Bioabsorbable Device Pins ACL Graft to Bone

The GraftGrab device is designed to reduce joint laxity associated with graft slippage and to obviate the need for specialized instrumentation and site preparation for graft fixation. The device has two parts, a base section and an interconnecting cap, both composed of bioabsorbable polymer called poly-L-lactic acid. The base has a central hole with an attached hollow sleeve extending from the flat surface of the base into the bone tunnel. On the opposite surface are struts with notches for the cap hinge on one side and serrations that interdigitate with the cap serrations on the opposite side.

The hinge of the cap is snapped onto the struts and the graft is pulled through the hollow sleeve as it is pressed into the bone tunnel, so that the flat surface of the washer abuts bone. The graft is then tensioned, positioned across the base at 90° to the bone tunnel, and then secured by pressing the free end of the cap onto the base. The GraftGrab is a product of Tesa Medical (Worcester, MA, USA).

“Loss of initial graft tension continues to be a problem with soft tissue interference screws and can contribute to problems associated with joint instability,” said co-inventor Mandi Lopez, MD. “The bioabsorbable GraftGrab is positioned on the cortical surface of the tibial bone tunnel and has a simple mechanism for anchoring the graft immediately after tensioning that minimizes the likelihood of graft tension loss.”

The ACL is a broad, thick cord with long collagen strands woven together that originates on the anterior portion of the femur in the intercondylar notch and inserts on the posterior aspect of the tibial plateau. The ACL guides the tibia through a normal, stable range of motion, along the end of the femur, maintaining joint stability. The ligament unfortunately is poorly vascularized, and thus has no ability to heal after a complete tear, leading to further destruction of the articular and meniscal cartilage over time.

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