title: Self-flip Technique of the TightRope RT Button for Soft-Tissue Anterior Cruciate Ligament Reconstruction.
abstract: The TightRope RT (Arthrex, Naples, FL) is a suspensory device for anterior cruciate ligament reconstruction. However, there is a potential risk of the button being pulled too far off the lateral femoral cortex into the soft tissue because the adjustable loop is long. The purpose of this article is to present an easy and safe technique for self-flip. As to the preparation of the graft, we draw the first line in the loop of the TightRope RT at the same length as the femoral tunnel, and we draw the second line 7 mm longer than the length of the femoral tunnel as a self-flip line. Concerning passing of the graft, the side sutures are pulled from the lateral side. We stop pulling the sutures just at the self-flip line by holding the graft at the tibial end. The side suture is inclined to the medial side with strong pulling of the suture at full extension of the knee. Then the surgeon pulls the tibial end of the graft to feel a secure positioning of the button on the lateral femoral cortex. Although it has limitations, the present technique is easy and certainly helps surgeons achieve appropriate positioning of the button.
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kengo
authors.initials: K
authors.lastname: Harato
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Niki
authors.affiliation: Nishiwaseda Orthopedic Clinic, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Toyoda
authors.affiliation: Department of Orthopedic Surgery, Ashikaga Red Cross Hospital, Tochigi, Japan.
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Kamata
authors.affiliation: Masumoto Sports Clinic, Tokyo, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Masumoto
authors.affiliation: Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Otani
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Suda