Endobutton

from Wikipedia, the free encyclopedia

An endobutton is an implant that is used as part of the surgical reconstruction of a ligament or tendon to fix the ligament or tendon and is a registered trademark of the English company Smith & Nephew .

application

Image 1: Graphic representation of an endobutton as it is used to reconstruct a cruciate ligament.
Fig. 2: Graphic representation of an endo button with a loop, as it is connected to a patellar graft.

Endobuttons are mainly used for the femoral ( thigh bone ) fixation of grafts in the reconstruction of cruciate ligament tears . The transplant, for example a patellar tendon with bone remnants at its ends (BTB transplant, bone-tendon-bone ), is connected with a loop made of non- absorbable thread material with a titanium tilt button (four-hole plate). A channel approximately 2 mm in diameter is drilled into the bone of the graft. The loop is pulled through this hole. The composite transplant-endobutton is then pulled from below through a canal drilled into the thigh bone with the help of a pulling thread (see picture 1). The oval four-hole plate is tilted with a thinner tilt path so that it prevents the transplant from falling back.

An end button can also be used to fix an autologous transplant, for example a hamstring , in the event of a rupture of the distal biceps tendon ( biceps tendon tear ).

Endobuttons can also be used for untreated Achilles tendon ruptures .

However, due to the very low incidence compared to rupture of the anterior cruciate ligament, these applications are relatively rare.

Complications

A frequently observed effect of an endobutton is the widening of the drill channel in the bone. This is due to the longitudinal movements of the graft within the drill channel, the so-called bungee effect . This effect can only be observed during the healing of the graft into the bone. This phase lasts around 8 to 12 weeks. The expansion of the drill channel can largely be prevented by fixing it close to the joint.

Individual evidence

  1. ↑ S. Fromm: Reconstruction of the anterior cruciate ligament (ACL) with a bone-tendon-bone transplant using the ENDOBUTTON CL BTB fixation system. Smith & Nephew GmbH brochure.
  2. ^ P. Hallam and GI Bain: Repair of chronic distal biceps tendon ruptures using autologous hamstring graft and the Endobutton. In: Journal of Shoulder and Elbow Surgery 13, 2004, pp. 648-651. PMID 15570233 .
  3. ↑ RG Ranelle: Use of the endobutton in repair of the distal biceps tendon. In: Proceedings (Baylor University. Medical Center). Volume 20, Number 3, July 2007, pp. 235-236, PMID 17637875 , PMC 1906570 (free full text).
  4. ↑ GJ Bauer and S. Hingelbaum: The distal biceps tendon rupture. In: Obere Extremität 3, 2008, pp. 101-107. doi : 10.1007 / s11678-008-0087-0
  5. ^ CC Wang: Anatomic reconstruction of neglected Achilles tendon rupture with autogenous peroneal longus tendon by EndoButton fixation. In: The Journal of Trauma 67, 2009, pp. 1109-1112. PMID 19901676 .
  6. ↑ M. Lind et al: Bone tunnel widening after anterior cruciate ligament reconstruction using EndoButton or EndoButton continuous loop. In: Arthroscopy 25, 2009, pp. 1275-1280. PMID 19896050 .

further reading

  • W. Petersen and T. Zantop: The anterior cruciate ligament: Basics and current practice of operative therapy. Deutscher Ärzteverlag, 2009, ISBN 3-769-10562-1 limited preview in the Google book search
  • S. Plaweski et al: Anterior cruciate ligament reconstruction: assessment of the hamstring autograft femoral fixation using the EndoButton CL. In: Rev Chir Orthop Traumatol 95, 2009, pp. 606-613. PMID 19944664
  • JA Greenberg et al: EndoButton-assisted repair of distal biceps tendon ruptures. In: J Shoulder Elbow Surg 12, 2003, pp. 484-490. PMID 14564273
  • GI Bain et al .: Repair of the distal biceps tendon rupture: a new technique using the EndoButton. In: J Shoulder Elbow Surg 9, 2000, pp. 120-126. PMID 10810691
  • JC Eck and SD Baublitz: Endobutton-assisted repair of complete distal biceps tendon rupture in a woman. In: Am J Orthop (Belle Mead NJ) 38, 2009, pp. 626-628. PMID 20145790
  • JA Greenberg: Endobutton repair of distal biceps tendon ruptures. In: J Hand Surg Am 34, 2009, pp. 1541-1548. PMID 19801110
  • T. Peeters et al: Functional outcome after repair of distal biceps tendon ruptures using the endobutton technique. In: J Shoulder Elbow Surg 18, 2009, pp. 283-287. PMID 19101177
  • J. King and M. Bollier: Repair of distal biceps tendon ruptures using the EndoButton. In: Journal of the American Academy of Orthopedic Surgeons 16, 2008, pp. 490-494. PMID 18664638
  • JT Spang et al .: A biomechanical comparison of EndoButton versus suture anchor repair of distal biceps tendon injuries. In: J Shoulder Elbow Surg 15, 2006, pp. 509-514. PMID 16831659

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