Das subtalare ProStop Arthrorise-Implantat dient zur Korrektur des hyperpronierten Fußes durch Stabilisierung des Subtalargelenks. Es soll eine übermäßige Eversion des Rückfußes durch Blockierung der Talusverschiebung verhindern. Die Konusform der ProStop-Schraube entspricht der Anatomie des Tarsalkanals, sodass die Schraube gut sitzt und sich nicht lockert. Das stumpfe Gewindedesign unterstützt dabei den Implantat-Knochen-Kontakt.

Foot and Ankle

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A comprehensive overview of a product team’s portfolio.

Ein umfassender Überblick über das Portfolio eines Produktteams.

Kataloge

Visão geral e abrangente do portfólio de produtos de cada segmento.

Catálogos

Descripción general y completa sobre la cartera de productos de cada segmento. 

Catalogs

Foot and Ankle: Next Generation in Foot and Ankle Technology 2023

A document containing information about Arthrex products and product lines.

Ein Dokument mit Informationen über Arthrex Produkte und Produktlinien.

Broschüren

Documento contendo informações sobre produtos e linhas de produtos da Arthrex.

Brochuras

Documento que contiene información sobre los productos y líneas de productos de Arthrex.

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Brochures

ProStop® Implant For Correction of Posterior Tibial Tendon Dysfunction

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ProStop® - Para la correción de la disfunción del tendón tibial posterior

Lew Schon, MD, (Baltimore, MD) describes his rationale for incorporating the ProStop® subtalar arthroereisis implant into his practice. The ProStop implant was designed to treat patients with Stage II flexible flatfoot deformities. In this video, Dr. Schon shares his surgical experience of flatfoot cases where he uses the ProStop implant to correct the deformity.

