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. 2012;5(4):236-8.
doi: 10.4066/AMJ.2012.1241. Epub 2012 Apr 30.

Hamstrings tendon graft preparation for anterior cruciate ligament reconstruction using the WhipKnot™ soft tissue cinch technique

Amin Masoumiganjgah  1 , Umesh Dhanjee, Tendai Mwaturura, Cameron Carmody
Affiliations

Hamstrings tendon graft preparation for anterior cruciate ligament reconstruction using the WhipKnot™ soft tissue cinch technique

Amin Masoumiganjgah et al. Australas Med J. 2012.

Abstract

Background: Appropriate graft tension and secure graft incorporation in bone tunnels are essential for successful anterior cruciate ligament (ACL) reconstruction using hamstrings tendon autografts. The WhipKnot™ soft tissue cinch, introduced by Smith and Nephew in 2004, is an alternative option to the commonly used whipstitch technique during preparation of the hamstring autograft in ACL reconstruction.

Aims: To investigate the effectiveness of the WhipKnot™ soft tissue cinch and technique during the preparation of the tendon graft for ACL reconstruction.

Method: A total of 33 ACL reconstruction operations performed between February 2011 and December 2011 were included in this study. These were performed by a single senior surgeon who used the Whipknot™ technique for the preparation of each graft. Four were used for each operation; two for each end of the harvested hamstrings tendons, including semitendinosus and gracilis tendons respectively.

Results: In total, 132 WhipKnots were used during the knee operations. Use of the WhipKnot™ technique resulted in successful graft preparations, tensioning and effective graft placement in the tibial and femoral tunnels in almost all instances. Only one case of WhipKnot™ failure (slippage) was recorded.

Conclusion: These results indicate that the Whipknot™ technique is a safe, reliable and practical option for the preparation of the hamstrings autografts.

Keywords: Anterior Cruciate Ligament; Whipknot™; graft preparation; reconstruction.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare that they have no competing interests

Figures

Figure 1:
Figure 1:. The Whipknot™ as supplied by Smith & Nephew. Four WhipKnots (two white, two blue) are shown prior to use during surgery. The left three are still in situ in the original packaging and the knot to the right has been moved on to the shaft of the clamp.
Figure 2:
Figure 2:. Previous cadaver studies show that the mean time required for use of the WhipKnot™ cinch (15 seconds) is statistically significantly smaller (p < 0.001) than the time to whip-stitch a comparable tendon end (1.5 minutes)[2].
Figure 3:
Figure 3:. One WhipKnot™ is applied at each end of the tendon.
Figure 4:
Figure 4:. WhipKnot™ is used to hold and tension graft inside tunnel.
Figure 5:
Figure 5:. Once the fixation is achieved, the ends of the WhipKnot™ and tendon are cut off and discarded.
See this image and copyright information in PMC

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