Osteotomy Plate
Miqueo Snyder
The correction of axial malalignments in extremities is constantly gaining importance in orthopedic surgery. Particularly in regions close to the knee corrective osteotomies for varus and valgus malalignments (bowleg and knock-knee) change the load on the knee joint and may delay the need for partial or full joint replacement. With the aap osteotomy system, surgeons perform this type of elective surgery in a minimally invasive, secure and load-stable manner.
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The titanium ContourLock HTO Plates were designed to be a anatomically curved and low profile. The ContourLock HTO Plate is a great choice for high demand patients needing a stronger locking construct for weight-bearing. These plates are available in wedgeless, straight, and sloped options.
The titanium Tibial Opening Wedge Osteotomy Plates feature a 4 hole design and are available with either a straight or sloped wedge to change or preserve the native tibial slope. The simplistic design facilitates minimally invasive surgery and is optimal for lower demand patients.
These plates are fixated using Arthrex titanium locking 6.5 mm cancellous and 4.5 mm cortical screws. Each screw can be angled to the proper anatomic orientation within a swiveling bushing before being locked to the plate.
While requiring minimal dissection, these low profile plates provide excellent stability and durability. By using a spacer on the plate to maintain correction, the system offers a technique that is fast, effective and reproducible.Features & Benefits:
The Activmotion S range, developed in collaboration with our experts, represents this latest generation. It proposes an extensive rage of anatomical plates to maintain the bone corrections obtained by opening and closing osteotomy, on the tibia as well as the femur.
This conservative surgery allows realigning a leg, and thus transferring the mechanical constraints from the damaged sections of the joint (cartilage wear) to the healthy knee compartment. The damaged cartilage is better preserved in this manner, which delays the insertion of a prosthesis.
Furthermore, our solution includes a broad offer, combining reusable instruments, single use kit and cutting guide specific to the patient, in order to ensure the safety and precision of your surgical procedure.
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The purpose of this information is to present the Newclip Technics range of medical devices. These products must be handled and/or implanted by trained and qualified personnel who have read the instructions for use. The surgeon remains responsible for his or her own professional and clinical judgement prior to the use of specific products on a given patient.
Patient Surgeon: S. Robert Rozbruch, MD
Yang is an athletic young man who was having difficulties related to his knock-knees including pain and awkward gait. He was also concerned with the aesthetics and about further degeneration of the knee in the future. With knock-knees, the lateral joint compartment is overloaded causing pain and progressive degeneration. Notice the line drawn in the x-ray (Figure 4) from hip to ankle passes outside the center of the knee.
A staged bilateral surgery was performed. The left side was addressed first with an open wedge osteotomy. A partial bone cut was made and the lateral cortex was shimmed open (Figure 1). The alignment was checked in the OR (Figure 2). The new position was secured with a titanium plate (Figure 3) and the space was filled with synthetic bone graft.
With well healed bones and straight legs, Yang has improved athletically and has no pain. He is very happy with his new appearance and is pleased that the normal alignment helps protect his knees from developing degenerative arthritis in the future.
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Objective: To determine the biomechanical properties of different fixation methods for high tibial medial opening wedge osteotomy in order to determine appropriate surgical and rehabilitation guidelines.
Results: Both constructs failed under compression and torsion at the lateral cortex and occurred at higher maximal forces by using the TomoFix Plate. After fracture of the lateral cortex the axial stiffness was reduced by 47% and the torsional rigidity by 54% for the TomoFix. For the Puddu Plate these reductions were 66% and 78%, respectively. The differences between the two groups were significant in all conducted tests (P < 0.05).
Conclusions: This study indicates that an unharmed lateral hinge largely dictates the stability after high tibial osteotomy. If the lateral cortex is injured, the TomoFix plate provides superior stability in both compression and torsion compared to the Puddu Plate. In the latter case additional fixation might be considered.
The DFOS system includes implants to correct several distal femoral conditions, such as flexion contractures and varus/valgus deformities. Offset plates help maintain the mechanical axis. The instrumentation includes a pin guide and cut guides to assist with more precise osteotomies and implant placement.
To investigate the use of a locking 3.5/4.0-mm jumbo tibial plateau leveling osteotomy (TPLO) plate in maintaining the postoperative tibial plateau angle (TPA) in giant-breed dogs weighing > 50 kg and to report the associated complications.
Retrospective case series retrieving postoperative outcomes from the medical records. Healing scores and TPAs were calculated using postoperative and recheck radiographs. Owner-perceived outcomes were obtained via questionnaire.
The use of a locking 3.5/4.0-mm jumbo TPLO plate did not prevent a statistically significant increase in TPA through convalescence. This procedure displayed an unacceptably high complication rate when compared with contemporary literature of TPLO. Despite a high complication rate in this patient population, most complications were successfully managed with medical and/or surgical treatment, and high mean and median healing scores were achieved at the radiographic recheck. Additionally, owner-perceived long-term outcomes were excellent.
Cranial cruciate ligament (CCL) disease is one of the most common etiologies of pelvic limb lameness in canines.1 Cranial cruciate ligament disease can be surgically managed in a variety of ways; however, a recent survey2 of veterinary surgeons suggests tibial plateau leveling osteotomy (TPLO) to be the favored technique.2 This procedure, as first outlined by Slocum and Slocum,3 has the goal of neutralizing cranial tibial thrust experienced during pelvic limb weight bearing by leveling the tibial plateau via a radial osteotomy. The segments are subsequently stabilized to maintain the new tibial plateau angle (TPA) via a TPLO plate and screws.
Change in TPA during the convalescent period following TPLO has been reported in dogs.9 The clinical consequences of change in TPA during convalescence following TPLO have not been rigorously described in the literature; however, an increase in TPA at recheck evaluation has been associated with an increased risk of tibial tuberosity fracture following TPLO.10 Different stabilization systems for management of TPLO patients > 50 kg have been described in the literature, including double plating. Double plating involves the addition of a second plate on the proximal tibia, caudal to the TPLO plate, to promote rigid fixation of the osteotomy and decrease the risks of increasing TPA and micromotion at the osteotomy.4,11,12 An abstract13 on the use of a single locking 3.5-mm jumbo TPLO plate for stabilization following TPLO reports a major complication rate of 20% (approx 3/14) and minor complication rate of 6% (1/14). There was no statistical change in TPA when comparing immediate postoperative and 6 week postoperative values.
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