video

Presentation Videos

ProStop® Subtalar Arthroereisis Implant

I'm Liu Xiao, an orthopedic surgeon at MedStar Union Memorial in Baltimore, Maryland. Here to talk about the ProStop. The ProStop is an arthrodesis implant, an implant that is used between the talus and calcaneus to help position the talus on top of the calcaneus and correct proper alignment between the talus and navicular. The ProStop can be used as a standalone procedure, or as an adjuvant procedure in both pediatric feet and adult feet. I have found that ProStop a very useful adjuvant in my treatment of these patients. The Arthrosis concept was to splint the bones in proper position and allow correction of the soft tissues through natural healing processes. This probably doesn't occur unless we have a pediatric case with over two years of growth remaining. In the cases where we would use it in adult population. We're typically doing it in conjunction with soft tissue or bony procedures. I have done it in 24 cases of adult flat feet, where we had a severe flat foot next to a more moderate flat foot. In these situations, I had to do major bony and soft tissue reconstructions on the more severely affected foot. And on the other foot I just inserted the ProStop. I did so because the patient was already in a brace, having trouble functioning, and I was concerned that during the reconstruction recovery, on the more affected side that the other foot would fail. We are augmenting the strength of our reconstruction by using the ProStop and effectively blocking excessive eversion of the foot, leaving physiologic valgus, and making sure that we don't supinate the foot inadvertently by overstuffing the sinus tarsi. It's important to note that there is no weight limit to use of the ProStop implant. The biggest consideration with a heavier patient is the degree of the deformity, not their weight. There was a study recently published in the Journal of Pediatric Orthopedic Surgery, July 2015. Chung et al. Presented a prospective comparison of subtalar arthrosis with lateral column lengthening for the painful flat foot, and they found in this pediatric population that the both procedures were effective. In my opinion, this article provided a strong argument in favor of use of the subtalar arthrosis. Given the potential for complications with the lateral column lengthening that would include nonunion malunion impingement Need for hardware removal or worry about extrusion of the graft. The Arthrex is a simple, easy, safe, and effective procedure versus the lateral column lengthening. Although the lateral column lengthening can be performed and is performed very frequently by skilled providers, the recovery time after a lateral column lengthening is also much greater than the recovery from a subtalar implant. The subtalar implant patient can walk on the foot right away, and after two weeks the stitches are removed. They progress with activity as tolerated, even though they may be sore and still have some aches and pains, and feel unusual about walking on their foot, which has been flat for the last many years. They can still get around, unlike with the lateral column lengthening. The patient has to be off their foot for six weeks and between 6 and 12 weeks progressively weight bearing. Not to overdo it for fear that the osteotomy will collapse. And also, it does take longer for these cases to heal, because typically they're done in conjunction with soft tissue procedures. Thus, if we're looking at similar efficacy based on the Chung study between the subtalar arthrosis and lateral column lengthening, I feel this is a strong push for the subtalar arthrosis because of the quicker recovery time and the lower risk of complications. This is a really interesting case. This was a nine year old boy who was the son of an orthopedic surgeon. He was very bright and very agile and was excellent in athletics. He developed a bilateral painful flat foot deformity left greater than right. He wore braces, performed exercises to strengthen the foot. He was doing some Achilles stretching, but had continued pain and deformity as he had been active with athletics. He became more and more weak, more fatigued, and his parents became concerned about the pain, dysfunction and deformity. They wanted to avoid a major reconstruction in the future and became interested in the ProStop arthrosis. They brought him to me from another city to have an evaluation and potentially have bilateral ProStop inserted in one. Anesthesia. On physical exam, the foot and ankle were supple with relatively weak posterior tib tendon function, the foot inverted with four out of five strength with pain along the posterior tib tendon. The arch was low, particularly more on the left than the right. He had a lack of varus positioning when he rose up on his toes. More on the left than the right. He walked with an a propulsive gait without activation of the posterior tib tendon. Tenon. There was some mild Achilles contracture and some forefoot varus. His pulse is. Neurologic status were normal. Here's his X-rays. You see here on the lateral view of the foot weight bearing. The shoulder of the talus sits deep in the ankle. The medial column is below the lateral column. This is a severely flat foot. You do see the growth centers open. And so this is a nine year old foot. And we anticipate maybe four years or more of growth, maybe six years of growth. On the right side, you see also that cassian's angle is obscured by the shoulder of the talus. The medial column is at the same level as the lateral column. So on the AP view you see that on the left foot we had almost 50% coverage of the talus by the nvic. And on the right side about 40 to 45% on average. So this was a very flat foot. But he was nine and I was open to considering the Arthrex as the sole procedure. You see on these oblique views that there were no coalitions. Here's his hind foot view again showing no coalitions. When you when you see him standing here, you see the severe valgus. It's about 25 degrees on the left, maybe 23 degrees on the right. When he rides up on his toes, his left heel stays in neutral. The right side goes into Varus. He had weakness with inversion against resistance. And he walked with an a propulsive gait. Here's his foot again, showing the toe rise and the weakness. The collapsed arch with the midfoot sitting on the ground. So we did bilateral ProStop implants in one setting. Here you see the guidewire going across the sinus tarsi out over the sustentaculum talus. Then we inserted the the sizer and you could see the lateral edge of the sizer was just medial to the lateral side of the talus and did not cross the midline. Then I removed the implant screwdriver. And you see that the screw is still in the proper position. And then I remove the guidewire and you see again that the implant has stayed in position about 50% across the neck, with the lateral aspect of the implant just medial to the lateral shoulder of the talus. And here's the lateral view showing the implant properly positioned in the sinus tarsi. Here he is pre-op on the left side. Here he is post-op. And you can see the talus is now sitting up relative to where it was before. And the medial column is now sitting about a centimeter higher than the lateral calm on the right side. Here's the pre-op. Notice the obliterated gains angle and the low arch. Now look at the post-op. You see, the talus is lifted up. The shoulder of the talus sits back, no longer in the ankle, and the medial column is now about a centimeter and a half above the lateral column. So a very excellent correction. Now let's look at the AP. Here's pre where we had about 50% coverage on the left side 45 or so percent on coverage on the right side. And now look at the coverage. Maybe he has 10 or 15 degrees on coverage on the right and on the left, maybe 20% on coverage. So pre again and post. Now this kid this is how he looked pre. This is how he looks post nicely corrected. Notice I left him with physiologic valgus. Here he is back at sports. And he went back to Back to sports about three months post-op and progressively did well. He's able to play at a higher level than he was pre-operatively. He's able to run fully. No limitations, no fatigue. His parents are delighted. He's delighted. He's not needed. The implants removed and it's now nearly four years and we have a huge success. A very gratifying success because we did this in one procedure, both sides with one anesthetic exposure and a very short recovery time. I do think if you follow the technique and do the proper procedures as indicated, you will have excellent outcomes with a ProStop device. Thank you very much.

A Flexor Digitorum Longus Tendon transfer is indicated for patients with dysfunction of the posterior tibial tendon, where the tendon has become stretched beyond its functional length or has ruptured. As a result, the FDL tendon is transferred into a bone tunnel in the navicular bone and fixated with a screw from the Bio-Tenodesis™ Screw System.

A general overview including the relevant steps of an Arthrex surgical technique. These animations always include a voice-over explaining the process.

Eine allgemeine Übersicht, einschließlich der relevanten Schritte einer Arthrex Operationsanleitung. Diese Animationen enthalten immer Voice-Overs, die den Prozess erklären.

