Pdf high tibial osteotomy with puddu plate for the. In 2003, the anthony plate was developed by france bloc s. Indications for a proximal tibial anterolateral osteotomy include symptomatic genu recurvatum with genu valgus alignment, usually in patients with a flat sagittalplane tibial slope. Arthrex acp kit, series i abs10011 arthrex acp kit, series ii abs10012 arthrex acp double syringe abs10014 centrifuge hettich rotofix 32 with swing out rotor, 220 v 1206art centrifuge hettich rotofix 32 with swing out rotor 24, 110 v 120601art bucket with. Arthrex 15 mm wedge puddu plate arthrex inc, naples, florida, usa followed by arthroscopic acl and pcl reconstructions with hamstring autografts. We present a case of a 28yearold man with a severe osteoarthritic varus knee after a neglected multiligamentous injury sustained 10 years prior. As several new tibial osteotomy plates recently appeared on the. Recent research supports the use of a locking plate design to enhance fixation and allow earlier weightbearing to decrease risk of nonunion.
The humeral sutureplate is an anatomically designed polyaxial locking plate and screw system designed for the. The plates are fixated using standard ao stainless steel 6. 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. Screws in d1, d2 and d3 are fixed with 5mm lock ing screws using 4. Comparison of theoretical fixation stability of three. After 1 screw is inserted proximally and distally, the remaining tine is removed, and the other 2 screws. The full text of this article is available in pdf format. High tibial osteotomy hto is a valuable treatment option in the highdemand patient with chondral damage and an altered mechanical axis. Proximal tibial anterolateral openingwedge osteotomies have been reported to achieve successful biplanar lowerextremity realignment. The opening wedge osteotomy system was developed for the facilitation of safe and reproducible osteotomies for the treatment of pain andor instability associated with lower extremity malalignment. The titanium femoral opening wedge osteotomy plates provide a straight toothed option to aid in maintaining the osteotomy correction. The openingwedge high tibial osteotomy technique was performed as described previously by franco et al 12 using the puddu plate arthrex, naples, florida, a butterflyshaped plate that contained.
Stability of medial opening wedge high tibial osteotomy. Only a few articles are focused on the treatment of infected nonunion. Arthrex osteotomy plate puddu plate and the tomofix. Patients were analysed for any complications and their. Hemispheric ball joints between the fixation cylinders and the testing machine allowed free rotation on both sides. The overall stresses in the bone were lower for the tomofix plate with bone graft and the puddu plate with lhs, followed by the tomofix plate without bone graft and the first generation puddu plate. Lateralextraarticulartenodesiswasassociated mean in. Platerelated results of opening wedge high tibial osteotomy with a. Medial opening wedge high tibial osteotomy for medial. These plates are optimal for unique anatomy where customizing fit with multiple bends may be required.
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. A trapezoidal wedge locking puddu plate arthrex inc is then fixed with 4mm locking figure 3. Safety of a novel high tibial osteotomy locked plate. Simultaneous anterior cruciate ligament acl and posterior cruciate ligament pcl reconstructions with high tibial osteotomy hto were performed at a single stage. The distal femoral osteotomy system utilizes the same principles of design featured in the tibial osteotomy system. Screw, fixation, bone class ii legally marketed k041709 numelock ii system manufactured by predicate devices howmedica osteonics corp now stryker orthopaedics and k973812 arthrex puddu osteotomy system manufactured by arthrex, inc. 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. The biplanar approach is able to simultaneously address both components of a. Opening wedge osteotomy using contourlock hto plate system. We placed the plate as far posterior as possible to avoid increasing the tibial slope.
Since 2010, the 2nd generation peekpower hto plate arthrex inc. Opening wedge high tibial osteotomy performed without filling the. The calibrated wedges are now removed to allow the osteotomy to close down on the plate and obtain bonetoplate contact. Lateral distal femoral opening wedge osteotomy using the.
Five years after surgery, there were no signs of effusion and no instability, and. Opening wedge high tibial osteotomy using a puddu plate. Anterolateral biplanar proximal tibial openingwedge. Surgical procedures were performed in the following order.
The median plate tooth size in plates with tooth was 11. Biomechanical investigation of the modified arthrex osteotomy plate puddu plate and the tomofix plate. Prospective outcomes of young and middleaged adults with. Biomechanical properties of five different currently used implants for. Osteotomy for medial compartment arthritis of the knee using a closing wedge or an opening wedge controlled by a puddu plate. Hto plate aesculap, tuttlingen, germany, the puddu plate arthrex inc. A 50yearold obese patient was operated on by medial openingwedge hto. All the patients were followed up between 6 months and 28 months and the mean followup is 18. The contourlock hto plate is a great choice for high demand patients needing a stronger locking construct for weightbearing.
