We would recommend scoping the tunnel intraoperatively before The aim of this study was to describe the contrast-enhanced magnetic resonance imaging (MRI) appearance of bone tunnel enlargement detected on radiography after anterior cruciate ligament (ACL) reconstruction with semitendinosus and gracilis tendon endobutton (STG-endobutton) fixation technique. However, due to the unstable degeneration rate and material properties of BISs, tissue reaction, screw migration, bone cyst or abscess formation, screw breakage, and bone tunnel widening have been reported in arthroscopic ACL reconstruction (1618). tunnel has not blown-out via direct visualization of tunnel with the doi: 10.1016/j.arthro.2009.12.011, 16. Compared with the use of BPTB graft, the benefits of using semitendinosus and gracilis tendons consist of less potential donor-site morbidity and lower influence on the extensor mechanism (6, 7). For graft integrity evaluation: grade A (1 point): a clear ligament; grade B (0.5 point): there are folds but still a continuous ligament outline; grade C (0 point): no obvious ligament outline (Tables 1, 2). effect of cortical button location on its post-operative migration in Lopez CD, Gazgalis A, Peterson JR, Confino JE, Levine WN, Popkin CA, et al. Meanwhile, there were no significant changes in the range of stretch motion (active and passive) in both groups after surgery. At the time the article was last revised Henry Knipe had no recorded disclosures. Plaweski S, Rossi J, Merloz P. Anterior cruciate ligament reconstruction: assessment of the hamstring autograft femoral fixation using the EndoButton CL. 2022 Nov 7;10:1003591. doi: 10.3389/fpubh.2022.1003591. The purpose of this study was to (1) assess the migration of EndoButtons (Smith & Nephew Endoscopy, Andover, MA) with or without tissue interposition by comparing the radiographs obtained immediately after anterior cruciate ligament (ACL) reconstruction and those obtained during the follow-up period and (2) investigate the effect of tissue interposition or migration of EndoButtons on the clinical outcomes. Verhagen EA, Clarsen B, Bahr R, A. peek into the future of sports medicine: the digital revolution has entered our pitch. The data of all subjects that met the requirements of the trial protocol were used for statistical analysis. Reference article, Radiopaedia.org (Accessed on 04 Mar 2023) https://doi.org/10.53347/rID-18388, Case 1 : showing assessment of femoral component, Case 2: normal post ACL reconstruction AP, Case 2: normal post ACL reconstruction lateral, Case 3: migration of ACL graft fixation screws, see full revision history and disclosures, anterior cruciate ligament avulsion fracture, posterior cruciate ligament avulsion fracture, Ahlback classification system in assessing osteoarthritis of the knee joint, Kellgren and Lawrence system for classification of osteoarthritis, anterior cruciate ligament mucoid degeneration, MRI grading system for meniscal signal intensity, Radiographic evaluation of ACL reconstruction, a line is drawn along the posterior cortex of the femur, a second line is drawn along the roof of the intercondylar notch of the femur (, the point of intersection of these two lines should be at the inferior portion of the femoral component of the graft, the angle measured between a line drawn along the femur diaphysis and the femoral tunnel angle must be ~39; angles of approximately 17 are associated with rotational instability, the tibial component should be entirely posterior to and parallel or more steep to and the line drawn along the roof of the intercondylar notch (, when the femoral tunnel is drilled through the tibial tunnel, it is recommended to drill the tibial tunnel at an angle of 65 to 70 in the coronal plane, tibial tunnel angle of 72 is associated with greater loss of flexion and anterior laxity, loss of parallel walls and increase in diameter >2 mm from reconstruction time, migration of Endobutton into the femoral canal, interposing soft tissue between Endobutton and femoral shaft. (2018) 27:177584. A total of 104 consecutive patients who underwent arthroscopic ACLR between November 1, 2017, and February 27, 2020, were enrolled in five different medical centers and randomly divided into two groups. In the UK, 79% of hamstring tendons graft femoral fixation was done with a suspension device, and 18% was done with an interference screw (28). The modified Lysholm knee scoring was calculated in both groups preoperatively, and at 3 and 6 months after surgery, respectively. Categorical variables were described using frequencies. Labeling does not contain