The value of osteotomy is in the knee with localised osteoarthritis, and a corresponding malalignment that is either causative of. An intramedullary approach results in decreased blood loss compared to plate fixation. Sep 17, 2015 traumatic ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. Whipstitchpost tibial fixation for anterior cruciate. A complication of soft tissue graft tibial fixation with the intrafix device. Transtibial surgical technique for placement of the femoral tunnel in the i. Tibial fractures after tibial tubercle osteotomies for patellar instability. Surgical technique phoenixtm tibial nail system featuring corelocktm technology each nail features corelocktm technology, a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up. Improvements in surgical technique of valgus high tibial. Femoral intrafix, first introduced in 2009, is a polyethylene sheath and polyether ether ketone peek interference screw anchor based on the design of tibial intrafix fig. Abstract essentially, only three methods are currently used for gripping anterior cruciate ligament acl grafts so that they may be fixated to bone. Soft tissue repair for tibialis anterior tendon ruptures. Femoral intrafix, with its unique patented polypropylene.
Phoenix tibial nail system featuring corelocktm technology. The graftbolt comes in biocomposite and peek and consists of a sheath and mating screw, which are fully cannulated. Hamstring anterior cruciate ligament reconstruction with intrafix. Dec 12, 2015 statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Vishwanath c department of orthopaedics, adichunchangiri institute of medical sciences, b g nagar, mandya, karnataka, india surgical outcome of tibial plateau fracture using minimally invasive technique with locking compression plate. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Traumatic ruptures of the tibialis anterior tendon are rare but can cause substantial functional deficiencies. Incision placement for intramedullary tibial nailing. The tunneloc tibial fixation device, manufactured by biomet sports medicine, is a. The instruments and implants in the expert tibial nail permit a more percutaneous technique and less tissue stripping than other treatment methods. Early, active mobilization the expert tibial nail provides secure fixation which permits.
Tibial resection depth tibial island alignment tibial posterior slope tibial resection tibial vertical resection patella preparation femoral preparation. The proximal lateral tibial plate is designed with divergent. In an independent biomechanical study comparing commonly used hamstring tendon graft tibial fixation devices, kousa et al20. Depuy synthes mitek sports medicine anteromedial acl reconstruction bonetendonbone. The value of osteotomy is in the knee with localised osteoarthritis, and a corresponding malalignment that is either causative of or contributory to the arthritis.
Knee joint replacement components include femoral, tibial, and patellar components. Sync tibial fixation device into the tibial tunnel. Bone tendonbone grafts surgical technique depuy synthes mitek sports medicine. Produced for depuy mitek, this brochure depicts the surgical steps for the proper installation. This article outlines the surgical technique for an amp acl reconstruction with a tibialis anterior allograft fixed with the mitek femoral and tibial intrafix sheath. Identification of acl foot print on tibial articular surface.
The intrafix tibial fastener was designed with two. Three innovative locking options, in combination with cancellous bone locking screws, increase the stability of the proximal fragment for proximal third fractures two state of the art mediolateral ml. Mitek sports medicine expands anatomic acl reconstruction portfolio. This content is intended for health care professionals in the united states.
Tibial tunnel widening after anterior cruciate ligament. Transtibial surgical technique for placement of the femoral. The intrafix advance tibial fastener system provides rigid. Over 250,000 doctors use vumedi to improve patient care and grow their practice. Specialty components are available including femoral stems, femoral screws, femoral augments, tibial stems, tibial screws, tibial augments, tibial. Depuy synthes intrafix advance tibial fastener system surgical technique. Anatomic acl reconstruction using a single tunnel through an. This article outlines the surgical technique for an anteromedial portal acl reconstruction with a tibialis anterior allograft fixed with the mitek femoral and tibial intrafix sheath and screw system depuy synthes, raynham, ma. Allpoly tibial option 31 balancing the soft tissue 34 ultracongruent and traditional posterior stabilized component indications 35 zimmer naturalknee ii mis surgical technique developed in conjunction with aaron a.
