process Transfer for Glenoid Deficiency

Treatment of shoulder instability due to glenoid bone loss can be challenging. Common reconstructive techniques include the Latarjet procedure (coracoid transfer) or glenoid augmentation using autograft iliac crest. Dr. Matthew Provencher has described an alternative that uses fresh distal tibia allograft (DTA).1 The lateral portion of the distal tibia is a great match to the patient’s glenoid because it has similar curvature, dense bone, and cartilage.
The Distal Tibia Allograft Workstation is used along with the instrumentation and cannulated screws from the Arthrex Glenoid Bone Loss Set. It allows the surgeon to use trials to determine the desired size and shape of the bone block and then provides a set of simple cutting guides to precisely machine the DTA to match the trial.
Reference
1. Provencher MT, et al. Arthroscopy. 2009;25(4):446-452. doi: 10.1016/j.arthro.2008.10.017.

Distal Tibia Allograft Augmentation for Glenoid Deficiency 

After an acute glenohumeral dislocation, the glenoid labrum and the ligaments attached to it may avulse from their bony attachments. Alternatively, in cases of chronic instability/MDI, the labrum and surrounding ligaments may be stretched to the point where they no longer support the glenohumeral joint. SLAP tears resulting in chronic pain and dysfunction, particularly in athletes, can also be addressed through arthroscopic labral surgery. In any scenario, the labrum/ligaments can be secured back to their attachments (either glenoid or humerus) by a series of sutures/suture anchors (knot-tying or knotless) resulting in normal shoulder function.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Knot Tying Labral, Instability, ALPSA and HAGL Lesion Repair

Glenohumeral Instability / Labral Tear 

Glenohumeral instability may arise from an acute injury or become a chronic disorder due to multiple injuries. Most often, anterior instability occurs after Glenohumeral dislocation/subluxation. Posterior instability occurs, more commonly, in contact athletes (football, lacrosse). Superior Labral Tears (SLAP Tears) do not result in instability but can have deleterious effects in overhead athletes and laborers. Multi-directional instability (MDI) is usually classified as a congenital disorder secondary to another systemic disorder (Collagen/Soft Tissue Laxity Disorder). Instability occurs when the Glenoid Labrum and surrounding ligaments are stretched/torn. Bankart (with or without glenoid bone loss), HAGL and ALPSA lesions are responsible for anterior instability. Kim/Reverse Bankart Lesions are present with posterior instability. Global capsular laxity and Labral insufficiency are seen in MDI. Arthrex has developed specific techniques to address each type of instability.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Developed in conjunction with Sam Akhavan, MD (Pittsburgh, PA), and James M. Paci, MD (Long Island, NY), this knotless biceps tenodesis technique is a simple approach to the top-of-the-groove arthroscopic biceps tenodesis using the Loop 'N' Tack stitch configuration. For surgeons who want to transition from tenotomy to a quick arthroscopic technique, it is an excellent option for using existing portal placement while viewing familiar anatomy. This straightforward surgical approach helps minimize the potential for cramping or cosmetic "Popeye" deformity, which is often associated with tenotomy.1
Loop 'N' Tack Tenodesis Implant Systems provide everything required to perform Loop 'N' Tack biceps tenodesis in a simple, convenient kit.
Reference
1. Mirzayan R, McCrum C, Butler RK, Alluri RK. Risk factors and complications following arthroscopic tenotomy of the long head of the biceps tendon. Orthop J Sports Med. 2020;8(2):2325967120904361. doi:10.1177/2325967120904361

Loop 'N' Tack™ Biceps Tenodesis Technique

Use the all-suture FiberTak button in lieu of traditional metal buttons for both bicortical and unicortical tension-slide techniques. Its 2.6 mm-diameter sheath is preloaded with 2-0 FiberLink™ sutures that are used to shuttle the whipstitch limbs through the sheath.
Features and Benefits
- Button-first technique helps eliminate need to find the drill hole
- 2-0 FiberLink sutures in blue and white/black for easy identification
- All-suture FiberTak button is not visible on x-ray
- 17% stronger than metal buttons1
- 2.6 mm drill reduces the hole 19% compared to the 3.2 mm hole commonly used for metal buttons
Reference
1. Arthrex, Inc. Data on file (APT 04066). Naples, FL; 2019.

