19. It has a low profile shaft. Call For Best Price 888-502-2348. Learn the Meniscal repair using Smith and Nephew fast-fix 360 system and knee arthroscopy surgical technique with step by step instructions on OrthOracle. Kind Of Pump Shop by category. Remove the driver, and the screw will remain in place. Injury of the anterior cruciate ligament (ACL) can lead to knee instability associated with damage to other knee structures and the increased risk of degenerative joint disease.This has led to the frequent use of intra-articular tissue grafts for ACL reconstruction tissue grafts for ACL reconstruction CLAIMS . Our initial search was very broad and included the following MESH headings: (meniscus OR meniscal) AND (device OR all inside repair). Indications and Techniques for Meniscus Repair, Primary Repair of Posterior Cruciate Ligament Tears, Posterolateral Corner Hamstring Figure-Eight Reconstruction, Arthroscopic Treatment of Lateral Tibial Plateau Fractures, Repair and Reconstruction of Acute and Chronic Patellar Tendon Rupture, Patients with peripheral meniscus tears are the best candidates for repair. 1. If the split cannula is used, the curve of the needle must be inserted at a 90-degree angle to the split, The inner fragment of the tear is pierced with the needle and advanced to the depth set by the limiter for horizontal repair or through the outer fragment for vertical repair. Enter your search keyword. You can drill independent and diverging bone tunnels on the femoral and tibial side of the knee joint with consistent, reproducible separation. Advance the screw until the driver knob touches the cannula and the screw is flush with the meniscus surface. Registered in England and Wales No. The screw comes mounted on a cartridge. sharing sensitive information, make sure youre on a federal Amperage Clinical evaluations of these devices consisted largely of case series. Blue Bell, PA: Bionix, 1998, 9 Albrecht-Olson P, Lind T, Kristensen G, Falkenberg B. 36. 72201252 ACUFEX DIRECTOR Anatomic ACL Guide System, 72202437 Anatomic ACL Double Bundle Instrument Tray. Meniscal repair using the inside-out technique with cross stitch. In the USA contact: fda.gov After the tear has been prepared, the FasT-fix delivery needle is inserted into the appropriate portal through either a 5 mm 55 mm cannula (Acufex, Mansfield, MA) or a split cannula (Smith and Nephew). MeSH Other Specifications Arthroscopy 2001;17:7780, 16 Menche D, Phillips G, Pitman M, Steiner G. Inflammatory foreign body reaction to an arthroscopic bioabsorbable meniscal arrow repair. 35. Please enable it to take advantage of the complete set of features! Tekyard Medical closeout auctions take place on DOTmed.com. For all other tears place the first Arrow in the center of the tear initially. (From Mitek Meniscal Repair System Instructional Brochure, 2000. ZRG Medical closeout auctions take place on DOTmed.com. Tears can only be repaired if they are not deformed and easily reducible. Seventy-seven percent of studies identified were case series; 10% were retrospective, comparative studies; 6.5% were prospective comparative studies and 6.5% were prospective randomized studies (Table 2). Thirty-one clinical manuscripts were identified that studied the following all-inside meniscus repair devices: the meniscus arrow,1,2,13,16,19,20,24,25,27,29,33,35,36,38 T-Fix (Acufex Microsurgical, Inc, Mansfield, MA)4,9,10,14,21,38 and FasT-Fix (Smith & Nephew Endoscopy, Boston, MA)17,23 devices, the meniscus screw,11,15,18,37 the Biostinger (Linvatec, Largo, FL),6,8 the RapidLoc (DePuy Mitek, Norwood, MA) device,18,31 a meniscal repair system26 and a meniscal stapler.28 The most studied device was the meniscus arrow with 14 studies looking at clinical outcomes. The Mitek meniscus fastener is a double T-shaped device (polypropylene or PLA) that is delivered via a loaded needle and gun system. We are distributor of medical Devices. Used ACUFEX Meniscal Repair Kit Acufex Meniscal Repair Kit With Sterilization Tray Surgical Instruments For Sale - DOTmed Listing #2335491: Acufex Meniscal Repair Kit With Sterilization Tray Kit . acufex meniscal repair system. Barber