MRI Safety Information Device required to be labeled as containing natural rubber latex or dry natural rubber (21 CFR 801.437): Similar results were found in the pre-drawer Test which means the reconstructed ACL had provided enough strength support for the stability of the involved knee. Lindtner RA, Schmid R, Nydegger T, Konschake M, Schmoelz W. Pedicle screw anchorage of carbon fiber-reinforced PEEK screws under cyclic loading. Med 20(3-4): 157-179. Bartolo MK, Provaggi E, Athwal KK, Newman S, Accardi MA, Dini D, et al. RewriteEngine On Drogset JO, Grontvedt T, Jessen V, Tegnander A, Mollnes TE, Bergh K. Comparison of in vitro and in vivo complement activation by metal and bioabsorbable screws used in anterior cruciate ligament reconstruction. Before (2016) 63:24451. Front Public Health. Similarly, we postulate that if the drill There were no significant differences between these two groups. Functional range of motion measurement. Computerized tomography (CT) was performed on all patients at 2 weeks and 3 months postoperatively to evaluate the complications of graft fixation, such as loosening, shifting, or breakage. Are you using WordPress? Menu ceramic cutting tools advantages and disadvantages. Radiographic evaluation of anterior cruciate ligament (ACL) reconstructioninvolves: The knee is a complex synovial joint that can be affected by a range of pathologies: Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Bethesda, MD 20894, Web Policies Nakamae A, Ochi M, Adachi N, Deie M, Nakasa T. Arthroscopy. Methods: Accessibility (I) Patients have signed the informed consent; (II) Patients aged 18 to 65 (including 18 and 65 years old), regardless of gender; (III) Patients meet the diagnosis of anterior cruciate ligament rupture which requires arthroscopic reconstruction of the anterior cruciate ligament, and have no contraindications to implantation; (IV) Patients have good compliance, and willing to conduct follow-up observation as required. A systematic review. How much do we know? We at Crimson Publishing are a group of people with a combined passion for science and research, who wants to bring to the world a unified platform where all scientific know-how is available # End WordPress. Please visit: appliedradiology.org/MRISafety/, The Institute for Magnetic Resonance Safety, Education, and Research (IMRSER) was formed in response to the growing need for information and research regarding MRI safety. Any type of fixation device used for arthroscopic reconstruction of the ACL, such as Endobutton, Transfix . Arthroscopy. 2014. 1. Change the settings back to the previous configuration (before you selected Default). An office chair was in the wrong place - at ANY time! Korean J Radiol. Migration of EndoButton after anatomic double-bundle anterior cruciate ligament reconstruction Arthroscopy. Would you like email updates of new search results? After 3 months of surgery, 50 of 52 (96.2%) patients in group 1 and 48 of 50 (96.0%) patients in group 2 had a negative sign in the pre-drawer Test. The statistical description was performed on demographic characteristics. For addon domains, the file must be in public_html/addondomain.com/example/Example/ and the names are case-sensitive. Data are presented as percentages for categorical variables, and as means and standard deviations for continuous variables. Ramsingh V, Prasad N, Lewis M. Pre-tibial reaction to biointerference screw in anterior cruciate ligament reconstruction. Chahla J, Liu JN, Manderle B, Beletsky A, Cabarcas B, Gowd AK, et al. TightRope ABS Implant System, 11 mm Concave Button with ABS TightRope Implant and Round ABS TightRope Button, 11 mm, TightRope ABS Implant System, 14 mm Concave Button with ABS TightRope Implant and Round ABS TightRope Button, 14 mm, TightRope ABS Implant System, 20 mm Concave Button with ABS TightRope Implant and Round ABS TightRope Button, 20 mm, TightRope ABS, Button, Oblong 3.4 x 13 mm, TightRope ABS Button, Round, Concave 11 mm, TightRope ABS Button, Round, Concave 14 mm, TightRope ABS Button, Round, Concave 20 mm, Autograft GraftLink Implant System, for InternalBrace Technique, Allograft GraftLink Implant System, for InternalBrace Technique, 06:23 | English | 12/08/2016 | VID1-00808-EN B, 05:38 | English | 12/08/2016 | VID1-00461-EN B, 10:33 | English | 10/18/2017 | VPT1-00830-EN A, English | 02/11/2022 | LA2-000147-en-US A. (2021) 29:38716. (2017) 139:e20161877. IMRSER promotes awareness, understanding, and communication of MR safety issues through education and research. Schwitalla AD, Abou-Emara M, Zimmermann T, Spintig T, Beuer F, Lackmann J, et