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Related Experiment Videos

Potential pitfall of the EndoButton

P T Simonian1, C T Behr, D J Stechschulte

  • 1Sports Medicine Service, Hospital for Special Surgery, New York, New York, USA.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|March 5, 1998
PubMed
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Improper placement of the EndoButton during anterior cruciate ligament reconstruction can lead to fixation failure. Surgeons must avoid overdrilling the femoral socket and ensure correct depth to prevent complications.

Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Sports Medicine

Background:

  • Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
  • Endoscopic fixation using devices like the EndoButton is a key technique.
  • Potential complications during ACL reconstruction require careful consideration.

Purpose of the Study:

  • To identify and describe a specific pitfall during endoscopic ACL fixation with the EndoButton.
  • To elucidate the causes of improper EndoButton flipping during surgery.
  • To provide guidance for avoiding this complication in clinical practice.

Main Methods:

  • Analysis of clinical and cadaveric examples of EndoButton fixation.
  • Evaluation of femoral socket drilling depth and EndoButton advancement.

Related Experiment Videos

  • Assessment of knee flexion angles during device placement.

    • Main Results:

    • The EndoButton can flip outside the extensor mechanism or vastus lateralis, not the lateral femoral cortex.
    • Overdrilling the femoral socket beyond 6 mm and overadvancing the EndoButton are primary causes.
    • While overdrilling to 10 mm may allow proper cortical resting, increased knee flexion reduces safe flipping distance.

    Conclusions:

    • Precise control of femoral socket depth and EndoButton advancement is critical for successful ACL reconstruction.
    • Surgeons must be aware of the impact of knee flexion angles on safe EndoButton placement.
    • Avoiding overdrilling and overadvancement prevents EndoButton flipping complications, ensuring secure graft fixation.