Die flexible 8.25 mm Trim-It™ Custom Hip Cannula besteht aus weichem Polyvinylchlorid-Kunststoff und trägt so zu einer verbesserten Instrumentenmobilität und einer Minimierung der iatrogenen Traumatisierung der Gelenkflächen bei. Die verstärkten proximalen Gewindegänge verfügen über einen außergewöhnlich starken Halt im Weichteilgewebe. Außerdem kann die Kanüle auf Arbeitslängen von 7 - 15 cm zugeschnitten werden, was die Lagerhaltung für den OP reduziert und sie zu einer der vielseitigsten derzeit erhältlichen Kanülen macht.

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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

Hip Next Generation in Soft-Tissue Repair and Reconstruction

A step-by-step demonstration of how a product would (or could) be used in a surgical technique.

Eine schrittweise Demonstration, wie ein Produkt in einer Operationsanleitung verwendet werden würde (oder könnte).

Operationsanleitungen

Demonstração passo a passo de como um produto seria utilizado em uma técnica cirúrgica.

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Surgical Technique Guides

Hip Labral Repair Using the Knotless SutureTak® Anchor Surgical Technique

The 8.25 mm flexible Trim-It Custom Hip Cannula is made of a soft polyvinyl chloride plastic designed to provide enhanced instrument mobility and minimize iatrogenic damage to the articular surfaces. The reinforced proximal threads hold exceptionally well in soft tissue and the ability to cut the cannula from 7 cm – 15 cm working lengths minimizes O.R. inventory and makes it one of the most versatile cannulas available.

A document containing information about Arthrex products and product lines.

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Trim-It™ Custom Hip Cannula

John Gualdoni (Arthrex® Product Manager) discusses the latest technology advancements and innovations in hip joint preservation products. He highlights the features and benefits of some of the recently released hip products including the Hip Labral Scorpion™ suture passer, CapsuleClose Scorpion™ suture passer, TRIM-IT™ custom hip cannula and the CapsuleCut™ blades.

