Barber FA, Coons DA. Background:A bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR) procedure places an extracellular matrix implant, combined with autologous whole blood, in the gap between the torn ends . Prospective long-term followup is important to determine the failure rates of all-inside meniscus repair devices. Please contact 760-438-8835 ext. Our initial search was very broad and included the following MESH headings: (meniscus OR meniscal) AND (device OR all inside repair). Sound Level, Db 1991;7(3):297-300. doi:10.1016/0749-8063(91)90131-g, 2. 30. 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.. Post WR, Akers SR, Kish V. Load to failure of common meniscal repair techniques: effects of suture technique and suture material. Use the needle catcher to guide needles away from neurovascular structures. Line, Cc Illustration of the circumferential-surrounding meniscal repair technique. The concave, curved retractor efficiently retracts tissue and directs the needles for easy retrieval. Device failure for all of the all-inside meniscus repair devices ranged from 0% to 43.5%28,38 (Table 2). The Clearfix Screw (Mitek, Norwood, MA) is a meniscal repair device that uses a threaded, cannulated screw to obtain fixation across tears. Capacity Only two prospective randomized studies,1,18 two prospective comparative studies,8,35 and three retrospective comparative studies19,36,38 were found relating to all-inside meniscal repair devices. The patient may unlock the brace while sitting. 8600 Rockville Pike Insert the cutting needle, and advance across the tear (the needle protrudes 13 mm). Reduce the tear and maintain the position of the cannula with the flat dimension of the cannula parallel to the joint line. $207.00 + $56.15 shipping. It is made of PLA and is delivered via a flexible square nitinol needle-tipped driver. Tears with a 3 to 5 mm rim range and no definitive sign of vascularity should be repaired based on the physicians clinical judgment. We performed a systematic literature review using PubMed (January 1966-July 2006) to identify clinical studies looking at outcomes of meniscal repairs using various all-inside meniscal repair devices. Arthroscopy 2000;16:E17, 20 Kumar A, Malhan K, Roberts SN. 20. The Meniscal Root Repair System from Smith & Nephew is designed to support one- or two-tunnel arthroscopic knee procedures. 7. Given the paucity of randomized controlled studies comparing different all-inside meniscal repairs, no definite conclusions can be made regarding the difference in clinical outcomes of various all-inside meniscal repair devices. The basic method of repair and our approach to these different types of tears is presented. The over-the-back marking hook sits securely over the back of the tibia to allow stable drilling using a 6 mm FlipCutter II reamer for socket preparation. Hechtman and Uribe. Exp. There should be a vascular bed on the synovial side of the tear. For Arthroscopic bankart and SLAP lesion repair. Deteriorating outcomes after meniscal repair using the Meniscus Arrow in knees undergoing concurrent anterior cruciate ligament reconstruction: increased failure rate with long-term follow-up. (From Cooper D, Arnoczky S, Warren R. Meniscal repair. The end result is a single loop of suture with a clever self-locking knot on the meniscal surface. Figure 3-1 The zone system of meniscal tears. (C) First implant and tensioned suture construct after release. My Blog acufex meniscal stitcher set We are sorry but you must be a DOTmed user to save searches. One disadvantage is all-inside meniscal repair techniques tend to perform inferiorly to traditional suture repair in biomechanical strength testing.5,7,22,30,32 Whether this is of clinical importance has not been determined. Meniscal Repair System. We are distributor of medical Devices. Level of Evidence: Level IV, systematic review. The Mitek meniscus fastener is a double T-shaped device (polypropylene or PLA) that is delivered via a loaded needle and gun system. Onsite or virtual inspection available. This scatter chart shows the trend of increasing failure rates with longer followup for the meniscus arrow. Manual searching of the reference lists of these articles yielded 1 additional manuscript. Letters, biomechanical studies, animal studies, in vitro studies, duplicate studies and non-English language papers were excluded. 