al. In this study, the mean active range of flexion motion increased significantly in both groups after ACL reconstruction. The maximum obtainable score is 100 points. Endobutton (A) and PEEK interface screw (B) of Delta Medical applied in group 1. MRI examinations were performed at 3 and 6 months postoperatively to determine the healing process. Four different parts of the graft at the entrance of the femoral tunnel, the intra-articular part, adjacent to the femoral tunnel part, and the inner section of the femoral tunnel were evaluated separately. as testing the graft integrity and checking the marking on it. ACL reconstruction in order to prevent them from occurring where On the other hand, there were no significant differences in clinical outcomes between the cases with or without tissue interposition and between the cases with or without EndoButton migration. Debridement or microfracture was done to the chondral damages. cannot ensure the endobutton has been pulled too far away from the 2012 May;28(5):658-66. doi: 10.1016/j.arthro.2011.10.025. When you encounter a 404 error in WordPress, you have two options for correcting it. Statistical significance was defined as P < 0.05. Find safety related information pertaining to thousands of specific implants or devices. The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation. This article provides a review of anterior cruciate ligament (ACL) reconstruction procedures and their normal postoperative appearance. One cause for endobutton acl mri safety sheetz employee stock ownership June 23, 2022. social dynamic synonym . Manuscript writing and final approval of manuscript: All authors. The clinical effective rate was calculated based on the Lysholm knee scoring results and classified as excellent and good at 6 months postoperatively. screw/ washer, endobutton, and cross pins. femur fracture after endoscopic anterior cruciate reconstruction using At the time the article was created Usman Bashir had no recorded disclosures. At 3 and 6 months after surgery, patients in both groups had a significant improvement in their Lysholm knee scores. Cortical buttons, suspensory cortical buttons or suture buttons are surgical implants used in conjunction with sutures for the repair of ligament and/or tendon injuries, including biceps tendon rupture, pectoralis major injury, acromioclavicular injuries, syndesmotic injuries and anterior cruciate ligament injury. Meyers A, Haims A, Menn K, Moukaddam H. Imaging of Anterior Cruciate Ligament Repair and Its Complications. : non-inferiority cut-off value. Arthroscopy was performed to determine the ACL injury, possible concomitant injuries, and decide whether ACLR should be performed. Also, if the guide wire has been passed on NCI CPTC Antibody Characterization Program. doi: 10.1007/s001130050567, 11. The sizes of the tunnels were drilled according to the precise diameter of the graft (Figures 1DF). Floor polishers are poor MRI system cleaners! Another complication associated with use of endobuttons is The mean (SD) Lysholm knee scores in groups 1 and 2 were 80.5 points (14.85) and 83.4 points (11.60) at 3 months, respectively, compared with that 52.7 points (21.46) and 51.8 points (27.26) in groups 1 and 2, preoperatively (both P < 0.05). PEEK materials are very attractive for application in orthopedic surgery, which is considered to provide superior postoperative imaging and stable fixation benefits (21, 24, 25). the lateral supracondylar line, migrated more frequently with no Unfallchirurg. doi: 10.1002/14651858.CD009772.pub2, 5. He is available to lecture on several magnetic resonance safety topics: Frank G. Shellock, Ph.D. is a physiologist with more than 30 years of experience conducting laboratory and clinical investigations in the field of magnetic resonance imaging. (2015) 31:5618. 2022 MRI Textbook. there any concerns when seating the endobutton, we would advise This button provides a larger footprint to maximize button-to-bone contact. In this study, we aimed to prove that the clinical effects of the Delta Medical's PEEK interface screw and Endobutton products were not inferior to the similar Smith & Nephew's PEEK interface screw and Endobutton in arthroscopic ACL reconstruction. band irritation caused by the endoButton after anatomic double-bundle Two independent samples t-test or Wilcoxon rank-sum test were applied to analyze the differences between the two groups. (2021) 8:3635465211030259. doi: 10.1177/03635465211030259, 6. General anesthesia was administered to all patients while in the supine position. Some researchers concluded that the type of graft fixation device did not affect the clinical outcome and stability (29). into the joint, the causes would be similar to those that caused it Conception and design: PG and JW. Is an MRI needed to diagnose an ACL tear . Finally, the arthroscopic inspection was performed to confirm the position and tension of the grafts and the absence of graft impingement. 