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. 2015 Mar 6;473(8):2599–2608. doi: 10.1007/s11999-015-4226-9

Fig. 1A–E.

Fig. 1A–E

(A) ACL injury was simulated by cutting the ACL in the midsubstance. (B) Femoral and tibial tunnels (dashed lines) were drilled and an EndoButton pulled through the femoral tunnel and engaged on the proximal femoral cortex. The EndoButton was loaded with three sutures, resulting in six free ends. (C) A Kessler suture was placed in the tibial ACL stump, and the MIACH scaffold was threaded onto four of the strands, which served as the suture stent (red). (D) The four suture strands running through the scaffold (red) were then passed through the tibial tunnel. (E) The transtibial sutures (red) were tightened and tied over an extracortical button. The scaffold was then saturated with 5 mL of autologous blood and placed into the notch. The free ends of the ACL suture pulley (green) were tied to secure the ACL stump in the blood-scaffold composite. Adapted and modified from Vavken P, Fleming BC, Mastrangelo AN, Machan JT, Murray MM. Biomechanical outcomes after bioenhanced anterior cruciate ligament repair and anterior cruciate ligament reconstruction are equal in a porcine model. Arthroscopy. 2012;28:672–680, with permission from Elsevier.