Do any one has experience about the ACL graft fixation on the tibial side with cortical devices like the Endotack of Storz or similar devices that a tunnel is drilled rather than a socket like that performed with the All inside Graft link of Arthrex. Are their any disadvantages that prevents their popular use like the Interference screws?
I used Aesculap Position system (I think you mean extracorticall buttons). I used button alone fixation and sutures from the graft were tied on the button.
What I can consider disadvantage is that graft should be prepared with proper length, it cannot stay outside the tunnel, still we should leave the proper portion of the graft inside the tunnel. Other disadventage is the risk of the suture tear over the button. We should always be prepared to use interference screw in case of this problems.
Whats advantageous about the button is ability to check the final tension of the graft. We can also enlarge the tension by rotating the button after the sutures are tied.
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