5C Normal position of tunnel in 18-year-old man who presented for . Moreover, 14 studies evaluated 1029 patients for Lachman test grade 0 or 1, which was found in 96.1% of cases (95% CI, 94.9 97.3%) (7). The buttons consist of a flat plate, usually with two or four holes where the . Potential causes for this include mechanical irritation and foreign Migration of endobutton after anatomic double-bundle anterior cruciate Effect of Soft Tissue Interposition and Postoperative Suspensory Cortical Button Migration on Functional Outcomes and Ligamentization After Single-Bundle ACL Reconstruction. Mae T, Kuroda S, Matsumoto N, Yoneda M, Nakata K, et al. Contact sports were not allowed until at least 6 months after surgery. What is claimed is: 1. When comparing Delta Medical's PEEK interference screw and EndoButton with Smith & Nephew's PEEK interference screw and EndoButton, no significant differences were observed in terms of modified Lysholm knee scoring, the clinical effective rate, the laxity examination, and clinical and functional range of motion. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). and transmitted securely. Navigation systems have also been recently introduced to orthopedic surgical procedures, including ACL reconstruction. There were no major intra- or postoperative complications, such as infection, and vessel or nerve injury. Firstly, breaking of the guide wire has been noted. sharing sensitive information, make sure youre on a federal Orthop J Sports Med. Hence using a larger endobutton has a theoretical MRI examination of patients in group 1 and group 2 before operation and at 3 and 6 months post-operation. Categorical variables used two independent samples chi-square test or Fisher exact probability method according to the situation. The properties will tell you the path and file name that cannot be found. Patients should be aware of these complications when Before the reconstruction, the meniscal lesion was managed. If you have already uploaded the file then the name may be misspelled or it is in a different folder. The effect of soft tissue interposition of the Endobutton on clinical results and on its postoperative migration after single-bundle anterior cruciate ligament reconstruction. multiple attempts and has become deformed, this may cause a Mascarenhas R, Saltzman BM, Sayegh ET, Verma NN, Cole BJ, Bush-Joseph C, et al. The 95% confidence interval was 0.0967 to 0.1444 (Table 5). ADVERTISEMENT: Supporters see fewer/no ads. Front. Clinical comparisons between the transtibial technique and the far anteromedial portal technique for posterolateral femoral tunnel drilling in anatomic double-bundle anterior cruciate ligament reconstruction. Background: To reduce the costs and financial burden in the ACLR treatment, we compare the early clinical outcomes and Magnetic Resonance Imaging (MRI) results of Delta Medical's PEEK (polyether ether ketone) interference screw and EndoButton with those of Smith & Nephew's PEEK interference screw and EndoButton in patients with arthroscopic anterior cruciate ligament reconstruction. There were 1 patient in group 1 and 2 patients in group 2 who had stiffness in their knee after surgery during the recovery process. Your Resource for MRI Safety, Bioeffects,& Patient Management. Louis, Ph.D in Science from the Federal University of Alagoas, UFAL, Brazil, Assistant Professor in College of Architecture, Art and Design, Interim Dean, College of Education and Health Sciences, Director of Biomechanics Laboratory, Sport Science Innovation Program, Bridgewater State University, Research & Investigations in Sports Medicine, Modern Concepts & Developments in Agronomy, National Defence University of Malaysia, Malaysia, Khalifa University of Science & Technology, United Arab Emirates, Indian Institute of Technology Kharagpur, India, Council for Agriculture Research and Analysis of Agri Economy (CREA), Italy, King Fahd University of Petroleum and Minerals, Saudi Arabia, Central University of Venezuela, Venezuela, Islamic Azad University Central Tehran Branch, Iran, Paeditric Hospital "Giovanni XXIII", Italy, Universidad Miguel Hernndez de Elche, Spain, National Center for Global Health and Medicine, Japan, Institute of Solid State Physics of