Tetrous Reports New Clinical Applications of EnFix for Enthesis Repair

Tetrous, a company specializing in biologic solutions for bone-to-tendon healing, revealed expanded clinical use of its EnFix implants across anatomical enthesis beyond rotator cuff repair.

The new applications include proximal/distal biceps tenodesis, insertional Achilles tendinopathy, gluteus medius and proximal hamstring reattachment, lateral epicondyle repair, and subscapularis repair during total shoulder arthroplasty.

The expanded indications were driven by high failure rates in bone-to-tendon repair and increasing recognition of the enthesis as a critical biomechanical interface, according to the company. They’re anticipated to increase the tech’s total addressable market to almost $2 billion in the U.S.

EnFix TAC and EnFix RC are currently in clinical use in the U.S., Australia, and New Zealand, with global expansion underway.

EnFix implants are made of 100% demineralized bone fiber (DBF), which offers osteoinductive and osteoconductive properties to initiate endochondral ossification—replicating the enthesis’ emryologic development. Preclinical data demonstrates Sharpey-like fiber formation and enhanced biomechanical strength at the bone-to-tendon interface, reinforcing the implant’s role in biologic enthesis reconstruction.

The company was issued a fourth U.S. patent for the EnFix family of demineralized cortical bone fiber implants and its manufacturing method in October.

Enthesis injuries where surgeons have adopted EnFix

• Dr. Peter Howard applied EnFix TAC in biceps tenodesis, gluteal reattachment, muscle transfers, proximal hamstring repair, and repair of the lateral epicondyle, citing arthroscopic ease-of-use and regenerative support.
• Dr. Gerald Yeo reported using EnFix primarily in revision cases or in patients with particular comorbidities and has since expanded its use to most patients undergoing surgical treatment for insertional Achilles tendinopathy. He notes no issues with implantation or surgical technique, stating the implants fit well in bone and that the 4.5 mm anchors he utilizes fit within the EnFix RC.
• Dr. George Kartalian used EnFix TAC to biologically reinforce insertional Achilles reattachment and anticipates broader utility in ankle ligament repairs and flatfoot procedures.
• Dr. Lonnie Davis emphasized the importance of biologic healing in preventing tendon failure and views EnFix as a tool to accelerate recovery.