Indications for a proximal tibial anterolateral osteotomy include symptomatic genu recurvatum with genu valgus alignment, usually in patients with a flat sagittalplane tibial slope. This angular sta bility allows the stable fixation of an openwedge osteotomy and hence its rapid osseous healing. A 15mm medial opening gap was stabilized in each of eight medium composite tibial bones either with the modified arthrex osteotomy plate puddu plate or the. 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 a lag screw pulls the distal osteotomy segment towards the plate. The contourlock hto plate is a great choice for high demand patients needing a stronger locking construct for weightbearing. The plate is available in two lengths and features polyaxial bushings with locking screws. Arthrex distal extremity plate system summnary to the predicate devices, in which the basic features and intended uses are the same. Preliminary programme th icrs surgical skills course. Realignment osteotomy, such as distal femoral varus osteotomy dfo, is an established alternative to arthroplasty for the treatment of degenerative or traumatic valgus arthritis of the knee joint 1. The tomofix medial high tibial plate is suitable for both open.
All the patients were followed up between 6 months and 28 months and the mean followup is 18. The forked wedge tool is then removed and autologous bone is packed into the defect. Arthrex distal extremity plate system, may 2, 2011 arttwrew 510k. The osteotomy was fixed with a nonlocking plate in 30 cases puddu plate, arthrex, karslfeld, germany, fig. As several new tibial osteotomy plates recently appeared on the. Any differences between the distal extremiy plates stemi and the predicates are. The fixedangle locking holes provide multiple fixedangle constructs throughout the plate, improving retention of screws in the plate and in cortical bone. The contourlock hto plate system is indicated for use as a fixation device during opening and closing wedge osteotomies of the proximal tibia. Pdf high tibial osteotomy with puddu plate for the. Although the studies using the puddu plate arthrex, naples, fl, usa 6, 18 did not demonstrate inferior results compared to the studies using the blade plate synthes, oberdorf, switzerland or the locking tomofix plate synthes, it has been recommended to use these devices with greater axial and torsional stability 30. However, it has to be mentioned that saithna et al. Opening wedge distal femoral varus osteotomy using the puddu.
Openwedge high tibial osteotomy was performed medially approximately 4 cm below the joint line, with gradual opening of the osteotomy to preserve a bony bridge laterally. Any osteochondral defects are penetrated using arthrex chondro picks available from arthrex, inc. A comprehensive plating system for stable fixation of. Based upon these results, we believe that a distal femoral varisation osteotomy using the puddu plate and injectable bone cement is an equivalent treatment option compared to closing wedge techniques and leading to good results at midterm followup in patients with lateral gonarthrosis and valgus alignment. These plates are available in wedgeless, straight, and sloped options. High tibial osteotomy with puddu plate for the treatment of varus gonarthrosis article pdf available in knee surgery sports traumatology arthroscopy. The biplanar approach is able to simultaneously address both components of a. The biplanar approach is able to simultaneously address. Research article open access proximal tibia medial open. Puddu plate and calcium phosphate bone cement knee surg sports traumatol arthrosc 21.
In 2003, the anthony plate was developed by france bloc s. Lateral distal femoral opening wedge osteotomy using the. Open wedge high tibial osteotomy clinical biomechanics. Femur plate, and tomofix medial distal femur plate. Longterm results and comparison of the three different high. Whether used in primary or revision cases, this system enables surgeons to reduce, compress, and lock the 1st metatarsal phalangeal joint in the ideal position for arthrodesis. This study assessed 65 knees of 60 patients with varus gonarthrosis who underwent high tibial osteotomies. At the startof the 1990s, with the presentation of the puddu plate, the open wedge technique gained prominence in valgus osteotomy, as it provided a stable. This next generation titanium plating system consists of three distinct plate variations, including a straight wedge, ap sloped wedge and a flat plate with no wedge, that are compatible with the current titanium cortical and cancellous hto plate screws.
Once the plate is positioned and the bone graft is inserted, fixation is obtained by inserting a cancellous screw in the proximal hole and a cortical screw in the distal hole. The humeral sutureplate is an anatomically designed polyaxial locking plate and screw system designed for the treatment of proximal humeral fractures. May 12, 1998 the plate is then secured to the bone with bone screws, using standard ao technique. The utilization of the arthrex family of unique plates, in conjunction with an opening wedge osteotomy, provides the surgeon with a safe, reliable and. Novel unidirectional porous hydroxyapatite used as a bone. Bone plate system for proximal tibial osteotomy arthrex. These plates are fixated to bone using arthrex titanium locking 6. The distal femoral osteotomy system utilizes the same principles of design featured in the tibial osteotomy system.
