For the femoral fixation market, cortical fixation devices were most commonly used in 2010. These devices flip on the cortical surface and anchor the graft to the femoral tunnel, and thus do not rely on cancellous bone for fixation. Cross-pins were the second most popular femoral fixation devices in 2010 and work by retaining the graft ligament within the bone tunnel by securing it with a pin, extending transversely through the tunnel and the ligament. Interference screws were also used, but to a lesser degree, to fix soft tissue to femoral bone, however they were not as popular in the femur as in the tibia since the femur bone is denser than tibial bone. Intratunnel devices also existed for femoral fixation in 2010, however the number of these products available were more limited than for tibial fixation.
Cortical fixation devices were the most commonly used devices in 2010 and with their high ASP, took up the majority of the femoral fixation market. Although the intratunnel fixation market was the smallest segment in 2010, it experienced the fastest unit growth at 14.7% over 2009. Unlike the tibial intratunnel fixation devices which had several products available in 2010, there were only two femoral intratunnel fixation devices including the AperFix® II Femoral Fixation device by Cayenne Medical and the Femoral INTRAFIX™ Sheath & Screw System by DePuy Mitek. This segment will continue to experience the fastest growth and will comprise 11% of the femoral fixation market by 2017 as shown in Chart 5‑3.
Since the introduction of Smith & Nephew’s ENDOBUTTON® CL in 2004, other similar cortical fixation devices have emerged and led to increased growth in this market segment. Other such products include the ToggleLoc™ and EZLoc™ by Biomet and the RetroButton® by Arthrex. The increased innovation of these products drew many surgeons attention and adoption of these devices was quick.
Intratunnel devices also exist for femoral fixation, however the number of these products available are more limited than for tibial fixation. In 2010 the only two femoral intratunnel devices available were the Femoral INTRAFIX™ Sheath & Screw System by DePuy Mitek and the AperFix® II Femoral Fixation by Cayenne Medical. Femoral intratunnel fixation devices will continue to grow.