FA, Johnson DH, Halbrecht JL. PMC MRI does not accurately predict those tears that will be amenable to repair. The Bionix Meniscal Arrow is a sharp-tipped, barbed polylactic acid (PLA) device with a head. Repair of meniscal tears with the absorbable Clearfix screw: results after 1-3 years. Chondral injury from bioabsorbable screws after meniscal repair. From this initial search we were able to narrow our search using the following MESH headings: (meniscus) AND (arrow OR t-fix OR fasT-fix OR screw OR biostinger OR staple OR mitek OR biostinger OR tack). - We are temporarily unable to ship medical products to the state of California. Designed to freshen the edge of the meniscal tear prior to repair. Reduce the tear and maintain the position of the cannula with the flat dimension of the cannula parallel to the joint line. The Clearfix Screw (Mitek, Norwood, MA) is a meniscal repair device that uses a threaded, cannulated screw to obtain fixation across tears. A complete system for meniscal root repair includes the meniscal root marking hooks, the Knee Scorpion suture passer, and meniscal root repair kit with PEEK SwiveLock anchor. Ramappa AJ, Chen A, Hertz B, Wexler M, Grimaldi Bournissaint L, DeAngelis JP, Nazarian A. Arthroscopy. Certain products may not be approved for sale in all countries. Each of these 31 articles was reviewed independently by two authors (JL and CBM) who separately extracted data on the following categories: number of meniscal tear repairs, average patient age, meniscal tear characteristics (length, zone, type, medial versus lateral tear), simultaneous ACL repair, average followup, percent failures, definition of failure and level of evidence of articles. Manual searching of the reference lists of these articles yielded 1 additional manuscript. The end result is a single loop of suture with a clever self-locking knot on the meniscal surface. Pagnani MJ, Cooper DE, Warren RF. Patients undergoing concomitant anterior cruciate ligament (ACL) reconstruction and meniscus repair have a higher success rate for meniscal healing as compared with patients with isolated tears. Innovasive 7223 Orthopedic Meniscal Repair System Gray Left Up Cannula. The remaining all-inside meniscal repair devices are listed along with failure rates (according to available clinical studies): meniscal stapler (0% failure rate), Biostinger (5- 9% failure rate), FasT-Fix (10-14% failure rate), Mitek Meniscal Repair System (13.5% failure rate), meniscus screw (10-25% failure rate), RapidLoc device (9-35%) and T-Fix (2-43% failure rate). The type, location, size, and vascularity of the meniscus tear are evaluated and noted. All-inside techniques obviate the need for additional incisions and decrease the risk to neurovascular structures. Select the cannula that allows the most perpendicular approach to the tear. Kurzweil PR, Tifford CD, Ignacio EM. The repaired meniscus should be stable, and the edges remain tightly approximated. 22. Cannulas attach to the handle to efficiently target specific zones of the meniscus. 13. We also found no notable differences in the reported failure rates of various devices with the length of fol-lowup. Limited weight bearing, with two crutches, is employed over the first 4 weeks. (B) The red safety trigger is depressed, and then the main trigger is pressed to deliver the dart across the tear. It also serves to stop small cartilage fragments from flaking off are causing a reactive effusion. Sold as pictured. Tip Diameter (From Cooper D, Arnoczky S, Warren R. Meniscal repair. Arthroscopic techniques include inside-out repairs, outside-in repairs, and all-inside repairs. Al-Othman AA. This scatter chart shows the trend of increasing failure rates with longer followup for the T-fix device. Results of all-inside meniscal repair with the FasT-Fix meniscal repair system. Background:The cross-sectional area (CSA) of the anterior cruciate ligament (ACL) and reconstructed graft has direct implications on its strength and knee function. Such loose body formation may put the intraarticular structures, including the articular cartilage, at risk. 6. The ZoneNavigator System revolutionizes inside-out meniscal repair with single-handed control of needle placement. Annandale T. An operation for displaced semilunar cartilage. 