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Presentation Videos

Hip Preservation Product Updates

I want to start off with the first slide just showing sort of what I think is important to know here at Arthrex is that we really offer a full, comprehensive product offering everything from patient positioning to joint access all the way to tracking outcomes in SOS. If you look back, you know, roughly 5 or 6 years ago in 2011, we had some shoulder stuff we were using in the hip. We were making it work. We had a distraction system that was okay at best. And as you look to 2017, kind of where we've gone and where we're going again, we've got that full offering of products from patient positioning, hip distraction system all the way up to curve burst shavers, small implants dedicated just for the hip, and new Knotless technology that I think is very exciting. Patient positioning and hip access some updates. So we've got a very nice hip distraction system table. We've got it outside as well if you want to go through a demo. This system is designed to fit on most beds via some adapters. You've got easy controls for your gross traction and your fine traction. You can also manipulate the hip very easily by some distal controls on the end there. It's a It's a very fluid, very dynamic system. And you can also detach the boot very simply to do a full dynamic range of motion check at the end of your cam. Osteochondral Plasty. Additionally, the perineal post and pad can also be removed. So we've we've put together this nice system. It's easy to set up sets up in roughly seven steps. So it's easy for the staff for your nursing staff as well as for you, the surgeon. Very intuitive with the easily marked controls to manipulate the foot. Additionally, we've updated our hip access instrumentation, so we've just released the new updated hip Synergy.net. We've got a quick connect bridge system, we've got C-mount and IP scopes. There's slightly longer than traditional scopes, so there are 200 millimeter working length. They're not excessively long. So some of the competitive products are roughly 300mm. These are 200mm. So they're long enough for pretty much every procedure you're going to do or encounter in the hip. We've dulled down the ends of these as best we could to make them as atraumatic when entering the joint space as possible, and it's a quick connect bridge. Now, you can you can easily push a button that will connect to the scope as well as to the cannula, so you can easily bounce back and forth between your two portals very quickly, very effectively, very simply, between the two portals that you're maneuvering through. And additionally, again, the traumatic nature of the cannula, we've changed the tip geometry to these. We've removed and made these non fenestrated to make them as atraumatic on the cartilage surface when you're entering the joint space. Additionally, some different hip blades we offer we offer a retractable knife. So this is a left hip specimen anterior lateral with the scope. We're coming in the mid anterior portal. You can see we're going over top of a guidewire. So this blade allows you to safely put a blunt object into the joint space. There's a safety tab on the back of this device. And when you pull that off it exposes the black button. You'll then push that down and pull it up approximately. And that will actually move the sheath. It doesn't move the blade into the joint, it actually moves the sheath out of the capsule. So now your blade is exposed, you can simply do a very reproducible capsulotomy and then you then you can put the sheath back over top of your through your soft tissues, and then bring the device out of the joint. Flip portals and very safely do a capsulotomy. Additionally, we've seen the need for a more reinforced capsulotomy blade, so we just are in the process of launching the CapsuleCut blade. This is a very stout, straight double radius blade, so it's got a very sharp edge on each side, and you can simply cut through the thick iliofemoral ligament and also do a very effective T capsulotomy if you prefer that. We've got a version with a handle on the back end there that's all disposable. We also have a reusable handle for more economical purposes. But again, we're very excited to have this product. You can really go from taking a capsulotomy down from a couple of minutes. You can do this now in seconds. You can simply just push along the capsular tissue and it will cut it like a butter knife right through the tissue. You guys saw this yesterday. The knotless SutureTak. There's a lot of indications for this also in use in the hip. And you can see here this is paired with our hip label Scorpion. The nice thing with this anchor in the hip is it allows you to control that tension very simply and very effectively to avoid any labral reversion away from the femoral head. You'll see You'll see this presented later