Total weightbearing was allowed 45 days after surgery. This study assessed 65 knees of 60 patients with varus gonarthrosis who underwent high tibial osteotomies. Genu varum with medial compartment osteoarthritis treated with puddu plate. Arthrex are really interested in the whole idea of osteotomy, and they with giancarlo puddu an italian professor popularised the whole of the opening wedge technique about 10 years ago with the puddu plate, named after professor puddu who invented it. A novel technique in open wedge high tibial osteotomy to preserve the. Preoperative radiographic view of a patient with severe loss of medial joint space. Everyday low prices and free delivery on eligible orders.
Opening wedge high tibial osteotomy performed without filling the. These plates are fixated to bone using arthrex titanium locking 6. Agneskirchnerimprovements in surgical technique of. Information was intended for internal use only and. Long posterior flap a burgess technique b bruckner technique 2. The first is a true extraarticular approach in which a 12 to 15cm lateral incision. All of the tibial opening wedge osteotomy plates were designed to work in conjunction with the standard opening wedge osteotomy instrument sets. As with all orthopedic surgical procedures, the technique used. Use of 3d printed bone plate in novel technique to surgicall.
Openwedge osteotomy of the tibia can be performed without bone grafting or bone substitution in most cases. Mark coventry published his technique for closed wedge osteotomy in 1965 3, which became the gold standard for. Opening wedge osteotomy system using peekpower hto plate 2nd. 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.
The plates are fixated using standard ao stainless steel 6. Thieme ejournals the journal of knee surgery abstract. Arthrex are really interested in the whole idea of osteotomy, and they with giancarlo puddu an italian professor popularised the whole of the opening wedge technique about 10 years ago with the puddu. A closing wedge osteotomy with the technique as described by gross and hutchinson 4 will produce a tibiofemoral angle of 0 degrees. High tibial osteotomy with puddu plate for the treatment of varus gonarthrosis. High tibial osteotomy, open wedge, tibial slope, surgical technique, formula. All of the femoral opening wedge osteotomy plates were designed to work in conjunction with the standard opening wedge osteotomy instruments sets.
Finite element analysis of puddu and tomofix plate fixation. Dissection of the soft tissue is performed by the subvastus approach, and the periosteum is incised. Between june 2003 and july 2005, 40 tomofix medial opening wedge htos were. Download full thesis topics for ms dnb orthopaedics degree orthodnb. Extending down the shaft of the femur, the plate sits straight along the lateral cortex with an anterior curve beginning at the six hole plate option. Article pdf available in journal of orthopaedic surgery and. Nov 17, 2015 detailed surgical technique for medial closingwedge distal femoral osteotomy with proximal tibial locking plate. Gordon cleveland clinic foundation, cleveland, ohio, usa technologic advances in surgery include a trend toward less invasive procedures.
This procedure looked very attractive to many surgeons. Open wedge puddu plate hto technique advantages popularized in france puddu popularized accurate technique technically less dissection offers dial in correction on table allows biplanar correction stabilizes medial pseudolaxity. B determination of the size of the puddu plate to be placed on the osteotomy incision. In this study we analyse the outcome of open wedge osteotomy in patients having uni compartmental osteoarthritis with genu varum using the puddu plate. The surgical technique and 2 clinical cases describing the use of this procedure with. Detailed surgical technique for medial closingwedge distal femoral osteotomy with proximal tibial locking plate. The titanium femoral opening wedge osteotomy plates provide a straight toothed option to aid in maintaining the osteotomy correction. The posterior referencing technique begins on page 10. The plate protects the second metatarsal when tethering suture tape between the first and second. Shawn odriscoll, md, phd mayo foundation, ken yamaguchi, md washington university, barnes jewish hospital graham king, md, msc university of western ontario 2 table of contents table. All surgical tecniques described have the objective of shifting the weight load present in the medial compartment, due to a varum deformity, to the lateral side, at.