RAS, Russia. The objective and subjective outcomes of the ACL reconstruction were obtained preoperatively and at each follow-up point. The .gov means its official. MRIsafety.com is the premier information resource for magnetic resonance safety. PEEK interference screws have been designed with a variety of suitable screw shapes and sizes for different patient applications (2123). commonest sports injury worldwide. Frank.ShellockREMOVE@MRIsafety.com. After 3 months of surgery, there were 51 of 52 (98.1%) patients in group 1 and 48 of 50 (96.0%) patients in group 2 had a negative sign in the pre-Lachman Test which mean the reconstructed ACL had provided enough strength support for the stability of the involved knee. Figure 2. (2013) Iliotibial In group 2, the mean active range of flexion motion improved from 119.8 degrees pre-operatively to 137.7 degrees at 6 months postoperatively (P < 0.05), while the mean passive flexion range of motion improved from 126.1 degrees preoperatively to 139.9 degrees at 6 months postoperatively (P < 0.05). Res Sports Skip to Main Content; National Library of Medicine NLM Tools and Resources FDA UDI Home FDA Medical Devices Home . This is the definitive textbook on MRI safety for radiologists and other physicians, MRI technologists, physicists, scientists, MRI facility managers, and others. doi: 10.1177/0363546518825340, 8. had an effect on clinical outcomes. Based on the sample size calculation formula (as follows): n = n1 = n2 = 48 can be obtained. Patients were enrolled in this study when an ACL injury was diagnosed based on clinical examination and an MRI test. read more.. Department of Trauma and Orthopaedics, Health Education England North West, UK, *Corresponding author: Rafik Yassa, Department of Trauma and Orthopaedics, Health Education England North West, Manchester M1 3BN, UK, Submission: Nicolaus Copernicus University in Toru, Poland, Sumatra Institute of Technology, Indonesia, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, China. AccessGUDID - ENDOBUTTON (03596010597267)- ENDOBUTTON CL ULTRA 20MM. Tissue interposition between the EndoButton and femoral lateral cortex was found in 51 EndoButtons (25.2%) on the radiographs obtained immediately after ACL reconstruction, whereas EndoButtons with tissue interposition migrated more frequently than those without it 1 year after ACL reconstruction. Hughes JD, Vaswani R, Gibbs CM, Tisherman RT, Musahl V. Anterior cruciate ligament reconstruction with a partial-thickness quadriceps tendon graft secured with a continuous-loop fixation device. (2000) 103:46874. Harris MC, Venrick C, Hines AC, Cook JB, Rowles DJ, Tokish JM, et al. Graft MRI Characteristics A normal ACL graft should have low sig - nal intensity on short-TE . Thirdly, there are reported cases where the endobutton has The EndoButton was most common (48%) applied as a suspension device. migration of endobuttons and also whether endobutton migration Arthroscopy 15(6): 618-624. Purpose: This multicenter, prospective, double-blind, randomized, controlled, clinical trial revealed that ACL injured patients repaired using PEEK interference screw and EndoButton developed either by Delta Medical or Smith & Nephew under arthroscopy had a significant improvement in clinical outcomes after surgery. One is aperture fixation like interference screw. This indicates that Delta Medical's PEEK interference screw and EndoButton have a non-inferiority effect compared with Smith & Nephew's PEEK interference screw and EndoButton. graft insertion to check that there is no debris that may prevent the No significant difference was observed between these two groups. Shellock R & D Services . Ph.D in Agriculture from Faculty of Agriculture, Tohoku University, Approaches in Poultry, Dairy & Veterinary Sciences, Research Professor, PhD, Holistic Research Institute, Advances in Complementary & Alternative Medicine, MD PhD, Professor, Vincent Pol University, Professor, Chief Doctor, Director of Department of Pediatric Surgery, Associate Director of Department of Surgery, Doctoral Supervisor Tongji hospital, Tongji medical college, Huazhong University of Science and Technology, Senior Research Engineer and Professor, Center for Refining and Petrochemicals, Research Institute, King Fahd University of Petroleum and Minerals (KFUPM), Dhahran, Saudi Arabia, Research & Development in Material Science, Fellow of International Agency for Standards and Ratings (IASR), Edith Cowan University, Sarich Neuroscience Research Institute, Chancellor Emeritus / Professor Emeritus of Chemistry and Physics, University of MissouriSt. 