on this morning as well. But I think, you know, pay attention to the different pearls and techniques for this. There's a lot of unique things to this anchor that you can use for the hips specifically, aside from being a great construct in the shoulder as well. Different suture passers. We have a hip labral Scorpion. This is a fast pass. Scorpion. It allows you to effectively pass a suture from the extra articular side, from where your anchor is placed into the joint space and out in one simple pass. It will fit through an eight and a quarter cannula, and it's designed to go into the joint space so that angle is such that it will shoot the needle into the joint away from the femoral head, and follow your acetabular concavity. If you look here and compare some of the competitive products in the market. So let's say A15 diameter SutureLasso if you look at the area of that, if you do a cross section, just take the area of that metal surface when you cut or what's actually going through the tissue, it's roughly 1.77mm squared. If you take the actual needle that's going through the labral tissue and the hip labral Scorpion, and you cut that into a surface area, you get roughly 0.43mm Millimeters squared, so it's roughly four times smaller than most devices that are on the market. So it really does leave the smallest hole going through your tissue. So the jaws. Again will fit through an eight and a quarter cannula. A nice angle a nice curve to go into the joint. And that needle is is really really small to give you a nice or maintain that suction seal effect in the hip joint to play off the success with that product. We've also launched the capsule closed Scorpion. This device is like any other Scorpion very simple, very ergonomic to use. You simply squeeze the back of your handle to push a needle through that lower jaw. You load the suture in that distal jaw the same way for the first and the second pass. So it gives you a 4.5mm bite of tissue from where your capsulotomy was made for every pass. So very reproducible, very simple, very straightforward to, to use and load. So here's just a quick video showing sort of a cadaver use. So again we're doing a this is a right hip. We're looking at the proximal limb here. So you come down put that lower jaw underneath your tissue. You compress the tissue with that front trigger squeeze to push the needle through the the tissue. You grab the stitch, come out, disengage the suture, load the opposite side. And then we call it kind of walking the dog. So you pull the limb you've already passed and push the device into the joint to avoid any tangles. Flip your jaws and go in the distal limb. Now you can effectively close off within a mattress suture and tie that stitch and pass as many sutures as you would like for both the inner portal and a t Capsulotomy. Looking at different cannula options, we've recently launched the TRIM-IT hip specific cannula. This is designed just for the hip, and you can see here it's a very simple insertion mechanism. So you measure with a calibrated switching stick. You cut the cannula down to the desired length. You simply adjust an obturator and then insert the cannula into the joint space. You can see here in this video demonstration. The cannula itself is flexible. It's a polyvinyl chloride material. So it's very flexible and very atraumatic on the cartilage. It's easy to see through. So again, aside from being able to trim it down to size to custom fit to your patient, again, it's going to be very atraumatic on the articular surfaces and very simple and straightforward to insert. There's proximal threads, so they hold exceptionally well in the soft tissues of the hip. And again you can fit larger and curved instruments down there very easily and very effectively through your soft tissues to the hip joint. So I like to show this video. This compares sort of our polycarbonate, our hard plastic cannulas. If you look here this is a same incision for both of these videos. But the polycarbonate cannula just backs out. If I just pull those threads even though it's fully threaded. I've done a large capsulotomy on this, this patient, you'll pull out the cannula every time. And if you look here, we've increased the thread pitch as well as the diameter on these soft cannulas. And they hold exceptionally well in the soft tissues. So no more do you have to have your patient or excuse me, your PA or your surgical assistant hold the cannula as you're coming in and out with instruments. You can simply leave this cannula in and not worry about it as you're moving on with your procedure. So again, very, very effective for the hip joint itself. We've also launched a new set that includes all these instruments in it. So both Scorpion TRIM-IT cannula instrumentation, the CapsuleCut blade handle, as well as some longer drill guides for our two nine PushLock that are designed just for the hip specifically.

