Ankle Syndesmosis Repair System with Acu-Sinch® Knotless


The tibiofibular syndesmosis is disrupted in approximately 10–20% of ankle fracture cases and requires repair.1,3 For decades, screw fixation of the syndesmosis has been the gold standard for treatment.1 However, emerging clinical evidence has demonstrated that flexible, suture-based syndesmosis repairs have successful clinical outcomes and may reduce complications associated with malreduction of the syndesmosis when fixed with screws.2,3,4

Designed in conjunction with Alastair Younger, MB, Ch.B., M.Sc., Ch.M., FRCS(C); Selene Parekh, MD, MBA; and Steven Morgan, MD, the Acu-Sinch Knotless Implant enables the dynamic stabilization of laxity or syndesmotic disruptions to the tibiofibular joint.

The Acu-Sinch Knotless buttons may be augmented with a washer or may be used in conjunction with the Acumed and OsteoMed® fibula fracture fixation plates and intramedullary nails with 3.5mm nonlocking screw holes. Our patent pending release mechanism gives the user control to place the medial button subcutaneously without the need for direct visualization.

Related Documents

Key Features

  • Dynamic Stabilization

    Suture-based dynamic ankle syndesmosis stabilization.

  • Unique Inserter

    Unique inserter for implant deployment without a medial incision.

  • Integrated

    Integrates with Acumed and Osteomed fibula fracture fixation products.


Design Rationale of the Ankle Syndesmosis Repair System with Acu-Sinch Knotless Featuring Steven J. Morgan, MD
In this video, Dr. Steven J. Morgan discusses trends in surgical fixation options for syndesmosis injury, the reasoning behind the design of the device, and his perspectives on its effectiveness.
Repairing Syndesmotic Disruption with the Acumed Ankle Syndesmosis Repair System with Acu-Sinch Knotless Featuring Steven J. Morgan, MD
In this surgical lab, Dr. Morgan demonstrates both the percutaneous placement of the Acu-Sinch Knotless fixation device and repairing the syndesmosis and a fibula fracture with the use of the Acu-Sinch Knotless and an ankle plate.
Product Training Series: Ankle Syndesmosis Repair System with Acu-Sinch Knotless: System Overview Featuring Logan Hill
In this video, Product Manager Logan Hill gives an overview of the system components.
System Overview
With the addition of the Ankle Syndesmosis Repair System using the Acu-Sinch Knotless implant, Acumed can now offer a comprehensive solution for isolated syndesmotic disruption or tibiofibular ligament damage that may occur as part of a more complex ankle injury.
Surgical Technique Animation
In this surgical technique animation, we explore the system's features and benefits.


  1. Schepers T. Acute distal tibiofibular syndesmosis injury: a systematic review of suture-button versus syndesmotic screw repair. Int Orthop. 2012;36(6):1199-1206. doi:10.1007/s00264-012-1500-2
  2. Raeder B, Figved W, Madsen J, Frihagen F, Jacobsen S, Andersen M. Better outcome for suture button compared with single syndesmotic screw for syndesmosis injury: five-year results of a randomized controlled trial. Bone Joint J. 2020;102- B(2):212-219. doi:10.1302/0301-620X.102B2.BJJ-2019-0692.R2.
  3. Shimozono Y, Hurley E, Myerson C, Murawski C, Kennedy J. Suture Button Versus Syndesmotic Screw for Syndesmosis Injuries A Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2019 Sep;47(11):2764-2771. doi:10.1177/0363546518804804
  4. Laflamme M, Belzile E., Bédard L, van den Bekerom M, Glazebrook M, Pelet S. A prospective randomized multicenter trial comparing clinical outcomes of patients treated surgically with a static or dynamic implant for acute ankle syndesmosis rupture. J Orthop Trauma 2015; 29(5): 216-223.