5. Would you like email updates of new search results? ), Differential Diagnosis and Concomitant Injuries. We also found no notable differences in the reported failure rates of various devices with the length of fol-lowup. Albrecht-Olsen P, Kristensen G, Burgaard P, Joergensen U, Toerholm C. The arrow versus horizontal suture in arthroscopic meniscus repair: a prospective randomized study with arthroscopic evaluation. Designed to freshen the edge of the meniscal tear prior to repair. Tension is applied to test the seating of the implant. Federal government websites often end in .gov or .mil. Hantes ME, Zachos VC, Varitimidis SE, Dailiana ZH, Karachalios T, Malizos KN. For the meniscus arrow and T-fix device, there is a trend toward higher failure rates with longer followup. Clinical failure rates of available all-inside devices range from 0 to 43.5%. In general, tears repaired with all-inside devices were longitudinal, vertical tears greater than 10 mm (Table 1). Find Smith & Nephew, Arthrex, ConMed, and Arrow for sale on Machinio. Traumatic tears are more suitable for repair than degenerative type tears. The site is secure. Common signs of a meniscus tear include joint line tenderness, effusion, lack of knee extension, positive McMurray test, and patient apprehension noted with hyperflexion of the affected knee. Posterior horn tears are approached from the ipsilateral portal, and middle third and anterior tears are approached from the contralateral portal. ACUFEX Anatomic ACL Guide System for double bundle ACL reconstruction lets you restore the anatomic footprints of the AM and PL bundles. (A) Curved delivery needle positioned 90 degrees to split cannula. Epub 2013 Oct 10. With the rising popularity of these new all-inside meniscal repair devices, it is necessary to assess the effectiveness of various all-inside surgical interventions used in the treatment of meniscal tears. Before selecting a cannula, load the screw onto the driver by placing the needle into the cannula of the screw and turning the driver counterclockwise. With an all-suture method of fixation, the AS Meniscal Repair Device eliminates any migration risk of broken tacks or anchors which could cause damage inside the knee and may lead to increased operative time during removal. Open meniscal repair was done by to close the mouth of surgically open intrameniscal cyst with the help of 2.0 FiberWire horizontal sutures were taken by inside out technique and meniscus repair was done. acufex meniscal repair system. 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. and transmitted securely. Arthroscopic techniques include inside-out repairs, outside-in repairs, and all-inside repairs. 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. Meniscal root avulsions are a challenging injury causing meniscal extrusion and loss of hoop stress distribution, which can lead to the development of knee arthritis.1 Securing the meniscus in a small bone socket has proven to be an effective means to restore hoop stresses and improve outcomes.2 The FlipCutter II reamer and meniscal root marking hook allow for a minimally invasive RetroConstruction repair technique that helps preserve bone while securely fixing meniscal tissue. Formal physical therapy is employed for about 12 weeks after surgery. After visual assessment, probe the tear and measure for proper Arrow length. The surfaces of the tear should be freshened with a meniscal rasp or small-diameter shaver. Moreover, difference in clinical failures may also be influenced by how failure was defined in the study. All-inside techniques obviate the need for additional incisions and decrease the risk to neurovascular structures. It also features clear, laser-etched depth markings on the specially coated needles, allowing for precision in depth of penetration. 10. In tears where the vascularity is not readily obvious, clinical judgment must be made as to the appropriateness of the tear for repair. It also serves to stop small cartilage fragments from flaking off are causing a reactive effusion. Midterm results of meniscal repair using the BioStinger meniscal repair device. Historically, inside-out repair is the most common type of arthroscopic meniscal repair, but all-inside meniscus repairs are becoming more common with the invention of various implants including: meniscal arrows, darts, screws, staples, and other suture devices. Subscribe to get full access to this operation and the extensive Knee Surgery Atlas. 9. 19 ), Pre-Owned MPR Minimally Invasive Knee Positioner (MIKP). Thanks to its preloaded implants, pre-tied sliding knot, and innovative pusher/cutter device, this innovative system lets you deploy two implants vertically or horizontally on either side of the meniscus, tighten the suture, and trim the excess. Manufacturer: Body Solid. Abnormal signal often persists even in healed menisci. . Device failure for all of the all-inside meniscus repair devices ranged from 0% to 43.5% 28,38 ( Table 2 ). In: McGinty J, Caspan R, Jackson R, et al., eds. This will leave a 2 to 3 mm suture tail. Barrett GR, Treacy SH, Ruff CG. 