A retrospective analysis of a consecutive series of 45 patients with 49 medial opening hto for varus gonarthrosis using a spacer plate puddu i, arthrex, usa. Longterm results and comparison of the three different. Lateral compartment osteoarthritis in a young patient represents a challenge for the orthopedic surgeon. Biomechanical properties of five different currently used implants for. Coronal and sagittal slope of the tibial plateau were manipulated with a rectangular 9 mm wedge plate puddu plate, arthrex. Each screw can be angled to the proper anatomic orientation within a swiveling bushing before being. As the result of an improved locking bushing system, each of the screws lock tightly into the plate bushings without having to use the locking guide for titanium. Opening wedge osteotomy using puddu plate was performed in thirteen knees of twelve patients with minimum age of 35 and maximum age of 54 and the average age is 41. The patients were allowed to walk via two crutches without full weight bearing for 6 weeks. Opening wedge osteotomy system using peekpower hto plate 2nd generation keywords. Biomechanical investigation of the modified arthrex osteotomy plate puddu plate and the tomofix plate. Biomechanical properties of five different currently used.
The arthrex humeral sutureplate is an anatomically designed, low profile, titanium locking plate and screw system. In particular, local irritation was reported as a major complaint after hto using the plate 17, 18. Osteotomy for medial compartment arthritis of the knee. The titanium tibial opening wedge osteotomy plates feature a 4 hole design and are available with either a straight or sloped tooth to change or preserve the native tibial slope. Tibial opening wedge osteotomy plate, 5 mm ar200t05. Our cohort was also focused on patients treated by lowdfo without bone grafting. In the 6th icrs surgical skills course internationally acknowledged surgeons and experts in the field of cartilage repair will provide you the newest information, tips and. The openingwedge high tibial osteotomy technique was performed as described previously by franco et al 12 using the puddu plate. Design optimization of high tibial osteotomy plates using.
After fracture of the lateral cortex the axial stiffness was reduced by. The arthrex acp autologous conditioned plasma system allows for rapid and efficient concentration of platelets and growth factors from autologous blood, for use at the treatment site the unique doublesyringe design allows for convenient and safe handling, as the whole preparation process takes place in a closed system. Pars percutaneous achilles repair system achilles jig system arthrex 1 2 3 4 use. Pdf stability of medial opening wedge high tibial osteotomy. Drill guide for peekpower hto plate locking screws ar40dg depth gauge for peekpower hto plate ar40g drill, o 3. Opening wedge high tibial osteotomy using a puddu plate. Arthrex acp double syringe mechanism of acp using the described method with the arthrex acp double syringe to prepare blood, the plasma contains an increased plateled concentration of about 2 to 3 times. The simplistic design facilitates minimally invasive surgery and is optimal for lower demand patients. Proximal tibial anterolateral openingwedge osteotomies have been reported to achieve successful biplanar lowerextremity realignment. Osteotomy for medial compartment arthritis of the knee using. Tibial opening wedge osteotomy plates knee arthrex.
Since then, new plates have been developed for medial. Biomechanical investigation of the modified arthrex osteotomy plate puddu plate and the tomofix plate to determine the biomechanical properties. Peekpower implants, whereas we did not include the puddu plate. Sep 04, 2017 arthrex peekpower hto plate september 4, 2017 the first multidirectional angle stable hto plate made of carbon reinforced peek provides outstanding biomechanical properties, excellent biocompatibility and an anatomically adopted design. The titanium femoral opening wedge osteotomy plates provide a straight toothed option to aid in maintaining the osteotomy correction.
This procedure aims to reduce pain, slow the rate of progression of. The effect of closed and openwedge high tibial osteotomy. Opening wedge osteotomy system using peekpower hto. Research article open access proximal tibia medial open wedge. These plates are optimal for unique anatomy where customizing fit with multiple bends may be required. Anterolateral biplanar proximal tibial openingwedge. Pars percutaneous achilles repair system achilles jig. A trapezoidal wedge locking puddu plate arthrex inc is then fixed with 4mm locking figure 3. Distal femoral varus osteotomy for valgus arthritis of the. A 10cm incision was made over the anteromedial aspect of the proximal tibia, midway between the tibial tubercle and the posterior border of the medial tibia. Specifically designed femoral osteotomy plates take into account the anatomical differences between the distal femur and proximal tibia. Femoral opening wedge osteotomy plate arthrex contourlock hto plate arthrex puddu plate arthrex 12.
