Uploaded April 2026 | Updated September 2026, 2 weeks ago
This modern approach to ACL reconstruction offers strong fixation, improved control, and the benefits of a minimally invasive all-inside technique for optimal patient outcomes.
In this video, we demonstrate the advanced GraftLink® ACL reconstruction technique using the innovative TightRope® SB implant combined with the InternalBrace ACL technique.
The procedure begins with preparation of a quadrupled hamstring graft using the GraftLink® ACL reconstruction method. This technique utilizes a semitendinosus tendon graft that is carefully configured to maximize strength and graft thickness. The graft is equipped with the TightRope® SB implant on both ends, allowing for secure fixation in both the femoral and tibial tunnels.
One of the key innovations highlighted in this video is the soft button fixation ACL design of the TightRope® SB device. Unlike traditional metal buttons, this implant is composed entirely of suture-based materials, making it ideal for patients with metal sensitivity or for surgeons seeking metal-free fixation ACL solutions. Additionally, the implant allows for controlled flipping and even reversal if initial placement is not optimal—an important advantage in ensuring precise positioning.
The technique also incorporates the InternalBrace ACL technique, which provides additional reinforcement to the graft using suture tape augmentation. This added support enhances stability during the early healing phase and may contribute to improved long-term outcomes in knee ligament reconstruction.
During the procedure, surgeons carefully prepare the femoral and tibial tunnels before passing the graft into position. Using specialized passing and tensioning sutures, the graft is advanced into the femoral tunnel, where the TightRope® SB button is deployed and secured. The graft is then tensioned and passed into the tibial tunnel, ensuring proper positioning and alignment.
Another important aspect of this technique is the ability to fine-tune graft tension. Surgeons can independently re-tension both femoral and tibial fixation points, allowing for precise control of graft placement and stability. This level of adjustability is a major benefit of modern ACL reconstruction technique approaches.
Finally, the graft and InternalBrace are secured using an anchor system, completing the construct. The result is a strong, stable reconstruction that supports early rehabilitation while maintaining long-term durability.
This video is ideal for orthopedic surgeons, residents, and sports medicine specialists looking to refine their ALL-inside ACL reconstruction skills and better understand the advantages of soft tissue graft fixation systems.
👇 Helpful Arthrex Reference Links:
arthrex.com/resources/VID1-007961-en-US/anterolateral-ligament-reconstruction-using-hybrid-knee-fibertak-anchors?objectID=human.resource.en.35918432-e7bf-49b3-a979-f4234669d83d.3&queryID=61474eca5c0d0c846e4add4eee88efae&utm_source=youtube&utm_medium=video_description&utm_campaign=corp_knee&utm_content=oHlnXSmZsxI_surgical_technique
https://www.arthrex.com?utm_source=youtube&utm_medium=video_description&utm_campaign=corp_knee&utm_content=oHlnXSmZsxI_surgical_technique
👍 Like, comment, and subscribe to see more patient success stories and innovations in minimally invasive orthopedic procedures.
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.
Arthrex is a global leader in orthopedic surgical innovation, dedicated to advancing minimally invasive techniques and medical education. Our mission is to help surgeons treat their patients better by providing cutting-edge products, expert training, and comprehensive resources for orthopedic procedures, including sports medicine, joint preservation, and trauma care.
Stay Connected: 👍 Subscribe to our channel for the latest in orthopedic surgical techniques and product updates.
📱 Follow Arthrex on:
LinkedIn: / linkedin.com/company/arthrex
Facebook: / facebook.com/Arthrex
Instagram: / instagram.com/arthrexmeded
X: https://x.com/arthrex
This modern approach to ACL reconstruction offers strong fixation, improved control, and the benefits of a minimally invasive all-inside technique for optimal patient outcomes.
In this video, we demonstrate the advanced GraftLink® ACL reconstruction technique using the innovative TightRope® SB implant combined with the InternalBrace ACL technique.
The procedure begins with preparation of a quadrupled hamstring graft using the GraftLink® ACL reconstruction method. This technique utilizes a semitendinosus tendon graft that is carefully configured to maximize strength and graft thickness. The graft is equipped with the TightRope® SB implant on both ends, allowing for secure fixation in both the femoral and tibial tunnels.
One of the key innovations highlighted in this video is the soft button fixation ACL design of the TightRope® SB device. Unlike traditional metal buttons, this implant is composed entirely of suture-based materials, making it ideal for patients with metal sensitivity or for surgeons seeking metal-free fixation ACL solutions. Additionally, the implant allows for controlled flipping and even reversal if initial placement is not optimal—an important advantage in ensuring precise positioning.
The technique also incorporates the InternalBrace ACL technique, which provides additional reinforcement to the graft using suture tape augmentation. This added support enhances stability during the early healing phase and may contribute to improved long-term outcomes in knee ligament reconstruction.
During the procedure, surgeons carefully prepare the femoral and tibial tunnels before passing the graft into position. Using specialized passing and tensioning sutures, the graft is advanced into the femoral tunnel, where the TightRope® SB button is deployed and secured. The graft is then tensioned and passed into the tibial tunnel, ensuring proper positioning and alignment.
Another important aspect of this technique is the ability to fine-tune graft tension. Surgeons can independently re-tension both femoral and tibial fixation points, allowing for precise control of graft placement and stability. This level of adjustability is a major benefit of modern ACL reconstruction technique approaches.
Finally, the graft and InternalBrace are secured using an anchor system, completing the construct. The result is a strong, stable reconstruction that supports early rehabilitation while maintaining long-term durability.
This video is ideal for orthopedic surgeons, residents, and sports medicine specialists looking to refine their ALL-inside ACL reconstruction skills and better understand the advantages of soft tissue graft fixation systems.
👇 Helpful Arthrex Reference Links:
arthrex.com/resources/VID1-007961-en-US/anterolateral-ligament-reconstruction-using-hybrid-knee-fibertak-anchors?objectID=human.resource.en.35918432-e7bf-49b3-a979-f4234669d83d.3&queryID=61474eca5c0d0c846e4add4eee88efae&utm_source=youtube&utm_medium=video_description&utm_campaign=corp_knee&utm_content=oHlnXSmZsxI_surgical_technique
https://www.arthrex.com?utm_source=youtube&utm_medium=video_description&utm_campaign=corp_knee&utm_content=oHlnXSmZsxI_surgical_technique
👍 Like, comment, and subscribe to see more patient success stories and innovations in minimally invasive orthopedic procedures.
The InternalBrace surgical technique is intended only to augment the primary repair/reconstruction by expanding the area of tissue approximation during the healing period and is not intended as a replacement for the native ligament. The InternalBrace technique is for use during soft tissue-to-bone fixation procedures and is not cleared for bone-to-bone fixation.
Arthrex is a global leader in orthopedic surgical innovation, dedicated to advancing minimally invasive techniques and medical education. Our mission is to help surgeons treat their patients better by providing cutting-edge products, expert training, and comprehensive resources for orthopedic procedures, including sports medicine, joint preservation, and trauma care.
Stay Connected: 👍 Subscribe to our channel for the latest in orthopedic surgical techniques and product updates.
📱 Follow Arthrex on:
LinkedIn: / linkedin.com/company/arthrex
Facebook: / facebook.com/Arthrex
Instagram: / instagram.com/arthrexmeded
X: https://x.com/arthrex
