TATE ELBOW - KYON Veterinary Surgical Products · Purc The p segm elbow (righkinem Impl 3D r Larg...
Transcript of TATE ELBOW - KYON Veterinary Surgical Products · Purc The p segm elbow (righkinem Impl 3D r Larg...
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TATE ELBOW Randy Acker DVM
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End stage cartilage loss
Stem Cells?
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Elbow Arthritis Many new options
PAUL Unloading
Replacements CUE Wendleberg John Innes Iowa TATE
Watch and wait Design evolution
Joint replacement – long term results only get worse
Kyon total hip and ten years (cement)
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Design Evolution What we have learned – what is next
TPLO and TTA
TATE Elbow Five years
End stage elbow Mill and drill
Excited about implants for younger patients
Human: elbow, ankle, and knee
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Progress
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The Problem Elbow dysplasia
Common Current treatments often fail leading to progressive
OA
Tate
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Napkin to implant Concept
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Ulnar nerve Deep digital flexor only Sensory branch Triceps medial head
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Unlinked Systems (cemented)
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Linked Systems (cemented) Chancrin, 1989, France
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Center&of&rotation&
Collateral&ligaments&
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Surgical Technique
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Surgical Technique
Positioning - Stabilization
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Surgical Technique
Articular Surfaces Preparation
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Milling
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Surgical Technique
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Surgical Technique
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Surgical Technique
Range of Motion
+/- debridement If impingement
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TATE Pilot study Perioperative complications
Fractures, dislocations, other
Morbidity Cook – temper your excitement until you put it in a
clinical case
Some projects were scrapped instantly
Repeatability
Technical ease
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Clinical'Cases:'Pilot'Study'
#1 #2
#3 #4
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Clinical'Cases:Pilot'Study'
#5 6
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Pilot study Drop the ulnar ostectomy
Instruments COR Device, arm support, MEO guide
Courses
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Case Selection Owner has tried other treatments and feels the
patient is in pain
Global cartilage loss
Most are chronic elbow dysplasia cases
Some malunions and subluxations Humeral malunions
Not for old fractures if the mill does not remove the bone
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Implant limitations
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TATE pre-operative evaluation
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Digital Templating – Orthoview
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Post-op Radiographs
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Post-op Radiographs
Alignment in the frontal
plane: Varus/valgus
Reduction of the MEO
Radioulnar component
centered on the ulna
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Difficult case
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Post op
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TATE Elbow™ – Functional outcome
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Summary TATE Elbow™ - RLA
Primary surgeon 30 cases – Sun Valley Animal Center No explants or fusions Longest case 40 months
Assistant surgeon 20 cases One amputation One fracture – repaired One MRSA – currently on antibiotics
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Survival study Six patients have died of other causes at up to 38
months later
Average age is ten average weight is 70 #
No premature explants
Histomorphometry being done
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Bone ingrowth
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Radiographic evaluation
POST3OP&SX:&01311308&
APPROX.&7&MONTHS&POST3OP&08317308&
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On the workbench Surgical simplification
Alignment plate MEO cutting tool
Bone ingrowth R-U component Hollow segmented post
Soften constraints HA coating
Medial compartment replacement
Radial head – three component
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Floating radial head Young dogs
Confidence you have with a hip replacement
Each moving part increases your failure chances
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Prototype to production
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Younger dogs Dr. Moore
TPLO to TKA
Morbidity hip vses. knee
Periarticular injections Ropivicaine Torridol Morphine Decadron
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Unicompartmental Where we started
Will it prevent medial collapse and lateral compartment disease
You only get one surgery on our patients
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Medial epicondylar osteotomy
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Locking alignment plate
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Over milling
Over milling caused by collapse
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Results of changes
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Trabeculae on HA coated femoral stem
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Unlinked Systems (cemented)
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Dejardin case Graftys and 15 implant
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Older patient Abby
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Post op
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Day one
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LONG TERM
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