Apr 11, 2006 therefore, we believe that high tibial osteotomy with a puddu plate is a valuable alternative to total knee arthroplasty in cases with varus gonarthrosis. Short spacer plates such as the puddu plate arthrex inc. These low profile plates with polyaxial bushings provide freedom to direct the locking screws within the anatomical template, based on the fracture pattern and bone quality for better fixation. Traditional opening wedge hto performed with metal plates has several limitations, including hardware irritation, obscuration of detail on magnetic resonance imaging, and complexity of revision surgery. Arthrex peekpower hto plate orthopaedic product news. Opening wedge osteotomy system using peekpower hto plate 2nd generation author.
All of the plates in the tomofix osteotomy system are designed according to locking compression plate lcp system principles. A routine arthroscopy is performed and general joint debridement is carried out. This is done over several minutes to allow stress relaxation and prevent fracture migration to the lateral cortex or superiorly into the lateral tibial plateau. Subperiosteal dissection was carried out anteriorly under the. Contourlock high tibial opening wedge osteotomy system. Compression plate system lcp and enables angularstable connections between the screw and plate. These plates are fixated using arthrex titanium locking 6. Nov, 2018 however, it has to be mentioned that saithna et al. Biomechanical study of the fixation plates for opening. The plates are fixated using standard ao stainless steel 6. The titanium tibial opening wedge osteotomy plates feature a 4 hole design and are available with either a straight or sloped tooth to change or.
Biplanar open wedge high tibial osteotomy in the medial. Bone plate system for proximal tibial osteotomy arthrex, inc. All of the tibial opening wedge osteotomy plates were designed to work in conjunction with the standard opening wedge osteotomy instrument sets. The calibrated wedges are now removed to allow the osteotomy to close down on the plate and obtain boneto plate contact. High tibial osteotomy performed with allpeek implants.
Opening wedge osteotomy using contourlock hto plate system. In a biomechanical study, a long locking plate had a greater effect on primary stability than a short spacer plate 14. Patients were analysed for any complications and their. The tibial osteotomy then begins by placing the arthrex hto cutting guide on the.
High tibial osteotomy with puddu plate for the treatment of varus gonarthrosis article pdf available in knee surgery sports traumatology arthroscopy 1410. The effect of a proximal tibial medial opening wedge. To determine the biomechanical properties of different fixation methods for high tibial medial opening wedge osteotomy in order to determine. Although early results are satisfactory, longterm followup studies are required especially in the middle aged and elderly patient populations. The calibrated wedges are now removed to allow the osteotomy.
Lateral distal femoral opening wedge osteotomy using the peekpower. Arthrex peekpower hto plate september 4, 2017 the first multidirectional angle stable hto plate made of carbon reinforced peek provides outstanding biomechanical properties, excellent biocompatibility and an anatomically adopted design. In this study, the results of openwedge osteotomy with puddu plate for the treatment of varus gonarthrosis have been evaluated prospectively. Opening wedge osteotomy system using peekpower hto plate 2nd. Biomechanical study of the fixation plates for opening wedge. More than a plate, this is a complete system for joint preparation and fixation for the treatment of severe hallux rigidus and other mtp pathologies. The osteotomy was fixed with a puddu plate arthrex, naples, florida, and the osteotomy site was grafted with an autogenic or allogenic bone graft.
However, several studies have reported higher complication rates of nonunion, fixation failure, and correction loss, due to unstable fixation in medial opening hto using the puddu plate9,10. A, and it differed from the others used up until then in that it had a coupling system which. Both constructs failed under compression and torsion at the lateral cortex and occurred at higher maximal forces by using the tomofix plate. To request a price quote andor surgical evaluation of products, please add all products of interest to your cart by selecting the respective product checkboxes in the quote 1 andor surgical evaluation 2 column of the products view 3. Traditional opening wedge hto performed with metal plates has. High tibial osteotomy hto is a valuable treatment option in the highdemand patient with chondral damage and an altered mechanical axis. After the closure of the layers and the placement of a drain, the patients knee was placed into a hinged immobilizer. A 15mm medial opening gap was stabilized in each of eight medium composite tibial bones either with the modified arthrex osteotomy plate puddu plate or the tomofix plate.
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