CrossFix® II

All-Suture, All-Inside Meniscal Repair System

 Surgical Technique

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All-Inside Repair with Inside-Out Results 

The CrossFix II Meniscal Repair System is a suture only device that creates an instantaneous mattress stitch for a fast, strong, and reliable all-inside meniscal repair.

Step 1 

Access the location of the meniscal tear and determine the repairability. If the tear is repairable, determine appropriate portal placement for instrumentation. Using the Probe in the CrossFix II Disposable Kit, measure the tear (Figure 1). 

Note: The tip of the Probe can be bent to the desired angle by using hemostats or other instrumentation.

Step 2 

Set the depth limiter to the desired distance by pulling the black lever on the handle of the CrossFix II device backwards (Figure 2). 

Note: This is done outside of the knee joint.

Step 3 

Insert the Introducer (from the Disposable Kit) through the portal first, and then slide the exposed CrossFix II needles along the Introducer into the joint space (Figure 3). 

Note: This helps the CrossFix II pass through the tissue and into the joint space without torquing the needles

Step 4 

Once the needles are in the joint space, remove the Introducer from the knee (Figure 4)

Step 5 

Insert the needles into meniscus capturing the tear. The needles will be in position when the depth limiter pushes against the meniscal surface, limiting advancement (Figure 5). 

OR Tip: To avoid needle torque, let go of the CrossFix II device after insertion through the meniscal tissue to allow the needles to re-align. 

OR Tip: Lightly mallet CrossFix II into the knee space to ensure needles enter evenly.

Step 6 

With the needles in position, squeeze the device trigger, deploying the needle and passing the suture. The trigger can be released after hearing an audible click (Figure 6 and 7). 

Note: A 20º oblique stitch is biomechanically equivalent to a vertical stitch

Step 7 

Remove the needles from the knee and gently pull the device out of the joint allowing the pre-tied sliding knot to advance into position (Figure 8). 

Note: You will feel tension as the knot slides off the needles.

Step 8 

The locking curly (black) end will fall off the needle as the device is slowly removed from the knee space. Cut the post (white) end off the needle tip (Figure 9). 

Note: Be careful not to cut or prematurely pull the black end of the suture as this results in permanently locking the knot.

Step 9

Pull the post (white) end of the suture to advance the sliding knot to reduce the meniscal tear (Figure 10).

Optional 

If not satisfied with the reduction of the meniscal tear, thread the post (white) end of the suture through the CrossFix II Knot Pusher/Suture Cutter and apply tension to the post end (Figure 11). 

Note: Suture can be threaded through the Knot Pusher/Suture Cutter with packaged snare or by hand (Figure 12).

Step 10 

With the knot in position, lock the knot by pulling on the curly black end of the suture. Half hitches can be added as needed (Figure 13)

Step 11 

Thread both ends of the suture through the CrossFix II Knot Pusher/Suture Cutter. Rest the tip of the Knot Pusher/Suture Cutter on the knot to allow for a 2-3 mm tail (Figure 14)

Step 12 

Cut the suture by pulling the black trigger backwards (Figure 15).

Step 13 

Assess the fixation and repeat as needed (Figure 16).

Ordering Information
CrossFix II Meniscal Repair System (Sterile)

INDICATIONS FOR USE 

The CrossFix II Meniscal Repair Device is intended for approximation of soft tissue in meniscal repair procedures.