For your patients whose arthritis is too severe for a HemiCAP®, Arthrosurface® also offers the CheckMATE® Fusion plate, a MTP Arthrodesis system. This system features low profile & anatomically pre-contoured plates with an interfragmentary screw guidance system to provide accurate & rapid installation. There are multiple plate options with either a combination of locking and non-locking holes or all-locking variable angle holes for primary or revision cases.
- Custom low profile elevator to gain exposure of metatarsal head and phalangeal base
- Multiple plate options for primary or revision cases
- Variable angle locking holes allow desired orientation of screw placement
- Built in templates for sizing purposes
- Low profile, anodized titanium alloy bone plate
- Interfragmentary screw guide eliminates the need for fluoro guidance and eyeballing
- Tack pins eliminate drilling, stabilize the plate and create pilot holes for the screws
- Color coded nubbins for locking and non-locking screws built into the plate are provided pre-assembled and sterile
- Depth gauge is built into the inter-fragmentary screw guide
- Compression clamp technology built into the plate allows up to 2mm compression across the MTP joint
The CheckMATE® Arthrodesis System consists of a anatomic Bone Plates (Standard or All-Locking; Right or Left) and Bone Screws (locking, non-locking & interfragmentary). The instruments are organized in the order of surgery, proceeding from left to right and top to bottom. The procedure begins with preparation of the 1st metatarsal head and phalangeal base using the cup and cone reamers. The appropriate precontoured Bone Plate is selected. The laser line etch mark on the plate is aligned with the 1st MTP joint. The plate is temporarily affixed by placing tack pins distally, and proximally within the compression slot. If using the standard plate, the joint is reduced using the Compression Clamp which is positioned on the compression slot tack pin and on one of the distal nubbins. A Tack Pin is then inserted in the other proximal bone plate hole(s) to maintain the compression. If using the all-locking plate, the proximal tack pin is removed and an appropriate length non-locking screw is inserted. The ramp feature on the compression slot of the all-locking plate provides dynamic compression at the joint as well as at the plate to bone interface as the non-locking screw is inserted and makes contact with the plate.
The Interfragmentary Aimer is then placed in a distal-medial to proximal-lateral orientation across the 1st MTP joint, followed by creation of a pilot hole using a guide wire through the aimer. The Depth Gauge on the aimer is used to determine the appropriate length of the Interfragmentary Screw, which is inserted using the Hexalobe Driver. Following this step, if using (i) Standard Plate: the non-locking screws are inserted into the non-locking bone plate holes (one with gold nubbins) after removing the nubbins and measuring the screw length required using the depth gauge. This procedure is repeated for the locking screws that are placed in the locking bone plate holes (one with blue nubbins). In the final configuration, the plate has 2 Non-Locking Screws and 4 Locking Screws (ii) All-Locking Plate: the locking screws are inserted into the locking bone plate holes (one with blue nubbins) after removing the nubbins and measuring the screw length required using the depth gauge. In the final configuration, the plate has 6 Locking Screws and 1 Non-Locking Screw.
Hallux Valgus Correction System
The KISSloc™ Suture System consists of two low profile titanium plates and a self-cinching suture construct that corrects Hallux Valgus by reducing the intramedullary angle between the 1st and 2nd metatarsal. KISSloc™ allows accurate tunnel placement, uses strong #5 suture, and the self-cinching feature adjusts the correction angle for each patient individually. The small Ø1.2 mm bone tunnels and low profile plates minimize stress risers and distributes the load across each bone bridge.
- Large bone plates disperse metatarsal loads over greater area.
- Small bone tunnels minimize stress risers
- Strong knot construct prevents IM angle slippage
- Artifact-free titanium plates allow for better post-op imaging
Surgical access is routine, using standard access surgical incisors and orthopedic techniques.
Create adequate surgical incisions to expose the bones to be reduced. Using the Drill Guide, insert a Passing Pin through both cortices of the 2nd metatarsal. Confirm position of the 2nd bone prior to inserting the Passing Pin through the 1st metatarsal. Repeat for the second Passing Pin.
Link the Contractible Loops of the KISSloc™ Suture to the eyelets of the Passing Pins by using the shuttle suture. Pass the Contractible Loops through both bones. Tension the Contractible Loops so the Suture Plate sits flush on the surface of the 2nd metatarsal. Hook the exposed ends of the Contractible Loops over the Arrow Plate, such that each loop is captured by the adjacent arrow head. Hold the Arrow Plate off of the surface of the 1st me tarsal while reducing the KISSloc™ Suture. Reduce the KISSloc™ Suture by pulling the Locking Limbs, opposite the Contractible Loops, away from the Suture Plate. Manually reduce the two bones to the desired final position.
While maintaining reduced position, complete placement of the KISSloc™ Suture by applying one final cinching of the locking limbs so desired tension is maintained in the system. Confirm that the Contractible Loops are captive on the Arrow Plate, and that the Arrow Plate and Suture Plate are still in the correct position. Tie a square knot with the Locking Limbs against the Suture Plate. Trim excess suture.
- Wider, low profile plates distribute the load across the bone
- Small tunnels reduce the risk of fracture
- A secure and stable construct still allows coronal motion
- Suspensory fixation eliminates the need for bone healing associated with osteotomies
- Simple technique that starts on the second metatarsal to optimize tunnel placement
- Strong #5 suture for a more stable correction & reduced slippage
- A fast technique using simple instrumentation and a self-cinching construct
- Stable and flexible fixation that still allows coronal motion
- Self-cinching knot allows real time evaluation of suture tension up to 14⁰ of correction
- Lateral to medial approach allows more accurate pin shot on second metatarsal.