Operationstechnik-Animationen

Visão geral incluindo as etapas relevantes de uma técnica cirúrgica Arthrex. Essas animações sempre incluem uma narração explicando o processo.

Animações de técnicas cirúrgicas

Descripción general que incluye los pasos relevantes de una técnica quirúrgica de Arthrex. Estas animaciones siempre incluyen una voz en off que explica el proceso.

Animaciones de técnicas quirúrgicas

Surgical Technique Animations

Flexor Digitorum Longus (FDL) Tendon Transfer

Flexor digitorum longus tendon transfer, utilizing Arthrex tenodesis screw technology to aid in flat foot reconstruction procedures. An FTL transfer is typically performed as an adjunct to other corrective flat foot procedures. Begin by making a 5 to 7 centimeter incision over the medial aspect of the navicular bone and a vicolo cuneiform joint, and carry out proper dissection to expose the FTL tendon. Once the tendon has been located, cut the FTL and place a number two FiberWire traction stitch at the distal tip of the tendon and measure the diameter of the tendon using the appropriate tenodesis driver handle. It is important to use a reamer that is 0.5mm to one millimeter larger than the measured tendon diameter. Place a 2.4mm tenodesis guidewire into the navicular from plantar to dorsal drill with the appropriate reamer to a depth of 17mm. Maintain tension on the FDL and mark the tendon at the insertion point of the bone tunnel. Then measure a point 17mm distal to the insertion site and make a second mark. Cut any excess tendon and whipstitch appropriately using a number two FiberLoop. Load the appropriate tenodesis. Screw onto the driver and shuttle a number two suture. Loop through the tip of the Bio-Tenodesis driver using the nitinol passing pin. Capture the tendon with a suture loop and insert the tendon and driver into the navicular tunnel. Hold the thumb pad on the Bio-Tenodesis driver and turn the handle clockwise until the screw is fully seated and flush with the cortical bone. Cut the remaining sutures and the tendon transfer is complete.

Soluciones Arthrex para el Pie Plano

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Videos - OP-Anleitung

Vídeos — Técnicas cirúrgicas

Videos de técnicas quirúrgicas

Surgical Technique Videos

ProStop® Subtalar Arthroereisis For Correction of Posterior Tibial Tendon Dysfunction

The following procedure is performed by Doctor Amol Saxena in Palo Alto, California. The patient is placed supine. If needed, a bump can be placed underneath the ipsilateral hip. The incision markings are directly over the sinus tarsi slash tarsal canal region. The neurovascular structures are identified superiorly and inferiorly. The nerve. I prefer to make the skin incision within the skin lines over the tarsal canal. And this is generally between 1 and 2cm. The incision is deepened with blunt retraction. One can use a hemostat or a freer and then the guidewire is inserted. And this should be placed from anterolateral to posteromedial. And if you're making an incision medially, you can go ahead and create that incision and allow the guidewire to exit medially. Otherwise you can tent the skin and make a small stab incision over the guidewire and the medial aspect. And then people often like to stabilize this guidewire with a hemostat clamped onto it, so that the guidewire does not piston through the tarsal canal. So once the guidewire has been established in the proper direction with the tarsal canal, it's a good idea to assess the subtalar range of motion and get an appreciation for how much extraneous eversion the patient has. We'll start sizing the implant by placing the actual sizers over the guidewire through the tarsal canal. It starts with the size seven, and if you see too much excursion with the size seven, you can certainly just start sizing up the next size, which is eight. If you feel like you have a good reduction of the eversion, then you can certainly just stop. What I like to do is look at where the skin lines line up with the laser markings on the sizer. Generally, these markings line up with the skin between 2 and 3cm. So that gives you a good idea for depth. And then again you want to assess the subtalar eversion. And if you have too much eversion then certainly go up with the size until you get a sufficient reduction of the eversion. Then you can image when you take the intraoperative imaging, what you want to look for is the Taylor neck bisection. So get an appreciation for that, because the leading edge of the implant, or even the sizer should not go beyond this. Namely, the medial portion of the implant should not go beyond the Taylor neck bisection. Then you can actually remove the sizers when you've got the appropriate size that you think reduces the eversion or extraneous pronation. Generally, the most common sizes are between 8 and 10. After you've placed the actual implant, certainly you can re-image and verify the placement again. Two ways to do this are by looking for the Taylor neck bisection, making sure the implant is not medial to this, and assessing where the laser markings on the screwdriver line up with the skin. This is generally between 2 and 3cm. Then you can remove the screwdriver. A helpful way of making sure the implant does not dislodge is keep the hind foot in eversion. Or you can put an instrumentation on the actual implant itself just to help stabilize it, and then remove the screwdriver and subsequently the guidewire. And then I prefer to get final intraoperative views again, verifying the placement of the tarsal canal, both in the lateral plane and in the AP plane, making sure the implant is to the Taylor neck. Bisection, but not medial and skin is closed with two horizontal mattress sutures. And then if you're performing additional procedures, certainly those can be performed. Those would dictate the post-operative care. Otherwise, if just the ProStop procedure is being performed, a patient is placed in a below knee cast boot, generally between 2 and 4 weeks. Sutures get removed at two weeks. Other Arthrex surgical solutions for posterior tibial tendon dysfunction include the TRIM-IT screw system for calcaneal osteotomy, the Bio-Tenodesis screw system for FTL tendon transfer. A variety of arthritic suture anchors for PTT repair. And the LPs plate for cotton osteotomy. For information on the Arthrex Surgical Skills Training program, contact Arthrex or visit the Arthrex website at arthrex.com.

