SwiveLock® Anchor System

Surgical Technique

The patient is positioned in lateral or dorsal recumbency under general anaesthetic. A hanging limb technique with aseptic preparation and appropriate draping should be performed.

A lateral parapatellar approach with arthrotomy is performed and through exploration of the internal structured of the joint is completed. Pathologic ligament and meniscus should be treated appropriately. Using standard technique, lavage the joint and close the joint capsule incision.

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A simulated joint specimen showing the isometric sites for suture anchorage in the femur and tibia. In the femur, the isometric position is located caudally below the level of the distal pole of the fabella (F2). In the tibia, the isometric site is located 2-4 mm caudal to the bony protuberance, which forms the caudal wall of the sulcus for the long digital extensor tendon.

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Drill with the Spade Tip Drill at the F2 site. Advance the drill until the drill “bottoms-out”. Drill at an angle towards the centre of the trochlear groove to ensure the drill will not “blow-out” the back of the femoral condyle.

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Use the Tap to thread the tunnel created with the Spade Tip Drill. Advance the Tap until the black laser line is flush with the surrounding bone.

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Locate the T3 site by palpating the bony protuberance, which forms the caudal wall of the sulcus for the long digital extensor tendon. The T3 site is located at the peak of the LDE groove just caudal to the LDE. Drill a tunnel with a .041 Guide Wire, which will pass beneath the sulcus and exit the caudomedial cortex of the proximal tibia.

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Place a 2.5 mm Cannulated Drill over the Guide Wire and drill over the Guide Wire. The Guide Wire is removed, leaving the Cannulated Drill in place.

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Pass the Nitinol Suture Passing Wire into the cannulation of the drill, looped end first. Advance the Nitinol Suture Passing Wire through the cannulation of the drill until it just exits the tip of the drill. Remove the drill, but leave the passing wire in place.

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Load the 3.5 mm Suture Button onto the FiberTape suture and advance it down to the middle of the suture. Take the tails of the FiberTape suture and pass up to one inch of suture into the loop of the Nitinol Suture Passing Wire.

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Pull the suture through the tunnel and pull tight to ensure the button is taut against the bone. Note: It is important to ensure no soft tissue is between the button and the bone.

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Take both limbs of the FiberTape suture and pass them through the anchor eyelet of the SwiveLock. Remove the excess slack in the suture and place the tip of the eyelet into the tunnel at the F2 site.

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Pull the FiberTape up the side of the anchor driver and with a sterile marking pen, mark the FiberTape at the black laser line.

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Move the eyelet to the mark on the FiberTape and advance the anchor and FiberTape into the F2 tunnel. If necessary, use a mallet to advance the eyelet into the tunnel until the lip of the anchor is at the entrance of the femoral hole.

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Advance the anchor by turning the handle clockwise until the anchor is a quarter way into the tunnel. Check for joint stability. If unstable, remove the anchor by turning the knob counter clockwise. Tension can be increased or decreased by repositioning the eyelet on the suture, either left or right of the marking on the suture.

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If the joint is secure, advance the anchor fully into the tunnel. Unwind the white suture around the handle of the inserter and pull the driver out of the anchor. Cut the excess suture flush at the anchor.

Knotless SwiveLock Anchors and FiberTape®
Provide our Strongest and Lowest Profile Constructs:

  • Strong, Knotless Constructs
  • PEEK Anchor Material
    • PEEK (polyetheretherketone) is an inert, nonabsorbable, thermoplastic material
  • Vented Anchor Bodies
    • Promotes bone marrow flow and allows for bony ingrowth
    • Canine pilot study shows evidence of bony ingrowth at eight weeks
  • FiberTape Suture
    • High strength
    • More resistant to tissue cut-through than round sutures
    • Large footprint

Cross section of a Vented BioComposite SwiveLock eight weeks after implantation in a canine model showing bony ingrowth in the vents and center cannulation.

 

ORDERING INFORMATION

Implants/Disposables:

PEEK Knotless SwiveLock Kit includes:

VAR-2323PSLK

– PEEK SwiveLock, 5.5 mm x 19.1 mm, closed eyelet, qty. 5

AR-2323PSLC

– FiberTape, 2 mm, 54 inches, qty. 6

AR-7237

– Suture Button, 3.5 mm x 11 mm, qty. 5

AR-8920

Suture Passing Wire, Nitinol, 8"

AR-1255-08

Instruments:

Tap for 5.5 SwiveLock Anchor

AR-1927CTB

Spade Tip Drill for 5.5 SwiveLock Anchor

AR-1927D

Cannulated Drill, 2.5 mm

AR-1530C-25

Guide Wire, .041, qty. 4

AR-1530K

Banana Knife

VAR-5001

Hook Knife

VAR-5003

Push Knife

VAR-5005

Handle for Knives

VAR-5020

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