38. Patient outcomes following T-Fix meniscal repair and a modifiable, progressive rehabilitation program, a retrospective study. The lack of randomized controlled studies does not allow us to make any definitive suggestions on the use of various all-inside meniscal repair devices. ACUFEX Meniscal Root Repair (3) GMDN Term. Select the proper-length Arrow for each part of the tear and arrange on the back table before proceeding. Review of the clinical results of arthroscopic meniscal repair. Using the criteria above, this process of exclusion yielded 30 manuscripts. A running program (treadmill) is employed at about 4 months. [Expired] Smith Trailer available immediately For example, some studies look at meniscal repairs occurring in a knee with concurrent ACL reconstruction. Orthopaedic implant calibration pin (1) Surgical drill guide obturator (1) Surgical instrument handle, non-torque-limiting (1) FDA Product Code Name. We are sorry but you must be a DOTmed user to save searches. view more. To cut the tensioning suture, rest the tip of the knot pusher against the knot and pull the gold trigger of the FasT-Fix system. Both the meniscus arrows and the T-fix devices showed a trend of increasing failure rate with longer follow-up (Figs 1 and 2). Request PDF | Proximity of the Neurovascular Bundle During Posterior-Lateral Meniscal Repair: A Comparison of the Transpatellar, Anteromedial, and Anterolateral Portals | Purpose: To compare the . ACUFEX Access; ACUFEX . Arthroscopy 2001;17:34, Click to share on Twitter (Opens in new window), Click to share on Facebook (Opens in new window), Click to share on Google+ (Opens in new window). The FasT-Fix device compares favorably to vertical mattress sutures for maximum force at failure in human meniscus, and it showed the least deformity of fixation when studied in vitro:5, 6. Circular saw blade WOOD UNIVERSAL HW 260x2,5x30 SMITHCO SX2 LEAD Illustration of the circumferential-surrounding meniscal repair technique. Expiration Date Using feedback from our surgeon customers, we designed the AS Meniscal Repair Device to deliver optimal performance to address one of the fastest-growing orthopedic procedures performed today.. Insert the cannula into the joint with the obturator in. In tears where the vascularity is not readily obvious, clinical judgment must be made as to the appropriateness of the tear for repair. Year of Manufacture. Arthroscopy 2000;16:749753, 18 Ross G, Grabill J, McDevitt E. Chondral injury after meniscal repair with bioabsorbable arrows. Select the proper Dart size and load to the end of the sheath. Arthroscopic meniscal repair using the BioStinger. Add 3 to 5 mm to that measurement plus 1 mm for capsule penetration. MRI is not a good predictor of clinical healing in menisci that have already undergone repair. Frosch KH, Fuchs M, Losch A, Sturmer KM. Numerous commercial fixation devices are currently available for arthroscopic, all-inside meniscus repair. Unsatisfactory clinical results of meniscal repair using the meniscus arrow. Data is temporarily unavailable. may email you for journal alerts and information, but is committed Barrett GR, Treacy SH, Ruff CG. Pass the appropriate cannula through the portal and make certain that the obliquely angled tip makes full contact with the meniscus surface. official website and that any information you provide is encrypted Exp. Generally, all-inside devices require simpler surgical techniques and shorter surgical times, and have reduced surgical risk because accessory incisions are not necessary. Complete radial tears are typically not suitable for repair because the circumferential collagen bundles of the meniscus have been disrupted and there is little hope of functional restoration. Starting at $104/mo with Affirm. If a meniscal repair cannot be adequately achieved using all-inside methods, a suture-based repair should be employed to increase the likelihood of a successful repair. acufex meniscal repair systemproforce senior vs safechoice senior. On the contrary, Koukoulias