Cortical buttons, suspensory cortical buttons or suture 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, tendon or suture is attached to 1-6.
Like other implants, they come in different configurations, designs, sizes and materials 3-6. They might be combined with other fixation devices like a tenodesis screw.
On this page:
Radiographic features
Cortical buttons are supposed to be fit tight against the opposite cortex of the structure they are supposed to attach.
Plain radiograph
Cortical buttons are radiodense; they should be seated flat, snug fit to the cortex. Their position should be confirmed fluoroscopically after placement.
MRI
On MRI, they usually have a metallic appearance with a signal void in all sequences 7.
Radiology report
The radiological report should mention the following:
- position of the cortical button
- the integrity of the repair
- the bone tunnel
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