If You Treat Hips Arthroscopically...Think Arthrex

Dave King, MD, (St. Louis, MO) demonstrates a surgical technique for single portal capsular closure of the iliofemoral ligament using the self‐retrieving CapsuleClose Scorpion™ suture passer, TRIM‐IT™ custom hip cannula and #2 FiberWire® suture. Dr. King outlines a straightforward technique for closing an interportal capsulotomy made between the anterolateral and midanterior portals.

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

Arthroscopic Capsular Closure of the Hip Featuring the CapsuleClose Scorpion™ Suture Passer

I'm Dave King from Saint Louis, Missouri. We are going to be talking today about the hip arthroscopic capsular management. So we are specifically going to be talking about closing it with the capsular closure. Scorpion right now, just to give you a little background on my setup. I have my scope in my anterolateral portal. Traditional viewing portal. So through my mid anterior portal, I have the TRIM-IT custom hip cannula, which can be cut down to various sizes. This hip is actually fairly small, so we have it on one of the smaller settings. One thing I really like about this, you can see the portion of it coming in here. We've cut it at a slight angle. You'll see the different that's part of a seven where we cut it. But you can start out doing all your intra-articular work with this cut, say to a 9 or 10, depending on what it needs to be with having the external threads engage so that it's not moving back and forth when you're coming in and out doing labor, repair, or other type of intra-articular work. When you go to move to your capsular management, you can simply use the same cannula, trim it down to the appropriate length so that it's sitting. Now Extracapsular if we can see here, here's inside the joint, here's Extracapsular. So you've used the single cannula that you've been able to trim exactly the size you want. You're going to avoid suture bridges at this point. And it's going to make this procedure a lot easier. We have made our capsular incision right here. It's important to say that leaving as much of this capsule tissue is important, so that you can manage it later in the form of closure. If we come in and we ablate all this or we shave it out, then we're not going to have tissue to close. So the first rule of capsular management is to maintain the volume of the capsule. So today we're going to be using this capsule closed Scorpion which was designed for this. The handle, this portion of the handle. As you grasp the trigger you're going to actually Engage this portion of the jaw, which will compress the tissue and will hold the tissue in the palm, typical of a scorpion. When you compress in this direction, you're actually going to fire the needle. So when I'm putting pressure on the back portion of the handle, it's driving this through, and you'll hear an actual audible click and you'll feel it in your hand. So there's no mystery when it's fired. This was designed for a number two FiberWire. So there's a little groove that it sits in. We pull it in and you, you'll feel it engage. One thing I like about this, though, is you can then adjust once it's in. How much? Tail you'd like on it. So there are varying degrees. I typically use a tail much like this. Then when you come through, what you'll see is. As we fire this down. Fire the needle. It clicks back and it grasps the FiberWire. And then to unload Load this, you will push out about halfway and you simply pull down on the suture and it it disengages. So we're going to close this capsule. Now we're going to start at the apex. So this is most anterior and medial as I'm going in the cannula. I like to use this compression component to keep the suture in place. So here we're coming in. My cannula is now has pushed back and it's sitting in a great position. I can come down slide into the tissue. You can see you can really get a good bite of that tissue. Now I'd like to show the compression component of it. See that. Now I'm compressing the tissue. I'm actually going to slide mine down a little bit more towards the apex. If this is somebody with a little bit of laxity and you really want to get a good tight closure on them, you're going to try to get as much of the tissue closed as close as possible. So we'll compress the tissue. And now I'm going to fire the needle. You can hear it audibly and you can feel it manually. Now we're going to simply spin our hand and rotate. And then you'll see the suture is grasped there as we pull back. The suture will come with us. You can see in this normally there's a lot of friction on this. If this was a more traditional cannula, you would see that pulling back. But these threads buried in there, it's amazing. I'm doing this without the assistance of somebody holding the cannula in place. So now we've brought this out. And here's one of the most important parts of this when you start using this. So instead of trying to pull this limb all the way out to even it up, I actually want to leave the portion that is in the capsular closure Scorpion right now. I want to leave that relatively short. I'm going to fire this halfway and pull down as we showed before. So we've unloaded at that point. Now we're going to perform. We're going to get the tail end of this. But this is important. So so this end is running through this is basically the top or the most superficial portion of the suture. So we're going to leave that short and I'm going to reload Scorpion here. So again pulling I can feel it hear it and feel it. And then what you want to do is as you're inserting this into the cannula, your assistant is going to be pulling up the slack. So I like to close this and then we'll come down together. Great. It just helps limit the chance of you having a suture tangle. So now we're back in. We're going to go get the other side. So you want to match this up depending on what you're trying to do. Are you doing a straight closure. Are you trying to do a placation where you might change the angle so you can get a pants over vest type configuration? Again, I'm going to use this to compress the tissue once I'm all the way in. I actually when I'm on the femoral head side, I'll actually pull my hand back a little so that my needle isn't piercing the articular cartilage. I fire through and then, just like before, come back, I can see that I'm that I've enclosed it. Now I'll simply wiggle my hand. You see again, all that force in that cannula is staying put. So again, pull down on these sutures as I unload. And there you have it. So after this, it simply becomes your own choice of of not tying. So I use a Western slotting knot. So when we're going to cut this knot we're going to use the closed end. Fiberwire cutter. Because we can see it a little bit here. But a lot of times you as you're putting your additional sutures in, you can't see the end of it. So you have to be careful that you're not cutting it too close. So we're going to do another pass here, and we'll just show you how we can systematically close this. You can see just how user friendly this device is. Again Cannulas holding still got a nice bite of tissue there. Easy to load and unload. So we'll grab our second limb. Compress it where we like. Grab that tissue there. You can look at it right away. Make sure you've engaged. And then again, it's just a product of tying your knots. Now we're going to pass our fourth suture, the very lateral aspect of this defect. And. There you have our final configuration. We have completely closed this capsule. This can be used again for a T capsulotomy or to enclose your inner portal Capsulotomy, in addition to using this device for capsular closure. You can also use it to pass a traction stitch when you're doing your cam lesions. You can see this is the most lateral strand. Then moving medial second and then our farthest medial here. Therapy protocols with a capsular closure. If you're doing this for somebody that has instability you may limit things like flexion external rotation and extension to help protect this and allow this to start healing before you stress this capsular closure. Again, that is also a work that is being further explored.

John J. Christoforetti, MD, (Pittsburgh, PA) presents his technical pearls and insertion technique when using the TRIM-IT™ Custom Hip Cannula as a working portal in hip arthroscopy. Dr. Christoforetti outlines the technique for accurate measuring of the cannula and discusses the features and benefits of this atraumatic flexible hip cannula that can be cut to length depending upon patient specific needs.