FiberTak® Button Tenodesis Technique

The FiberTak Biceps Implant System delivers an all-suture anchor designed for use in open, onlay-tissue fixation procedures, particularly proximal and distal biceps repairs. The implant is double-loaded with sliding SutureTape and includes 4 attached needles. The system includes a FiberTak biceps implant, drill guide, 1.9 mm drill, and a free curved needle.

FiberTak® Biceps Tenodesis Technique

Subpectoral biceps tenodesis using cortical buttons and the tension-slide technique allows for reliable tensioning and a bicortical or unicortical repair of the long head of the biceps.
Featuring a locking jaw, the TensionTight™ button is used for performing knotless onlay biceps tenodesis with an arthroscopic suprapectoral or open subpectoral approach. Securing the biceps tendon with a Loop 'N' Tack™ stitch enables an all-arthroscopic suprapectoral tenodesis.
With the bicortical technique, use the BicepsButton™ implant to draw the tendon against the distal cortex of the bone socket. A tenodesis screw can be added to further support the repair. 
 
The unicortical technique requires the 8.5 mm long proximal tenodesis button, which has angled edges to promote a toggle effect when the button contacts the far cortex. The tension-slide technique reliably draws the tendon onto the humerus.

Cortical Button Tenodesis Technique

The family of SwiveLock tenodesis implants is designed to support a multitude of proximal biceps tenodesis techniques and maximize OR efficiency. Implants are available with suture eyelets or closed eyelets for surgeons who prefer a whipstitching technique. Forked eyelets are also available for an all-arthroscopic approach. There is no need to predetermine tendon length, as position and tension can easily be set and visualized prior to final implant insertion. Obtain strong fixation by simply advancing the preloaded SwiveLock tenodesis implant. The system also features piloted headed reamers with built-in guide tips that eliminate the need to ream over a guide pin.

SwiveLock® Tenodesis Technique

The Birmingham Biceps technique for subpectoral tenodesis was developed in conjunction with Drs. Lyle Cain, Jeff Dugas and Benton Emblom from the Andrews Sports Medicine &amp; Orthopedic Center.
The technique was designed to minimize the potential for postoperative humeral fractures by placing a small 5.5 mm PEEK SwiveLock® tenodesis implant near the top of the pectoralis at a newly defined anatomical landmark, the Pallium Pectoralis. The Pallium Pectoralis is a fascial sleeve that connects from the top of the pec to the medial border of the humerus approximately 2 cm distal to the transverse humeral ligament at the metaphyseal-diaphyseal junction. All implants and disposable instrumentation required for this procedure are conveniently available in the Birmingham Biceps implant system.

Birmingham Biceps™ Technique

The Bio-Tenodesis Screw System was designed specifically for the reattachment of soft tissue, both ligament and tendon, to bone. The Bio-Tenodesis Driver facilitates accurate graft tensioning into a bony socket in a simple “push-in” method. The interference fit provided by the Tenodesis Screw and FiberWire virtually eliminates graft separation from the bone. Because of the strength of the repair achieved with the system, patients are generally allowed to begin postoperative rehab earlier than previously permitted. The Bio-Tenodesis Screws are composed of PLLA and are available in numerous sizes to fit all applications. There are also titanium and PEEK Tenodesis Screws available for use with the system, if desired. The system is ideal for the reattachment of soft tissue to bone in proximal/distal biceps tenodesis.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Tenodesis Technique

Proximal Biceps Pathology

Arthroscopic biceps tenodesis is indicated for the treatment of severe biceps tendinopathy, partial or full-thickness tendon tears, or biceps instability typically associated with rotator cuff tear.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Secondary (C)

As part of the distal biceps repair procedure, the tension-slide technique with the BicepsButton™ implant provides a simple, reproducible, and biomechanically stable repair. This tensioning technique reliably draws the tendon against the distal cortex of the bone socket. Adding a tenodesis screw improves the biomechanical strength and allows the tendon to be placed in a more anatomic position.
The all-suture FiberTak® button can be used in lieu of traditional metal buttons for both bicortical and unicortical tension-slide tenodesis techniques.

