There are an estimated , ACL repairs in the US each year: most ACL tears occurs from noncontact injuries. The % of the knee ligament injuries. Among femoral cortical suspension devices, the EndoButton CL . to confirm the position of the EndoButton after ACL reconstruction (Fig 3). One device used for femoral fixation of ACL grafts is the EndoButton Continuous Loop (Smith & Nephew. Endoscopy, Andover, Mass). This device has been well.

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Clinical Biomechanics Bristol, Avon. Therefore, the results do not warrant comparison to a clinical situation.

Over the top or endobutton for ACL reconstruction?

Further research is needed to determine the clinical relevance of these findings relating the ACL replacement at femoral side. Biomechanical analysis of human ligament grafts used in knee-ligament repairs and reconstructions. The porcine bone does not have the same bone mineral density as a healthy human bone. This method allowed for harvesting of the soft tissue. Biomechanical analysis of femoral tunnel pull-out angles for anterior cruciate ligament reconstruction with bioabsorbable and metal interference screws.

There is a risk of damage to the EndoButton loop by using the Vulcan. Physical therapy, consisting of exercise without resistance, to improve range of motion is initiated immediately after surgery.


This technique requires careful cleaning of the soft tissue over the lateral cortex of the femur. Migration of EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction. This minimally invasive approach assists in the correction of the migrated EndoButton to the femoral cortex to the proper position. Endobuton fixation devices failed during the cyclic loading test.

The previous studies showed a positive correlation between a malpositioned EndoButton and a higher rate of button migration. Current surgical techniques do not allow adequate visualization of the button in its final position to confirm that it is correctly flipped over without soft-tissue interposition between the EndoButton and the iliotibial band ITB or vastus lateralis.

Postoperative Rehabilitation A standardized postoperative protocol is implemented for each patient. The slippage of the graft-fixation device interface was measured indirectly through the graft lengthening after 20,and load cycles.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

An unidentified pitfall of Endobutton use: A lower stiffness can, therefore, increase the displacement associated with anterior translation and may result in an unstable knee.

The position of the EndoButton is confirmed with fluoroscopy after manual assessment to ensure that the button has been flipped. Three femoral fixation devices for anterior cruciate ligament reconstruction: Fixation technique The fixation procedure followed the same clinical protocol established for ACL reconstruction at femoral side of human knees.


Bio Cross-Pin one cortical support point. Furthermore, the bone quality Brown et al. Open in a separate window.

Over the top or endobutton for ACL reconstruction?

Both are able to support the immediate post-operative loading applied N. The Bio Cross-Pin broke in 5 cases, and the tendon failed in 2 cases. Femoral suspension devices for anterior cruciate ligament reconstruction: One is the use of animal tissues. The fixation device should promote stiffness near the native ACL to avoid an excessive graft motion and knee laxity until graft integration, To et al.

The stiffness decreases and the fixation tends to fail. The American Journal of Sports Medicine. National Center for Biotechnology InformationU.

Footnotes The authors report the following potential conflict of interest or source of funding: We describe an arthroscopic technique for making femoral tunnels through the outside-in method that reduces the migration of the EndoButton through a lateral femoral portal. Our minimally invasive procedure can facilitate a quicker recovery. A fixed-loop cortical suspension device, the Endoburton CL, is used for femoral fixation. Tendon healing in a bone tunnel.

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