All patients were treated with either a 2nd generation puddu plate arthrex inc. Partial meniscus substitution with a polyurethane scaffold. Tibial opening wedge osteotomy plate, 5 mm ar200t05. Design optimization of high tibial osteotomy plates using. The arthrex distal extremity plate system is intended for use in stabilization of fresh fractures, revision procedures, osteotomies, joint fusion and reconstruction of small bones and bone fragments of the handwrist, footankle, and osteopenic bone.
The sprawling campus houses corporate and manufacturing operations, as well as arthrexs premier medical education center, which serves as an education. From day 1 to week 4 after surgery, passivefree motion during. Each screw can be angled to the proper anatomic orientation within a swiveling bushing before being. Opening wedge distal femoral varus osteotomy for lateral. Do microfractures improve high tibial osteotomy outcome. For openings greater than 10 mm, the osteotomy gap was filled with bone substitutes hatric, arthrex inc or autologous iliac crest bone grafting. For more than a decade, we have applied our expertise in orthopedics and orthobiologics to develop hundreds of products for the treatment of large and small animals like horses, dogs and cats. Bone plate system for proximal tibial osteotomy arthrex. Help your orthopedic surgeons do bone debridement faster and with more control with the arthrex powerasp. As a privately held corporation, we are dedicated to patient clinical outcomes. High tibial osteotomy with puddu plate for the treatment of varus gonarthrosis article pdf available in knee surgery sports traumatology arthroscopy 1410.
Pars percutaneous achilles repair system achilles jig. It is for this reason that the choice of implant changed during the study period from the puddu plate n 16 to favour the tomofix implants n 5. The tomofix plate synthes gmbh, oberdorf, switzerland figure 1 b was a long tshaped titanium plate. Orthopedics abstract the aim of this study was to determine if microfractures improve the outcome of high tibial osteotomy in patients with medial compartmental osteoarthritis in genu varum. Arthrex s contribution to fracture management innovation starts with our unique mission of helping trauma surgeons treat their patients better. Traditional burrs use a rotating motion, creating a curved surface with scalloped edges that have to be resmoothed. 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. Arthrex offers a variety of stainless steel and titanium plate and screw systems including the revolutionary ibalance hto peek implant and anchors system for osteotomies of the lower extremities. Fixation was performed in all cases with a firstgeneration puddu plate arthrex inc, naples, florida, usa with a rectangular spacer. Arthrex is secured along the medial cortex, with two 4. The utilization of the arthrex family of unique plates, in conjunction with an opening wedge osteotomy, provides the surgeon with a safe, reliable and reproducible technique for tibial or femoral. Anterior cruciate ligament reconstruction combined with.
Position hto plate, aesculap, tuttlingen, ger many9. All followed a similar postoperative protocol as was used in the ibalance study group. Management of an infected nonunion of an openingwedge. Case report simultaneous acl pcl reconstructions with. Arthrexs corporate headquarters is located in naples, florida where visitors will find a vibrant atmosphere of rapid product innovation, medical research and surgeon collaboration. Arthrex vet systems avs is a division of arthrex inc.
Opening wedge osteotomy system using peekpower hto. Coronal and sagittal slope of the tibial plateau were manipulated with a rectangular 9 mm wedge plate puddu plate, arthrex. Midterm outcome of openingwedge high tibial osteotomy. Distal fixation of peekpower hto plate intact hinge. This shows a higher fixation stability of the first three constructs and a lower comparative fixation stability of the first generation puddu plate. The implant used was the puddu i arthrex, usa spacer plate which. Specifically designed femoral osteotomy plates take into account the anatomical differences between the distal femur and proximal tibia. These plates are fixated using arthrex titanium locking 6. Peekpower implants, whereas we did not include the puddu plate. The osteotomy site was grafted with autogenous tricortical bone. 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. These plates are available in wedgeless, straight, and sloped options. We did not try to change the sagittal slope for any patients in this series. Pdf stability of medial opening wedge high tibial osteotomy.
Pars percutaneous achilles repair system achilles jig system arthrex 1 2 3 4 use. All of the tibial opening wedge osteotomy plates were designed to work in conjunction with the standard opening wedge osteotomy instrument sets. Stoffel compared two different implants puddu plate versus tomofix plate. The utilization of these industry leading fixation systems, when used with. Since then, new plates have been developed for medial. Biomechanical studies have demonstrated greater axial and torsional stability with the tomofix plate synthes, switzerland, when compared to the puddu plate arthrex inc. Opening wedge high tibial osteotomy performed without. Clinical results for patients treated with these im. Symptomatic relief in medial opening wedge high tibial. A, and it differed from the others used up until then in that it had a coupling system which.
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