Tension-Slide Technique

Distal Biceps Rupture

A distal biceps rupture off the radial tuberosity often presents with painful swollen elbow and significant loss of strength in rotation and flexion. Distal biceps tendon repair using the BicepsButton™ and tension-slide technique allows the surgeon to tension and repair the biceps tendon through a single anterior incision.

The low-profile AC implant and Dog Bone™ button combine to form a tensionable device optimized for the reduction and stabilization of acute and chronic acromioclavicular joint separations. This preassembled construct features two independent TightRope® sutures that attach to a Dog Bone button separately after passing the construct antegrade through a 3 mm bone tunnel.

Low-Profile Tensionable AC Repair Technique

The precontoured, titanium Dog Bone button allows the use of knotless TightRope® technology or multiple FiberTape® sutures for AC joint reduction. The buttons are attached to the sutures independently—only suture material will be passed through the clavicle and coracoid tunnels—allowing the repair to be completed through smaller tunnels.
The low-profile AC implant and Dog Bone button combine to form a tensionable device optimized for the reduction and stabilization of acute and chronic acromioclavicular joint separations. This dual construct features two independent TightRope sutures preassembled into a clavicle insert and a Dog Bone button, which attaches to the suture loops separately after passing them antegrade through the 3 mm bone tunnels.

AC Dog Bone™ Button Technique

AC joint separation can be effectively treated using the AC TightRope® technique. The Arthrex TightRope is a device consisting of two buttons - one round clavicle button and one oblong coracoid button. The buttons are joined by a continuous loop of #5 FiberWire®. This technique provides a simple, reproducible, minimally invasive technique for acute acromioclavicular joint stabilization which may enable a rapid return to activity for the acute injury.

AC TightRope® Technique

The Chronic AC Joint Reconstruction technique involves reconstruction of chronic AC joint separations anatomically using a tendon graft with backup mechanical fixation. The technique uses 5.5 mm x 8 mm PEEK Tenodesis Screws to achieve strong graft fixation in the clavicle that allows for the recreation of the conoid and trapezoid coracoclavicular ligament bundles. The graft is protected during the healing process by using a strand of FiberWire as backup mechanical fixation.
Please note that certain bio (PLLA) anchors and screws are not available for sale in EMEA.

Chronic AC Joint Reconstruction Technique

In the ongoing evolution of treating AC joint injuries, the Twin Tail TightRope® features two independent clavicle buttons designed to help reduce and stabilize the AC joint for open, acute AC repairs. Like the AC TightRope® and GraftRope®, each clavicle button is independently joined to the coracoid button with a continuous loop of #5 FiberWire®. The twin tails help enable stabilization of the AC joint with a device that matches the normal coracoclavicular ligament anatomy.

Twin Tail TightRope® Technique

Acromioclavicular Joint Separation

Indication of Acromioclavicular Joint Separation, also known as AC Joint Separation/Tear of AC ligament is typically due to a tear of the AC &amp; cc ligaments that causes the primary upper limb to separate from the clavicle producing a separation of the AC joint. Procedures include acromioclavicular reconstruction with AC TightRope®, Twin Tail TightRope®, Chronic AC Joint Reconstruction or AC Dog Bone™ Button.

A choice of a midshaft or lateral plate is determined by the site of the fracture. The fracture is held in reduction while the plate is positioned on the clavicle and temporarily fixated with the use of a BB-Tak pin. The plate is then secured using locking or nonlocking screws. Divergent locking screws can also be used laterally. The lateral plate can also accommodate AC joint reconstruction with the Dog Bone™ button.
The Knotless Distal Clavicle Plate Button TightRope® implant is designed to be used in conjunction with any Arthrex distal clavicle plate and gives the surgeon knotless coracoid ﬁxation to help stabilize distal clavicle fractures.