et al24 reported a 5% failure rate with the same device at 73 months. Nonetheless the meniscal repair market, which dates back a long way, but probably started in anger with the Acufex system of the early nineties, continues to grow. It is ideal for the central posterior horn tears that are difficult using conventional techniques. Clinical results of arthroscopic meniscal repair using biodegradable screws. The blood supply of the meniscus reaches the peripheral 1/3, which is known as the red-zone. Standard arthroscopy portals may be used in combination with one of the six color-coded, zone-related cannulae. Business & Industrial; Agriculture & Forestry; Construction; Electrical & Test Equipment; Fuel & Energy; Healthcare, Lab & Life Science; Dental; Imaging & Aesthetics . Barber and Herbert11 report a pullout strength similar to that of the meniscal Arrow, which is approximately half the strength of a single vertical suture. For the meniscus arrow and T-fix device, there is a trend toward higher failure rates with longer followup. Excellent condition. Am J Sports Med. Width The AS Meniscal Repair Device has improved my operative efficiency by delivering a high level of reliability and success., Covidien is setting new standards for consistency and reliability with this innovative, new design, said Peter Marshall, Director of R&D, Covidien. Lee JH, Lim YJ, Kim KB, Kim KH, Song JH. Depth 5. Place additional Arrows from anterior to posterior to anterior, alternating around the centrally placed Arrow at 5 mm increments, The Arthrex Dart is a flat, flexible, barbed device made of DLDA copolymer PLA-coD and L-lactalide, The Dart uses a delivery gun system. (F) Suture tensioning. Available in two styles: Catalog #. Red-on-white tears are on the periphery of this vascular zone. The Dart system comes with a flexible probe with indexed measuring lines to help determine proper Dart size. National Library of Medicine Asik M, Sen C, Erginsu M. Arthroscopic meniscal repair using T-fix. According to Warrens zone system for the classification of meniscal tears. Arthroscopy 2001;17:439444, 6 Coen M, Caborn D, Urban W, Nyland J, Johnson D. An anatomic evaluation of T-fix suture device placement for arthroscopic all-inside meniscal repair. The device with the longest average followup is the meniscus arrow with Lee and Diduch27 reporting an average followup of 79.2 months. 9. Typically long bucket-handle tears that are reasonably fresh (<3 months) are most suitable for repair. Barrett GR, Treacy SH, Ruff CG. Choose a Specification During the first weeks after surgery, the patient utilizes a home exercise regimen dedicated to maintaining quadriceps function. Insert additional Darts as needed in 5 mm increments. A biomechanical evaluation of all-inside 2-stitch meniscal repair devices with matched inside-out suture repair. 30. Reduce the tear with the needle and advance the screw by carefully turning the driver knob counterclockwise. Download scientific diagram | The Meniscal Viper Repair system. (B) Placement of the driver into the cannula to facilitate screw delivery. Institution: The Worcestershire Acute NHS Trusts, Uk. Escalas F, Quadras J, Caceres E, Benaddi J. T-Fix anchor sutures for arthroscopic meniscal repair. (B) The fastener is loaded onto a delivery needle. Lee GP, Diduch DR. Level of Evidence: Level IV, systematic review. Quantity Techniques for meniscal repair include open or arthroscopic techniques. Meniscal repair devices. This device comes in 6 and 8 mm sizes with either a 27- or 34-degree delivery needle ( Fig. An official website of the United States government. See Guidelines for Authors for a complete description of levels of evidence. Haas AL, Schepsis AA, Hornstein J, Edgar CM. This site needs JavaScript to work properly. The lack of randomized clinical trials prohibits one from making recommendations on using one particular all-inside meniscus repair device versus another. Arthrex offers two meniscus root marking hooks based on surgeon preference. Skip to main content. Hantes ME, Zachos VC, Varitimidis SE, Dailiana ZH, Karachalios T, Malizos KN. 2009;25(9):951-958. doi:10.1016/j.arthro.2009.03.018, Implant