Clinical Applications

EasyWhipTM is intended to be used for whip stitching in orthopedic reconstruction procedures. Whip stitching serves to reinforce a graft that will replace a torn ligament or tendon. These injuries can happen in many areas in the body.

Surgical Applications of EasyWhipTM

The Procedure

To repair a ligament injury, patients must undergo reconstruction surgery. The three main steps of reconstruction surgery are shown above.

  • First, a surgeon isolates a ligament from another part of the body that serves as a graft.
  • The surgeon then prepares the graft by using a needle and heavy duty suture to reinforce both ends with a pattern called a whip stitch. Stitching of the ligament is the backbone of successful reconstruction surgeries because the stitches help tension the graft and give it strength. While most of the surgery is done arthroscopically inside the knee joint, this preparation step is done outside the body.
  • After reinforcing the graft with whip stitches, the surgeon implants it back into the joint to replace the the torn ligament.

Statistics

  • In total, 250 000 ACL injuries are estimated to occur annually in the United States1
  • Approximately 70% of ACL injuries are non-contact injuries 2
  • The weakest component of ACL reconstruction is the method of fixation 3
  • Suturing the graft construct increases its failure load4
  • Up to 30% of young active patients who undergo reconstruction suffer a second ACL injury in the first few years after surgery 1
  • Overall graft failure rate in revision ACL reconstructions ranged from 6.0% to 25.0%, with 5 studies demonstrating a failure rate of 6% to 10% and 3 studies having a failure rate of 19.0% to 25.0%.5
  • Errors in surgical technique account for the majority of primary ACL reconstruction failures 5
  • Research estimates that overall there are over 1,000,000 ligament and tendon orthopedic reconstruction surgeries performed in the United States annually.16

References:

1 Grindem, H., Snyder-Mackler, L., Moksnes, H., Engebretsen, L. & Risberg, M. A. Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study. Br J Sports Med 50, 804-808 (2016).2 Sutton, K. M. & Bullock, J. M. Anterior cruciate ligament rupture: Differences between males and females. Journal of the American Academy of Orthopaedic Surgeons 21, 41+ (2013).3 Shelton, W. R. & Fagan, B. C. Autografts commonly used in anterior cruciate ligament reconstruction. Journal of the American Academy of Orthopaedic Surgeons 19, 259+ (2011).4 Pailhé, R., Cavaignac, E., Murgier, J., Laffosse, J. M. & Swider, P. Biomechanical study of ACL reconstruction grafts. Journal of Orthopaedic Research 33, 1188-1196 (2015).5 Wilde, J., Bedi, A. & Altchek, D. W. Revision anterior cruciate ligament reconstruction. Sports health 6, 504-518 (2014).6 Schilaty, N. D. et al. Incidence of second anterior cruciate ligament tears and identification of associated risk factors from 2001 to 2010 using a geographic database. Orthopaedic Journal of Sports Medicine 5, 2325967117724196 (2017).7 Centeno, C. ACL Surgery Choices: A Tale of Two Grafts, <https://regenexx.com/blog/acl-surgery-choices-a-tale-of-two-grafts/> (2016).8 Laprade, R. F. & Wijdicks, C. A. The management of injuries to the medial side of the knee. journal of orthopaedic & sports physical therapy 42, 221-233 (2012).9 Colvin, A. C., Egorova, N., Harrison, A. K., Moskowitz, A. & Flatow, E. L. National trends in rotator cuff repair. The Journal of Bone and Joint Surgery. American volume. 94, 227 (2012).10 Hsu, D. & Chang, K.-V. in StatPearls [Internet] (StatPearls Publishing, 2018).11 Hodgins, J. L., Vitale, M., Arons, R. R. & Ahmad, C. S. Epidemiology of medial ulnar collateral ligament reconstruction: a 10-year study in New York State. The American journal of sports medicine 44, 729-734 (2016).12 Chebli, C. An update on distal biceps tendon ruptures. Current Orthopaedic Practice 26, 119-125 (2015).13 Pope, J. D. & Plexousakis, M. P. in StatPearls [Internet] (StatPearls Publishing, 2018).14 Egger, A. C. & Berkowitz, M. J. Achilles tendon injuries. Current reviews in musculoskeletal medicine 10, 72-80 (2017).15 Sanders, T. L. et al. Incidence and long-term follow-up of isolated posterior cruciate ligament tears. Knee Surgery, Sports Traumatology, Arthroscopy 25, 3017-3023 (2017).16 SmartTrak.com database