Clavicle Plates Technique

Clavicle Fracture

Fractures of the clavicle are a common fracture type. These fractures are classified-based on anatomic location and displacement of the fracture fragments. While some fractures of the clavicle are treated nonoperatively, many need operative treatment including severely displaced midshaft fractures or lateral fractures with acromioclavicular disruption.

The Arthrex Pec Buttons are used for fixation of soft tissue-to-bone intended as fixation posts, a distribution bridge, or for distributing suture tension over areas of ligament or tendon repair. Each end of the buttons has an angled face to promote a toggle effect when the buttons contact the opposite cortex, enabling the Pec Buttons to be ideally suited for the repair of ruptures of the pectoralis major tendon back to bone. A unicortical pilot hole is formed with a drill bit and after attaching FiberWire® or FiberTape®&nbsp;sutures from the whipstitched pec tendon, the button is inserted in a unicortical fashion using the inserter.

Pec Button Technique

Pectoralis Major Tendon Rupture

The pectoralismajor muscle, or most commonly its tendon that attaches to the humerus, canrupture. Pectoralis major ruptures are uncommon injuries that occur almostexclusively in men between the ages of 20 to 50 and usually result fromviolent, eccentric contraction of the muscle. Surgery, whether early ordelayed, consistently yields superior results compared with nonsurgicalmanagement. A common method for reattachment of the pectoralis tendon is anopen procedure that requires bone tunnels with high strength suture or the useof multiple suture anchors.

The Humeral SuturePlate™ is an anatomically designed polyaxial locking plate and screw system designed for the treatment of proximal humeral fractures. These low profile plates with polyaxial bushings provide freedom to direct the locking screws within the anatomical template, based on the fracture pattern and bone quality for better fixation. Multiple chamfered suture eyelets along the margin of the plate allow the surgeon to pass FiberWire suture after the plate is fixed to bone. FiberWire Suture Kits, containing color-coded #2 or #5 FiberWire® sutures, with needles on each end, are available to facilitate suturing the soft tissue to the plate after it is in place.

Humeral SuturePlate™ Repair

The Percutaneous Humeral Fracture Repair System provides the necessary instrumentation and implants to percutaneously reduce and fixate two, three, and four part proximal humeral fractures using 2.8 mm Pins and 4.5 mm Cannulated Screws.

Percutaneous Pinning Technique

Proximal Humerus Fracture

Fractures of the proximal humerusare a common fracture type. These fractures are classified based on anatomiclocation, mechanism of injury, displacement of the fracture fragments andvascular supply. While some fractures of the proximal humerus are treated nonoperatively,many need operative treatment including displaced two, three and four part fractures.

Shoulder

Knotless 1.8 FiberTak^® Soft Anchor

Rotator Cuff Tear

Glenohumeral Instability / Labral Tear

Proximal Biceps Pathology

Distal Biceps Rupture

Acromioclavicular Joint Separation

Clavicle Fracture

Pectoralis Major Tendon Rupture

Proximal Humerus Fracture

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What's New in Shoulder

Shoulder

Knotless 1.8 FiberTak® Soft Anchor

Rotator Cuff Tearchevron_right

Glenohumeral Instability / Labral Tear chevron_right

Proximal Biceps Pathologychevron_right

Distal Biceps Rupturechevron_right

Acromioclavicular Joint Separationchevron_right

Clavicle Fracturechevron_right

Pectoralis Major Tendon Rupturechevron_right

Proximal Humerus Fracturechevron_right

Disclaimers

Disclaimers

What's New in Shoulder

Knotless 1.8 FiberTak^® Soft Anchor

Rotator Cuff Tear

Glenohumeral Instability / Labral Tear

Proximal Biceps Pathology

Distal Biceps Rupture

Acromioclavicular Joint Separation

Clavicle Fracture

Pectoralis Major Tendon Rupture

Proximal Humerus Fracture