TLS (Tape locking screw) system

ST4 short graft method – All inside

TLS is an ACL and PCL reconstruction system that uses a short graft.

Concept

Main principles of the TLS system:

Graft:
– only one tendon harvested
– short closed loop configuration (4 tendon strands, ST4)
– pre-tensioned
– introduced arthroscopically into knee (all inside)
– press fit in the bone sockets
– 360-degree bone contact 

Bone tunnels:
– independent tunnel positioning using outside-in targeting method
– small diameter (4.5 mm)
– manual retrograde reaming of bone sockets for the graft
– sockets match size of each end of the graft

Fixation:
suspension of ligament loop using anchoring tape
– TLS fixation screws placed in the tape using outside-in method

Indications

The TLS system is mainly indicated for:
– partial or complete ACL tears in adults
– PCL tears

Features

The TLS instrumentation consists of:
– a work table used to prepare and pretension the graft (0–300 N)
– a universal aiming device used for outside-in placement of guide wires in the tibia and femur for ACL and PCL reconstruction
– a set of winged drills used for retroreaming of the bone sockets (7 to 11 mm)

The TLS system consists of:
– a TLS screw (ø10 mm, length 20 or 25 mm) made of titanium, PEEK or biocomposite material

Publications

  1. Jenny, J.Y. and X. Clement, Patient-based decision for resuming activity after ACL reconstruction: a single-centre experience. Eur J Orthop Surg Traumatol, 2016. 26(8): p. 929-935.
  2. Lopes, R., et al., Does retrograde tibial tunnel drilling decrease subchondral bone lesions during ACL reconstruction? A prospective trial comparing retrograde to antegrade technique. The Knee, 2016. 23(1): p. 111-115.
  3. Marchand, J.B., et al., Do graft diameter or patient age influence the results of ACL reconstruction? Knee Surg Sports Traumatol Arthrosc, 2015.
  4. Lefevre, N., et al., Postoperative discomfort after outpatient anterior crucial ligament reconstruction: A prospective comparative study. Orthop Traumatol Surg Res, 2015.
  5. Cassard, X., et al., Anterior cruciate ligament reconstruction in children with a quadrupled semitendinosus graft: preliminary results with minimum 2 years of follow-up. J Pediatr Orthop, 2014. 34(1): p. 70-7.
  6. Lefevre, N., et al., Outpatient surgery feasibility in anterior cruciate ligament reconstruction: a prospective comparative assessment. Orthop Traumatol Surg Res, 2014. 100(5): p. 521-6
  7. Cazenave, M. and F. Deloge, Étude prospective sur la reprise d’activités physiques de 20 militaires après ligamentoplastie du genou par prélèvement au niveau de la patte d’oie. Kinésithérapie, la Revue, 2013. 13(137): p. 13-19.
  8. Mazana, C. and P. Junk. Etude de cohorte rétrospective sur la raideur postopératoire après ligamentoplastie du LCAE. 2012; KINEANNUAIRE:[Available from: http://www.kine-annuaire.fr/sante-et-actualites/etude-de-cohorte-retrospective-sur-la-raideur-postoperatoire-apres-ligamentoplastie-du-lcae.
  9. Colin, F., et al., Aseptic arthritis after ACL reconstruction by Tape Locking Screw (TLS(R)): report of two cases. Orthop Traumatol Surg Res, 2012. 98(3): p. 363-5.
  10. Cassard, X., et al., Comments on: “aseptic arthritis after ACL reconstruction by Tape Locking Screw (TLS): report of two cases” by F. Colin, F. Lintz, K. Bargoin, C. Guillard, G. Venet, A. Tesson, F. Gouin published in Orthop Traumatol Surg Res 2012;98(3):363-5. Orthop Traumatol Surg Res, 2012. 98(7): p. 854; author reply 855.
  11. Robert, H., R. Limozin, and T. de Polignac, Reconstruction mono-faisceau en quatre brins de semi tendinosus du ligament croisé antérieur selon la technique TLS. Résultats cliniques d’une série de 74 genoux à 18 mois de recul minimum. Revue de Chirurgie Orthopédique et Traumatologique, 2011. 97(4): p. S40-S45.
  12. Collette, M. and X. Cassard, The Tape Locking Screw technique (TLS): A new ACL reconstruction method using a short hamstring graft. Orthop Traumatol Surg Res, 2011. 97(5): p. 555-9.
  13. Alidrissi, N., et al., Ligamentoplastie du LCA aux ischiojambiers sous arthroscopie avec fixation de l’implant par le système TLS. Principes et résultats de 38 cas. Journal de Traumatologie du Sport, 2011. 28(3): p. 159-164.
  14. Besnard, N., M. Cazenave, and J. Hryszkiewicz, La TLS, une technique novatrice de ligamentoplastie de genou au service d’une rééducation ambitieuse. Kinésithérapie Scientifique, 2010(509): p. pp. 13-20.
  15. Piret, Q., Un nouveau concept de ligamentoplastie du genou : incidence sur la kinésithérapie. Kinésithérapie scientifique, 2008(488): p. 7.

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