Two surgical approach options can be considered for a lateral, distal femoral osteotomy. In pathology education within north america, there exists a wide gap in the pedagogy between medical school and residency. A true surgeons guide to navigating the operating room christopher j. Acp soaked osferion osteotomy wedges or arthrex quickset can be placed into the bone void to fill the osteotomy wedge. This article describes the complications after medial opening wedge high tibial osteotomy hto with the tomofix plate. The safety and efficacy of the novel limmed system locked plate fixation for. Patents on surgical techniques the new bread and butter. A servo hydraulic machine was used to cyclically load the tibia in compression, while a puddu plate construct. Unlike other medical disciplines, in which the skills of historytaking, physical. Patents on surgical techniques the new bread and butter of.
The full scope of the field is represented with uptodate, evidencebased coverage of every surgical procedure performed today, including orthognathic surgery, trauma surgery, surgical pathology, surgery of tm disorders, placement of dental implants, cleft palate correction, dentoalveolar surgery, craniofacial surgery, cosmetic surgery, and. After redefiniton of the concept of lower extremity deformities, paley. These plates are optimal for unique anatomy where customizing fit with multiple bends may be required. The procedure involves taking pressure off the damaged side of your knee by dividing the bone and. Less invasive stabilization system liss for liss and lcp. A novel technique in open wedge high tibial osteotomy to preserve. Evaluation of the screw position and angle using a postcontoured plate in the open wedge high tibial osteotomy according to the correction degree and surgical technique. Pdf design optimization of high tibial osteotomy plates using finite. The improvement in surgical technique 2, 22, preservation of. Please note that information on this site was not authored by dr. Counterlock and puddu plate in patients with medial compartment oa.
Opening wedge high tibial osteotomy using a puddu plate. My skill came not from any intrinsic abilities of my own but rather from knowing how things were supposed to be done and what to pay attention to, which this book taught me. A masterwork in three volumes, this comprehensive resource provides indepth information to help you perfect your oral and maxillofacial surgical technique and provide stateoftheart care for your. New surgical techniques and surgical site infections steven m. Opening wedge distal femoral varus osteotomy using 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. Conventional plate and screws in medial openingwedge high tibial.
Genu varum with medial compartment osteoarthritis treated with. 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. Advances in modern osteotomies around the knee springerlink. The procedure involves taking pressure off the damaged side of your knee by dividing the bone and realigning the limb so the leg is straight. While the puddu plate supports primarily the medial pillar, the tomofix plate also stabilizes the lateral pillar by providing angular stability.
In this study, the results of openwedge osteotomy with puddu plate for the treatment of varus gonarthrosis have been evaluated prospectively. Finite element analysis of puddu and tomofix plate fixation for open wedge high tibial osteotomy article in injury 436. Less invasive stabilization system liss for liss and lcp df plates surgical technique depuy synthes 11 preparation 1 prepare required sets instrument sets 01. Surgical technique prior to performing this technique, please consult the instructions for use documentation provided with the device for additional health. Because opening wedge osteotomies are believed to allow a more accurate correction. Use of 3d printed bone plate in novel technique to surgically. Plate is precontoured to fit the anatomy of the lateral aspect of the greater trochanter. Surgical technique at l1l5 levels patient positioning the nucleotome procedure is performed on a fluoroscopic table with the patient positioned in either the prone or lateral decubitus position. The cast and staple technique requires the patient to be immobilized for 5 to 8 weeks. The hardcover of the microsurgical reconstruction of the extremities. Weight bearing is begun gradually and, by 10 weeks after surgery, the osteotomy should be healed and nontender, at which time, full weight bearing is resumed. Use of 3d printed bone plate in novel technique to. Use of 3d printed bone plate in novel technique to surgically correct hallux valgus deformities kathryn e. 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.
Proximal tibial osteotomy is a widely performed surgical procedure for the treatment of. Finite element analysis of puddu and tomofix plate. The following surgical technique is for illustrative purposes only. New surgical techniques and surgical site infections. Home buy feat download full thesis topics for ms dnb orthopaedics degree. Knee realignment or knee osteotomy professor adrian wilson. Our experience at creating surgery medical illustrations. Safety of a novel high tibial osteotomy locked plate fixation for. Novel technique for measurement of screw bending in bone. Videos surgical technique proximal tibial opening wedge osteotomy. The experience and the development of new techniques for axis correction around the knee. The team has received anatomy training by professors of anatomy located at the royal college of surgeons of england whilst.