ProStop Arthroeresis Instrumentation Case

ProStop Instrument Case for Arthroereisis SubTalar Implant

Caja de instrumental para implante para artrorrisissubastragalina ProSto

CAIXA PARA INSTRUMENTAL PROSTOP ARTHROEREISIS

ProStop Arthroereisis Driver, 3.5 mm

ProStop, Setzinstrument, kanüliert, Hex, 3.5 mm

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 7 MM

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 8 MM

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 9 MM

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 10 MM

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 11 MM

AJUSTADOR DE TAMANHO PROSTOPARTHROEREISIS 12 MM

ProStop Arthroereisis Extraction Tamp

Arthrorise Stößel zur Implantatentnahme

Arthroereisis Arthroereisis Extraction Tamp

Nivelador de extracción ProStop para artrorrisis

ProStop Arthroereisis Instrumentation Set

ProStop, Instrumentenset, für subtalares Arthrorise-Implantat

ProStop Subtalar Arthroereisis Instrument Set

ProStop Arthroereisis Implant, 7 mm x 12 mm

ProStop Subtalar Arthrorise Implantat, 7.0 x 12.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 7 x 12 mm

Implante para artrorrisis subastragalina ProStop, Ø 7 mm x12 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 7MM X 12MM

ProStop Subtalar Arthroereisis Implant, 8 x 14 mm

ProStop Subtalar Arthrorise Implantat, 8.0 x 14.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 8 x 14 mm

Implante para artrorrisis subastragalina ProStop, Ø 8 mm x14 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 8MM X 14MM

ProStop Subtalar Arthroereisis Implant 9 x 14 mm

ProStop Subtalar Arthrorise Implantat, 9.0 x 14.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 9 x 14 mm

Implante para artrorrisis subastragalina ProStop, Ø 9 mm x14 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 9MM X 14MM

ProStop Subtalar Arthroereisis Implant, 10 x 14 mm

ProStop Subtalar Arthrorise Implantat, 10.0 x 14.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 10 x 14 mm

Implante para artrorrisis subastragalina ProStop, Ø 10 mm x14 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 10MM X 14MM

ProStop Subtalar Arthroereisis Implant, 11 x 16 mm

ProStop Subtalar Arthrorise Implantat, 11.0 x 16.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 11 x 16 mm

Implante para artrorrisis subastragalina ProStop, Ø 11 mm x16 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 11MM X 16MM

ProStop Subtalar Arthroereisis Implant, 12 x 16 mm

ProStop Subtalar Arthrorise Implantat, 12.0 x 16.0 mm, steril, IM

ProStop Subtalar Arthroereisis Implant, 12 x 16 mm

Implante para artrorrisis subastragalina ProStop, Ø 12 mm x16 mm

IMPLANTE PARA ARTROEREISIS PROSTOP 12MM X 16MM

ProStop Arthrorise Führungsdraht, Ø 1.98 mm, Länge 30.5 cm

PINO GUIA ARTHROEREISIS PROSTOP (305MM X 1.98MM)

ProStop Plus Guide Pin, .054" Diameter

ProStop Plus Arthrorise Führungsdraht, Ø 1.37 mm, Länge 30.5 cm

ProStop®-Arthrorise

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ProStop® Subtalar Arthroereisis Implant

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Videos - OP-Anleitung (1)

ProStop® Subtalar Arthroereisis For Correction of Posterior Tibial Tendon Dysfunction

Broschüren (3)

ProStop® Implant For Correction of Posterior Tibial Tendon Dysfunction

ProStop® - Para la correción de la disfunción del tendón tibial posterior

Soluciones Arthrex para el Pie Plano

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Foot and Ankle: Next Generation in Foot and Ankle Technology 2023

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Flexor Digitorum Longus (FDL) Tendon Transfer

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ProStop® Subtalar Arthroereisis Implant

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