Components are available in a variety of designs and size ranges intended for both primary and revision applications. This publication is not intended for distribution in the usa. Wsp was one of the first devised methods of graft fixation, but with the increase in popularity of bonepatellar tendonbone bptb grafts and interference screws in the. Art books entertainment film and motion picture magazines music. Strict adherence to the surgical technique is recommended and several hints on how to avoid complications with. Discover the procedures and products required for arthroscopic anterior cruciate ligament acl reconstruction. The superior clinical and biomechanical performance of the washerloc and bone dowel during aggressive rehabilitation and testing in the laboratory has been extensively documented since the technique was introduced in 1997. It provides aperture fixation, is stronger and more rigid than interference screw fixation alone, and prevents graft windup by the interference screw during. Surgical technique phoenixtm tibial nail system featuring corelocktm technology each nail features corelocktm technology, a preassembled, embedded locking mechanism for locking all proximal oblique screws, which can also be used to internally mechanically compress up to 5mm for a variety of tibial fractures. Several studies have indicated that a transpatellar approach may contribute to anterior.
The new femoral intrafix acl fixation system from depuy mitek, inc. Biomet is not responsible for selection of the appropriate surgical technique to be utilized for an individual patient. Surgical technique instruments and implants approved by the ao foundation. Tibial crest osteotomy in extensile knee exposurea. Comparison of open wedge high tibial osteotomy versus. We present four technical modifications of high tibial osteotomy which improve its safety and reproducibility. Otherwise, the surgical technique and decisionmaking process into the use of the tibial tubercle osteotomies did not change and remain unchanged up to the present. The surgeon who performs any implant procedure is responsible for determining and utilizing the appropriate technique for such procedure for each individual patient. The tension slide technique allows the surgeon to maximally tension the torn tendon into the prepared bone tunnel prior to inserting the appropriate sized biocomposite tenodesis.
Ensure that the tibial tunnel is a minimum of 40 mm long. Numerous reduction techiques are available to achieve an anatomic. Videos surgical technique anterior tibialis tendon repair using cortical button and tenodesis screw. Dec 12, 2010 the only aspects of this technique that were changed during the study period were the caudal end of the osteotomy and the screw sites. Zelle1 and guilherme boni2 abstract statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Objectives for intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Conclusions the new surgical technique preserving the tibial insertions of the stg. Intrafix advance tibial fastener system is a tibial. Meniscus and acl surgery are two of the most common knee procedures performed worldwide. This study aimed to evaluate the feasibility of a surgery for soft tissue repair of traumatic rupture of the tibialis anterior tendon by using a plate and screw fixation repair in combination with the free anterolateral thigh flaps transplantation. Position using the anatomy specific tibial guide, ezloc fixation, and washerloc tibial fixation. Compression of the lateral hinge features and benefits higher stability four locking screws in the plate head long shaft portion evenly transmits the occurring forces into the tibial shaft. For any surgical technique to be repeated, successfully in multiple hands, it must have welldefined steps that allow reproducibility during surgery and predictable outcomes postoperatively.
The intrafix advance tibial fastener system is an implant system used for fixation of. After opening the area by the usual technique, the front surface of the femur is freed up by. Ream over the guide pin with a cannulated reamer that corresponds to the graft size. Anatomic acl reconstruction using a single tunnel through. Uniflex femoral nail surgical technique zimmer biomet. Dynafix vs osteotomy and dfs angular hinge clamp system.
Femoral and tibial fixation of the allograft is achieved with mitek intrafix instrumentation. A complication of soft tissue graft tibial fixation with the. Pdf preserved insertions of the semitendinosus and gracilis. Implant had presented as a lump on patients left am portal site from a previous hamstring acl. Instruments simple technique, easy instrumentation with minimal components.
Tibial tunnel widening after anterior cruciate ligament reconstructions with hamstring tendons using rigidfix femoral fixation and intrafix tibial fixation. Trigen metanail tibial nail specifications distal end of nail all knee and distal tibial top view of nail nondriving end of nail ap view ml view set does not include all sizes. Depuy synthes intrafix advance tibial fastener system surgical technique femoral and tibial tunnel drilling femoral tunnel drilling drill the femoral tunnel per the surgeons preferred technique figure 3. All of the ttos were performed under direct vision. Depuy mitek will continue to track any related complaints within this device family as a means of monitoring the extent with which this complaint is observed in the field. Stanford childrens health lucile packard childrens hospital stanford 16,274 views. Intrafix advance tibial fastener system is a tibial fixation device designed to maximize the strength and stiffness of an acl reconstruction using soft tissue grafts. A complication of soft tissue graft tibial fixation with. Zimmer instrumentation surgical technique for trabecular metal tibial cones zimmer instrumentation surgical technique for trabecular metal tibial cones medium tibial cone tibial tray stem drill guide 005452021 fit the medium cone tibial tray drill guide onto the medium tibial cone sizing template and use the tibial stem drill from. The graft was then pulled through and it was secured in the femoral tunnel with bioabsorbable femoral st cross pin depuy, mitek, fig. Anterior tibialis tendon repair using cortical button and. Tibial fractures after tibial tubercle osteotomies for. The graftbolt instrument set includes dilators and sheath insertion and removal tools, as well as the hexalobe driver for insertion of the screw. Polyetheretherketone an overview sciencedirect topics.