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. Please try again soon. There have been many advances in meniscal repair since Thomas Annandale performed the first meniscus repair in 1883.3 Historically, a total meniscectomy was the primary treatment for a torn meniscus, but a better understanding of the function of the meniscus has led to the development of new meniscus-preserving interventions. Barber FA, Johnson DH, Halbrecht JL. Power Supply Voltage Pull the trigger to advance the fastener. The operating surgeon should be prepared to perform several meniscal repair techniques including all-inside and traditional, suture-based repairs. view more, Acufex 013351 Orthopedic Surgical Driver. The failure rates ranged from 0 to 43.5%. You may be trying to access this site from a secured browser on the server. Arthroscopic meniscal repair using the BioStinger. Sold as pictured. 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. Again, a bleeding surface should be readily visible on the synovial side of the tear. The ZoneNavigator System revolutionizes inside-out meniscal repair with single-handed control of needle placement. Each meniscus is divided into radial thirds represented by the letters A to F. The meniscus is then subdivided into circumferential thirds represented by 1, 2, or 3. Clearfix Meniscal Screw Surgical Technique Guide, 2001, 11 Barber F, Herbert M. Meniscal repair devices. Unauthorized use of these marks is strictly prohibited. Loose repair devices may detach from meniscal tissue. ACUFEX Meniscal Root Repair (3) GMDN Term. Business & Industrial; Agriculture & Forestry; Construction; Electrical & Test Equipment; Fuel & Energy; Healthcare, Lab & Life Science; Dental; Imaging & Aesthetics . Insert the delivery needle in the meniscus 4 to 5 mm from the first implant, If the suture repair needs to be tensioned, a knot pusher may be threaded over the suture and the desired tension achieved. OMNISPAN System Surgical Technique DePuy Synthes Mitek Sports Medicine 3 SURGICAL TECHNIQUE Meniscal Repair System The OMNISPAN Meniscal Repair System consists of a single-patient, multi-use applier and needles with pre-loaded implants in 0 (straight), 12, and 27 options. Correspondence to: C. Benjamin Ma, MD, University of California, San Francisco, Department of Orthopaedic Surgery, 500 Parnassus Avenue, MU 320W, San Francisco, CA 94143. Barber FA, Herbert MA. For example, some studies look at meniscal repairs occurring in a knee with concurrent ACL reconstruction. 1. Zone 0 is the meniscosynovial junction. Disclaimer. $1,299.99 + $96.05 shipping. 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. 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Operative Arthroscopy, 2nd ed. Blue Bell, PA: Bionix, 1998, 9 Albrecht-Olson P, Lind T, Kristensen G, Falkenberg B. Scott GA, Jolly BL, Henning CE. Select the cannula that allows the most perpendicular approach to the tear. This package includes a(n) (2) Adjustable Incline Bench, For warranty information please visit our FAQ page. Am J Sports Med. Steenbrugge F, Verdonk R, Hurel C, Verstraete K. Arthroscopic meniscus repair: inside-out technique vs. Biofix meniscus arrow. The Global Unique Device Identification Database (GUDID) contains key device identification information submitted to the FDA about medical devices that have Unique Device Identifiers (UDI). It is ideal for the central posterior horn tears that are difficult using conventional techniques. From the *University of California, San Francisco School of Medicine; and the University of California, San Francisco, Department of Orthopaedic Surgery, San Francisco, CA. Excellent condition. 33. 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). Kocabey Y, Nyland J, Isbell WM, Caborn DN. Figure 3-3 (A) Bionix Arrow. 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 . All of the studies, except one1 in this review, have a minimum followup of at least 6 months (Table 2). Institution: The Worcestershire Acute NHS Trusts, Uk. 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. CE Mark The device with the longest average followup is the meniscus arrow with Lee and Diduch27 reporting an average followup of 79.2 months. Using the criteria above, this process of exclusion yielded 30 manuscripts. Accessibility Biodegradable arrows for arthroscopic repair of meniscal tears. Clinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country. 09792457 | Ellermann A, Siebold R, Buelow JU, Sobau C. Clinical evaluation of meniscus repair with a bioabsorbable arrow: a 2- to 3-year follow-up study. The incidence of healing in arthroscopic meniscal repairs in anterior cruciate ligament-reconstructed knees versus stable knees. Meniscal repair using the FasT-Fix all-inside meniscal repair device. Wolters Kluwer Health This releases the first suture retention bar on the outside edge of the meniscus.