Addressing the Complications Associated With the Use of Arthrex TightRope RT in Anterior Cruciate Ligament Reconstruction

Abstract

TightRope Reverse Tension is a second-generation suspensory fixation device that is used for graft fixation in anterior cruciate ligament reconstruction, with distinct advantages compared with fixed-loop devices. However, despite adhering to standard precautions, there are certain complications associated with its use, such as the button getting stuck in the guide-pin hole, button being pulled out too far laterally beyond the femoral cortex, and transverse impaction of the button in the region of corticocancellous bone-bridge. Furthermore, complete loop discontinuity or breakage can also possibly occur during cycling, when appropriate precautionary measures are not taken during graft preparation and passage. In this article, we present various techniques to prevent and a bailout from potential complications that occur with the use of TightRope Reverse Tension with extensive first-hand experience in using this implant.