These views are not to scale and should be used as a pictorial representation only. The tension slide technique allows the surgeon to maximally tension. We are a liquidator of sutures and other surgical items from ethicon, covidien autosuture, synthes, stryker, arthrex and are able to pass our savings on to you. Spectra family of coils surgical stapling trumatch cmf wound closure. Among these factors, the tttg distance and patellar height are most amenable to surgical correction, through the performance of a tibial tubercle osteotomy tto. Rigidfix jig collar johnson and johnson, mitek, mumbai. Jan 11, 2003 we present four technical modifications of high tibial osteotomy which improve its safety and reproducibility.
Since 2006, our depuy synthes companies international organization has supported open arms malawi, providing housing, food and funds to the children of malawi impacted and orphaned by hivaids. Tibial plateau fractures have been studied and reported extensively and exhaustively but still 1. Surgical technique with assistance of a tibial guide, drill a guide pin through the tibia to exit in the center of the native acl footprint on the tibial plateau. Moinfar presents a soft tissue acl reconstruction highlighting tibial fixation with intrafix advance tibial fastener system. Prnewswire depuy synthes mitek sports medicine has. Recently, suprapatellar nailing in the semiextended position has been suggested as a safe and effective surgical technique. Proximal tibial osteotomies are an important component of the surgical treatment options in the management of knee osteoarthritis. Establishing an appropriate starting point is a crucial part of the surgical procedure. Tibial crest osteotomy in extensile knee exposurea modified.
Harris, md, pasadena, ca highlights his technique for acute anterior tibialis tendon ruptures using a cortical button and the tenodesis screw system. Technique for primary anterior cruciate ligament reconstruction with a tibialis anterior allograft, performed through the anteromedial portal, in a right knee. Intrafix advance tibial fastener system is a tibial fixation device designed to maximize. Position using the anatomy specific tibial guide, ezloc fixation, and washerloc tibial fixation rationale and. A precise overview on indications, patients selection, preoperative planning, surgical technique, methods of fixation, and complications have been presented. In our surgical technique, a tibial tunnel length of 35. Statically locked, reamed intramedullary nailing remains the standard treatment for displaced tibial shaft fractures. Anteromedial portal anterior cruciate ligament reconstruction with. The femoral tunnel can be prepared before or after the tibial tunnel based on surgeon preference.
Mitek sports medicine introduces comprehensive knee arthroscopy. The key steps in the tco are length, vascularity, and repair. Acl reconstruction tibial fixation with intrafix vumedi. Bio intrafix surgical technique guide vumedi the knee joint was accessed through two to three standard portals anteromedial and anterolateral. Tibial tunnel drilling per standard technique, use a beath pin and a tibial aiming guide to create an anatomic tibial tunnel. The graftbolt is designed for tibial fixation of a soft tissue graft in cruciate ligament reconstruction procedures. Depuy, 254629, depuy mitek biointrafix tibial sheath. Depuy synthes companies personnel will often travel with the mission volunteers to support their work as well. Tibial tubercle osteotomy in association with mpfl. Place the fixation device on the inserter, ensuring that the cortical tab of the device is. Washerloc and bone dowel tibial fixation of a softtissue. Transtibial surgical technique for placement of the. Home depuy mitek intrafix tibial sheath 30mm each depuy mitek intrafix tibial sheath 30mm each email to a. Intrafix advance tibial fastener system legacy of strength in tibial fixation the intrafix advance tibial fastener system is an implant system used for fixation of tissue including ligament, or tendon to bone during cruciate ligament reconstruction.