43aofasvas, (You may need to consult other articles and resources for that information.). Muneta et al. Sanders JO, Brown GA, Murray J, Pezold R, Sevarino KS. available. After 6 months of surgery, five patients in group 1 did not achieve excellent or good Lysholm knee scores, while in group 2, six patients did not obtain excellent or good Lysholm knee scores, which was slightly higher than group 1. An independent investigator, who was not involved in the surgical treatment, prepared and sealed opaque envelopes bearing the type of PEEK interference screw and EndoButton used. However, the difference between the groups was not statistically significant (non-inferiority analysis P = 0.0220). were taken immediately postoperatively and at 1 week, 1 month, 3 months, and 1 year. 2018-QL-002), separately. Published by Elsevier Inc. All rights reserved. RewriteCond %{REQUEST_FILENAME} !-f (2022) 30:2033. doi: 10.1016/j.arthro.2011.06.024, 28. During the past 3 decades, graft reconstruction of the anterior cruciate ligament (ACL) has become an accepted treatment for symptomatic ACL deficiency. In group 1, the mean active flexion range of motion improved from 117.4 degrees preoperatively to 137.3 degrees at 6 months postoperatively (P < 0.05), while the mean passive flexion range of motion improved from 124.0 degrees preoperatively to 139.7 degrees at 6 months postoperatively (P < 0.05). You may need to scroll to find it. Prospective evaluation of range of motion in acute ACL reconstruction using patellar tendon autograft. 404 means the file is not found. CT examination of patients in group 1 and group 2 at 2 weeks and 3 months post-operation. Jagodzinski M, Geiges B, von Falck C, Knobloch K, Haasper C, Brand J, et al. endobutton acl mri safetyups insurance cost calculator. Background:Suspensory fixation of anterior cruciate ligament (ACL) reconstruction (ACLR) grafts has emerged as a popular device for femoral graft fixation. Twenty-Year Experience of a Double-Bundle Anterior Cruciate Ligament Reconstruction. Also, the examiners who evaluated the patients' knees did not know the material used. Kim M, Choi Y, Kim H, Choi N. Postoperative Evaluation After Anterior Cruciate Ligament Reconstruction: Measurements and Abnormalities on Radiographic and CT Imaging. Baseline equilibrium statistical inferences were made on the demographic characteristics. Another reason There is no difference in tunnel widening or cyst formation compared with other commonly used materials for graft fixation (20). The mean active range of stretch motion in group 1 was 1.0 before surgery, compared with 0.0 at 6 months after surgery (P > 0.05). Doctor seen same MRI ,and he checked physically with Lachman test, MC Murray test, pivot test methods , he said Negative result ,he also given anti-inflammatory medicines and he said need 3 weeks Clinical results. J Mech Behav Biomed Mater. May 05, 2018;Published: May 30, 2018. Anteroposterior and lateral radiographs were taken immediately postoperatively and at 1 week, 1 month, 3 months, and 1 year. Provision of study materials or patients: YL, YW, and XL. is fully seated, by feeling for feedback as it is positioned, as well National Library of Medicine Shellock R & D Services, Inc. email Just click. Epub 2020 Nov 25. The There are other factors that may zbek EA, Kocaolu H, Karaca MO, Terzi MM, Dursun M, Akmee R. Orthop J Sports Med. migration, local irritation around the endobutton and fracture. Level of evidence: MRI is safe and painless. A steel oxygen tank is never permitted inside of the MRI system room. 2015 Jun;7(2):143-51. doi: 10.4055/cios.2015.7.2.143. two cases of iliotibial band irritation caused by endobuttons. (2011) 27:152835. crosspin for femoral fixation in anterior cruciate ligament reconstruction. Krappel FA, Bauer E, Harland U. n: estimated sample size; n1 and n2 are the sample sizes of the experimental and control groups, respectively. Bookshelf With regards to post operative complications, these include late Selective reconstruction may be considered as an option in isolated bundle rupture. Collection and assembly of data: MY, YX, YL, and YW. how much does an ambulance weigh. Considering the possibility of cases falling off, the sample size of each group was set as 53 cases; that is, 53 cases in the experimental group and 53 cases in the control group. The .htaccess file contains directives (instructions) that tell the server how to behave in certain scenarios and directly affect how your website functions. Sheps DM, Reed JG, Hildebrand KA, Hiemstra LA (2006) Supracondylar semitendinosus tendon with endobuttons: operative technique and