POTENTIAL PITFALL OF THE ENDOBUTTON

A clinical and cadaveric example show the EndoButton (Acufex Microsurg ical Inc, Mansfield, MA), used for anterior cruciate ligament endoscop ic fixation, flipping outside the extensor mechanism or vastus lateral is rather than flipping directly outside the lateral femoral cortex. T his pitfall was caused by overdrilling the femoral socket beyond the r ecommended 6 mm and overadvancing the EndoButton beyond the required d epth to flip the EndoButton. Overdrilling the femoral socket to a dept h of 10 mm still allows the EndoButton to rest properly on the cortex without soft tissue interposition. Increasing angles of knee flexion a t the time of Endobutton placement decrease the safe distance beyond t he lateral femoral cortex for flipping without soft tissue interpositi on. There is also potential to flip the EndoButton within the substanc e of the vastus lateralis, but the flipping action is blunted and not discrete.