The improved cortical button shows better breaking strength of sutures compared with 10 original cortical button after cyclic loading

Abstract

Background: Suspensory cortical buttons are widely used for fixation of reconstructed ligaments during anterior cruciate ligament (ACL) reconstruction because they have high usability and a favorable fixing force. However, it is not always easy to fix a reconstructed ACL while maintaining appropriate ligament tension. Therefore, we developed an improved cortical button that provides temporary tension until suturing is completed. Methods: Button holes of our improved EndoButton are not perpendicular to the bone surface on which the button is placed, but have an angle of 45 degrees so that the button can be temporarily fixed by applying tension to the suture. The improved EndoButton and the original EndoButton (Smith & Nephew Inc., Andover, Massachusetts) were each tied to FiberWire 5/7 metric (5 M) (manufactured by Arthrex). Ten cycles of preliminary loading (0-50 N) were applied to each suture, followed by test loading (0-250 N) for 500 or 1000 cycles. Then, a tensile test was performed at a displacement velocity of 20 mm/min. Results: The breaking strength of the sutures of the improved EndoButton were tend to higher than those of the sutures of the original EndoButton after 1000 loading cycles (p = 0.067, d = 0.883). The moduli of rigidity of the sutures of the improved EndoButton were higher than those of the sutures of the original EndoButton after 500 loading cycles (p = 0.027) and remained almost the same regardless of the number of loading cycles. Conclusion: We found that compared with the original cortical button, the improved cortical button was better able to retain suture breaking strength and modulus of rigidity, regardless of the number of load cycles.

Accessory plantaris muscle can result in symptomatic hardware impingement following ACL reconstruction

“…The standard femoral tunnel position is drilled near the 10 or 11-o'clock position for the right knee (1 or 2-o'clock for the left knee) in the intercondylar notch [17] . The Endobutton is a suspensory cortical button that is frequently used during ACL reconstruction for its relative strength, ease of application, and ability to retain sutures in the early postoperative period [20] .…”

Anterior Cruciate Ligament Rupture Combined with Complete Radial Tear of the Posterior Horn of the Lateral Meniscus: Suture or Resection?

“…XO Button (ConMed Linvatec, Largo, FL) and Bio-Cross Pin (RIGIDfix, DePuy Mitek, Raynham, MA) were used for femoral graft fixation. As intended, tibial fixation was performed using a bioabsorbable interference screw (Matryx, ConMed Linvatec, Largo, FL) 19,20 (►Fig. 2E).…”