The surgical technique of Endobutton (Acufex Microsurgical, Inc,. Mansfield, MA) button fixation for anterior cruciate ligament reconstruction is described. TECHNIQUE FOR ACL RECONSTRUCTION USING THE. ACUFEX DIRECTOR DRILL GUIDE AND ENDOBUTTON CL. 데 . A doubled surgeon’s knot is used. The surgical technique of Endobutton (Acufex Microsurgical, Inc, Mansfield, MA) button fixation for anterior cruciate ligament reconstruction is described.
|Published (Last):||2 June 2013|
|PDF File Size:||12.65 Mb|
|ePub File Size:||20.63 Mb|
|Price:||Free* [*Free Regsitration Required]|
Physical therapy, consisting of exercise without resistance, to improve range of motion is initiated immediately after surgery. Switch the shaver to a Vulcan probe to remove enfobutton interposed soft tissue beneath the EndoButton.
Several studies have shown that EndoButton malpositioning over the soft tissue around the knee induces either tissue irritation or migration of the button. E The position of the EndoButton arrow is fixed to the lateral aspect of the femoral cortex. They determined that migration of the EndoButton was more common with the presence of soft-tissue interposition and clinical outcomes were unaffected by migration and soft-tissue surrgical.
There is a paucity of available literature regarding how to best remove interposed soft tissue and reduce the position of the EndoButton.
Footnotes The authors report the following potential conflict of interest or source of funding: The authors report the following potential conflict of interest or source of funding: Pediatric anterior cruciate ligament femoral fixation: However, this technique requires a longer intraoperative time and a relatively higher level of surgical skills endobtuton may limit its use to more experienced surgeons.
This Technical Note presents an arthroscopic technique that successfully removes interposed soft tissue between the EndoButton and the lateral aspect of the femoral cortex and reduces EndoButton migration from the lateral aspect of the femoral cortex of the knee. However, arthroscopic ACL reconstruction is more technically complex, and inexperienced surgeons may have difficulty identifying the interposed soft tissue and EndoButton.
Right Rt knee with endoscopic visualization from lateral femoral LF portal. In addition, there is a small possibility of injury to the lateral superior genicular artery.
The advantages of this arthroscopic technique include small incisions and direct visualization that can help remove any soft-tissue interposition and reduce a migrated EndoButton. ICMJE author disclosure forms: Although they suggested that an increased angle of knee flexion was more likely to result in surgjcal interposition before flipping, they did not describe any complications resulting from the failure of flipping. Injury to arteries, such as the lateral superior genicular artery, is possible.
Caution is need when removing the soft tissue over the lateral aspect of the femoral cortex. The proposed procedure is routinely used in our practice and continues to show promise.
Author information Article notes Copyright and License information Disclaimer. The techniques allows direct visualization of the reduction of the migrated EndoButton.
Open in a separate window. All-inside anterior cruciate ligament graft-link technique: In the case in which the EndoButton migrates from the lateral aspect of the femoral cortex Fig 1 Aa lateral femoral LF portal is created through the femoral guide pin incision on the lateral aspect of the femur.
Confirm the migration of the EndoButton to the lateral cortex of the knee through the LF portal. Knee Surg Sports Traumatol Arthrosc.
Three femoral fixation devices for anterior cruciate ligament reconstruction: Several techniques have been proposed to ensure accurate placement of the EndoButton and lessen the probability of malpositioning.
The arrow indicates the EndoButtons of the anteromedial and posterolateral graft.
Excessive introduction of fluid may increase the risk of compartment syndrome. An arthroscope enndobutton inserted into the LF portal to evaluate for EndoButton migration from the lateral aspect of the femoral cortex Fig 2 A and B.
B The arthroscope is inserted through an LF portal, and a Vulcan probe arrowhead is inserted through another LF portal.