The osteotomy was opened and fixed with a wedge plate of puddu. I found basic surgical techniques so helpful that ive recommended it highly and gifted it to other med students. Surgical technique zmost common surgical techniques are. Indicationsplanningsurgical techniques using plate fixators aopublishing book online at best prices in. The first is a true extraarticular approach in which a 12 to 15cm lateral incision is made over the midline lateral femur and angulated anterior 2 cm distal to lateral epicondyle. Puddu plate and calcium phosphate bone cement knee surg sports traumatol arthrosc 21. Weight bearing is begun gradually and, by 10 weeks after surgery, the osteotomy should be healed and nontender, at. With plate and screw fixation, early mobilization may be undertaken.
When the patient is placed in a prone position, pressure points should be cushioned and the patient should be. This is the result because the 90degree blade plate is positioned parallel to the articular surfaces and the fragment is closed down until the plate portion fits to the femoral cortex, always producing a. Other authors 2, 5 have advocated rigid locking plates for both osteotomy techniques. Adrian is considered to be a global leader in the field of knee realignment osteotomy surgery. These less invasive procedures provide infection control. Opening wedge high tibial osteotomy using a puddu plate and. This anterior curve provides an anatomic plate fit to ensure optimal plate position on bone. Duration of surgery and tourniquet time were longer in the nav osteotomy group. Frederic a matsen iii and has not been proofread or intended for general public use. This early failure was attributed to the inadequate stabilization provided by the puddu plate. Lateral distal femoral opening wedge osteotomy using the peekpower ldfo plate.
Apr 11, 2006 in this study, the results of openwedge osteotomy with puddu plate for the treatment of varus gonarthrosis have been evaluated prospectively. Comparing conventional and navigationassisted techniques fo. The patient is placed in the supine position on the operating table, and a. Opening wedge osteotomy system using peekpower hto. The results show that in 4 to 6 months patients had a significant improvement of symptoms which induced to the surgical procedure. A comprehensive plating system for stable fixation of. Each screw can be angled to the proper anatomic orientation within a swiveling bushing before being. Pdf high tibial osteotomy with puddu plate for the treatment of. Position hto plate, aesculap, tuttlingen, ger many9, 69 and. A servo hydraulic machine was used to cyclically load the tibia in compression, while a puddu plate construct supported the open wedge osteotomy. Complete the radiographic assessment and prepare the preoperative plan.
Suture technique and closure instrumentation the latitude surgical technique has been developed in conjunction with. Puddu plate technique is an alternative method using a medial openup osteotomy, but currently there no longterm results are available. When one surgeon connects with one patient to provide personalized care, the promise of medicine is fulfilled. The space opened by the osteotomy was filled with autologous iliac graft. The use of conventional plates and screws is viable in the fixation of. As with all orthopedic surgical procedures, the technique used in each case will depend on the surgeons medical judgment as to the best treatment for each patient. The surgical stepwise technique used in a patient is shown in figure 911 and performed as shown in figure 912. Professor puddu is very imaginative and he developed this plate that was great at the time. The patient is placed in the supine position on the operating table, and a medialside approach is used in the left knee. Opening wedge distal femoral varus osteotomy using the puddu. Next, the opener is inserted and gradually opened until desired correction. Opening wedge high tibial osteotomy using a novel technique. With careful surgical technique, adjusted to account for the origin of the.
The way the system works right now appears to be very. Despite the unmet need for novel pharmaceutical therapies to alter the. Download full thesis topics for ms dnb orthopaedics degree. After redefiniton of the concept of lower extremity deformities, paley et al. The following describes the anterior referencing technique. Patents on surgical techniques the new bread and butter of patentgetting. Surgery illustrations creating medical illustrations for. The plate protects the second metatarsal when tethering suture tape between the. Lateral distal femoral opening wedge osteotomy using the. An overview of the status quo in knee osteotomy kneeguru. Surgical technique the profemurz is a femoral implant designed with a rectangular cross section and a conical profile characterised by a constant increase in volume from the distal tip to the proximal area.
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