Related Experiment Video
Updated: May 29, 2026
Athymic Rat Model for Evaluation of Engineered Anterior Cruciate Ligament Grafts
Published on: March 26, 2015
Migration of EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction
Tatsuo Mae1, Sanae Kuroda, Norinao Matsumoto
1Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. ta-mae@umin.ac.jp
Purpose:
The purpose of this study was to (1) assess the migration of EndoButtons (Smith & Nephew Endoscopy, Andover, MA) with or without tissue interposition by comparing the radiographs obtained immediately after anterior cruciate ligament (ACL) reconstruction and those obtained during the follow-up period and (2) investigate the effect of tissue interposition or migration of EndoButtons on the clinical outcomes.
Methods:
One hundred one patients underwent anatomic double-bundle ACL reconstruction with EndoButtons for femoral fixation. Anteroposterior and lateral radiographs were taken immediately postoperatively and at 1 week, 1 month, 3 months, and 1 year. The distance between the EndoButton and lateral femoral cortex was measured on the radiograph obtained immediately postoperatively, and more than 1 mm in distance was defined as positive tissue interposition. Moreover, the locations of the EndoButtons on the radiographs obtained at each follow-up visit were compared with those obtained immediately postoperatively, and EndoButton migration was considered to be present when the EndoButton had moved more than 1 mm or had rotated by more than 5°. The relations between clinical outcomes at 1 year and tissue interposition or migration of EndoButtons were also evaluated.
Results:
Tissue interposition was found for 51 EndoButtons and migration was observed for 71 EndoButtons, and there was a significant difference in the incidence of migration between anteromedial and posterolateral grafts. Of the 51 EndoButtons with tissue interposition, 32 migrated within 1 year, and 39 of 151 EndoButtons without tissue interposition migrated, whereas the EndoButtons with tissue interposition migrated significantly more frequently. On the other hand, there were no significant differences in clinical outcomes between the cases with or without tissue interposition and between the cases with or without EndoButton migration.
Conclusions:
Tissue interposition between the EndoButton and femoral lateral cortex was found in 51 EndoButtons (25.2%) on the radiographs obtained immediately after ACL reconstruction, whereas EndoButtons with tissue interposition migrated more frequently than those without it 1 year after ACL reconstruction. However, neither tissue interposition nor migration of the EndoButton affected the clinical outcomes.
Level Of Evidence:
Level IV, prognostic case series.