System, Meniscal Root Repair with BioComposite SwiveLock, Implant System, Meniscal Root Repair with PEEK SwiveLock, FiberLink SutureTape, 0.9 mm, with Loop (White/Black), TigerLink SutureTape, 0.9 mm, with Loop (White/Black), 2-0 FiberStick, 2-0 FiberWire, 50" (blue) one end stiffened, 12", Locking Guide for Meniscal Root Marking Hook. ), Differential Diagnosis and Concomitant Injuries. Height For example, failures were defined as need for further surgery in certain studies, while persistent low clinical outcome scores or failure to heal with repeat arthroscopy was designated a failure in other studies. Prospective comparison of arthroscopic medial meniscal repair technique: inside-out suture versus entirely arthroscopic arrows. Cannon WD Jr, Vittori JM. Endoscopic meniscus repair using the T-Fix suture device (Acufex Microsurgical, Inc, Mansfield, MA) allows ease of suture placement for meniscus stability without the problems associated with ancillary incisions such as neurovascular compromise. 2014 Jan;42(1):194-9. doi: 10.1177/0363546513505190. We performed an evidence based review of the outcomes of all-inside meniscus repair devices. Central, avascular meniscus tears have poor prognosis for healing. Clearfix Meniscal Screw Surgical Technique Guide, 2001, 11 Barber F, Herbert M. Meniscal repair devices. 1. Please enable scripts and reload this page. New In Box . Barber FA, Herbert MA. Wolters Kluwer Health Probe the tear after Dart deployment to confirm tear stability. Unauthorized use of these marks is strictly prohibited. History and physical exam can often accurately predict the presence of a meniscus tear but typically are not helpful in determining whether a particular tear is amenable to repair. 2006 Dec;18(5-6):411-23. doi: 10.1007/s00064-006-1186-y. Next, the gold trigger is moved forward to advance the second implant into the proper position on the delivery system needle for placement of the second bar. Commercial Body Solid EXM 3000LPS Multi Gym Starting at $104/mo with Affirm. Figure 3-2 (Continued) (D) Insertion of second implant. Common symptoms of meniscus tear include knee pain, catching, locking, giving way, and swelling. The decision to proceed with meniscal repair is made following a thorough arthroscopic assessment of the knee joint. Bohnsack M, Borner C, Schmolke S, Moller H, Wirth CJ, Ruhmann O. Complete knotless fixation of the sutures with the 4.75 mm PEEK SwiveLock anchor. 1991;7(3):297-300. doi:10.1016/0749-8063(91)90131-g, 2. 23. Results of meniscal repair using a bioabsorbable screw. All-inside meniscus repair techniques were designed to eliminate the potential risks and morbidity of the inside-out and outside-in repair methods, such as nerve injury, and the need for additional knee incisions. SECTION I: SYMPOSIUM: Evidence-based Medicine in Sports Medicine, Demographic Data for All-inside Devices Included in Systematic Review, Results of Clinical Studies for All-inside Devices Included in Systematic Review. Loose devices should be removed and replaced. The entire inferior surface of both medial and lateral menisci extending to the meniscosynovial junction is evaluated. Straight leg raise, quadriceps isometrics, and calf pump exercises are performed daily. Accessibility Bionx Meniscus Arrow Inserter With the development of a plethora of all-inside meniscal repair devices touting simpler surgical techniques, shorter surgical times, and reduced surgical risk, the clinician has more devices at his disposal to repair tears previously thought irreparable. Your message has been successfully sent to your colleague. Withdraw the needle from the tissue, and the fastener will remain in place across the tear. The second and third most popular studied devices included the T-Fix and the meniscal screw, which respectively had six and four clinical studies apiece. Description. My Blog acufex meniscal stitcher set Laprell H, Stein V, Petersen W. Arthroscopic all-inside meniscus repair using a new refixation device: a prospective study. polymer bars and a zero polyester nonabsorbable suture that has a pre-tied sliding knot that can be tensioned with arthroscopic assistance.