Citation, DOI and article data
Cortical buttons or suspensory cortical buttons are surgical implants used in conjunction with sutures for the repair of ligament and/or tendon injuries, including biceps tendon rupture, pectoralis major injury, acromioclavicular injuries, syndesmotic injuries and anterior cruciate ligament injury.
The buttons consist of a flat plate, usually with two or four holes where the suture is passed through, usually in a reciprocal fashion. The cortical button is deployed through a bone tunnel and tensioned at the opposite cortex of the bone to which the respective ligament or tendon is attached to 1-5.
Like other implants, they come in different configurations, designs, sizes and materials 3-5. They might be combined with other fixation devices like a tenodesis screw.
Cortical buttons are supposed to be fit tight against the opposite cortex of the structure they are supposed to attach.
Cortical buttons are radiodense; they should be seated flat, snug fit to the cortex. Their position should be confirmed fluoroscopically after placement.
On MRI, they usually have a metallic appearance with a signal void in all sequences 6.
The radiological report should mention the following:
- position of the cortical button
- the integrity of the repair
- the bone tunnel
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- 2. Sutton K, Dodds S, Ahmad C, Sethi P. Surgical Treatment of Distal Biceps Rupture. J Am Acad Orthop Surg. 2010;18(3):139-48. doi:10.5435/00124635-201003000-00003
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- 5. Shafiq B & Thamyongkit S. Bimalleolar Ankle Fracture With Syndesmotic Sprain: ORIF and Suture-Endobutton Repair. J Orthop Trauma. 2019;33 Suppl 1(4):S36-S37. doi:10.1097/BOT.0000000000001538
- 6. Bouguennec N, Colombet P, Graveleau N, Jambou S. The Migratory Cortical Button: A Rare Case of Hypersensitivity to Titanium After an Anterior Cruciate Ligament Reconstruction. Knee Surg Relat Res. 2019;31(2):132-136. doi:10.5792/ksrr.18.072