Clarification

Recently I was notified by Chris Powell, Product Manager Small Joint, Arthrex, Inc, Naples, FL, that we inaccurately referred to their product, namely the Ankle TightRope®, in connection with the term “Endobutton∗,” and that, in fact, the term “Endobutton∗” is trademarked by Smith & Nephew, Inc, London, UK (specifically, “Endobutton∗ CL BTB Fixation Device”). Mr Powell's concern was in reference to the following article: Cottom JM, Hyer CF, Philbin TM, Berlet GC. Transosseous fixation of the distal tibiofibular syndesmosis: comparison of an interosseous suture and endobutton versus traditional screw fixation in 50 cases. J Foot Ankle Surg 48(6):620–630, 2009. In that publication, the authors said: “To this end, traditional AO (Arbeitsgemeinschaft für Osteosynthesefragen, AO Foundation, Davos, Switzerland) screw fixation was compared with an endobutton and transosseous suture (Ankle TightRope®, Arthrex, Inc, Naples, FL), and radiographic and subjective and objective patient outcomes were compared between the treatment groups.” Because we make every effort to be as accurate as possible, and to avoid using proprietary terminology without the use of appropriate capitalization and trademark symbols, and noting the trademark owner's company name and address (city and state), I would like to make clear that the term “endobutton” was used in a generic sense to indicate a fixation device, much like a button, that is affixed to a suture, and this was not done in reference to Smith & Nephew's proprietary device. Moreover, we did not want to imply that Smith & Nephew's proprietary device, namely the EndoButton∗, was in any way a component of the Arthrex TightRope®. Along with taking steps to distinguish between generic and proprietary terminology, we also strive to avoid excessive commercial influence in the reports that we publish, and for this reason we encourage our authors to use generic terminology as much as possible after first identifying the product using the proprietary terminology. It is also interesting to note that as technical language changes over time, specific terms often evolve to convey a more general meaning. The term “endobutton” has, in fact, been used many times in the surgical literature over the past decade as a proprietary term, and also as a generic term, much like it was used in the aforementioned article that we published. With this in mind, the use of “endobutton” as a generic reference to a specific component of a fixation device is commensurate with the term's current use in the biomedical literature. Just the same, we understand and appreciate the concern that Mr Powell has pointed out, and in the future we will strive to be even clearer about our use of the term “endobutton” and, in fact, avoid mentioning the term in conjunction with the Ankle TightRope® and Mini-TightRope® devices, which are trademarked by Arthrex, Inc.