Animations demonstrating the features and benefits of a specific product.

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The graduated switching stick for establishment of the mid anterior portal is shown here. When we begin to select the length of our cannula, which has a range of options in the increments of centimeters, this would go anywhere from 7 to 15cm, with the longest trimmable length marked at 13cm. The other point to note is that the inner depth measurement begins at the distal most black marking, which is zero, not the tip of the silver switching stick. As we insert the dilator, which we'll keep as one piece in an elongated fashion without the cannula at first, as we do with all cannulas, so that we can be sure that we don't have any incarceration or problems with superficial tissues requiring excessive force for cannula placement. One other tip is to make sure that we always access and grab the switching stick at the skin, exit, and secure it in case there's any divergence while you or your assistant move the handle. So if we bring our cannula and we make an assumption that the endpoint of our cannula is the black line seen in the arthroscopic view, in the open gross view, we can see that the graduated measurement illustrates a nine. At the exit of the skin. We can see the corresponding place to mark your cut on the cannula which we're about to do. One comment concerning length and choice is that there is a valve and stopcock mechanism, and if twisting of the cannula is part of your operative plan, it may be reasonable to add an additional length of cannula to allow for excursion of the stopcock without engaging the skin. Now we're going to be trimming at the end of the cannula. And of course, one can make their cut in whatever direction that you'd prefer. My preferred technique is to make the cut obliquely with the distal most extent of the cannula, opposite of where the stopcock is. So I have a sense orientation to the end of my cannula. Once that's been trimmed, it gives us an opportunity to contour further if we'd like. Anything about the exit. And again, what I tend to do is trim, to make the sharp edges as smooth and atraumatic as possible. Once we've set our length, we can make a decision to adjust the adjustable handle, allowing the dilated end to correspond best with the inner cannula. The clicking mechanism twisting the rod into place, as well as securing the cannula, is facilitated through the knobs, which form a tongue and groove fit to the top of the cannula, allowing rotatory control of the cannula inside the handle. So now we create our cannula under standard closed cannula establishment technique. And we're able to remove the handle and the switching stick and focusing back. We've now had opportunity to select an appropriate length cannula. Then given the obliquity of the cut and the threading on the outer skin, we can match exactly how we'd like this to maintain its position. Intra-articular.

John Gualdoni (Arthrex® Product Manager, Knee and Hip Arthroscopy) discusses the features and benefits of the TRIM-IT™ Custom Hip Cannula designed specifically for the unique anatomy of the hip. The proximal threads, atraumatic material and the ability to cut the cannula to a measured length are highlighted in this product demonstration showcasing the versatility of the flexible TRIM-IT Custom Hip Cannula.

Today, I'm going to demonstrate the Arthrex TRIM-IT custom hip cannula designed for arthroscopic procedures of the hip. The TRIM-IT cannula has been designed with proximal threads to hold well through the soft tissues during arthroscopic procedures of the hip. The flexible material allows larger devices and curved instruments to be inserted through the portal, as well as allows the ability for static instruments to get to different angles that are often difficult and challenging in the hip joint. The cannula can be trimmed down to size depending on the patient's anatomy. Anywhere from 7cm to 15cm in length in odd increments. There's a single outflow inflow valve on the back portion for fluid management. The diameter of the cannula is an 8.25mm cannula. To accommodate almost any instrument that you'll need to push through your portal during hip arthroscopy. To insert the cannula, you'll simply take your switching stick that's cannulated. You'll push this into the joint space and reference the soft tissue distance off the calibrations that are located on the switching stick itself. You'll then cut your cannula to the desired length, and then use your telescoping dilator to adjust to whatever size you've just cut your cannula to. Again, seven centimeters being the shortest and 15cm being the longest. The nice thing with this cannula is it allows you to minimize your inventory that you keep on the shelf. You can simply keep one cannula for all your arthroscopic procedures and just trim it down to the appropriate size, depending on that patient's anatomy. To cut the cannula, you'll take your scissor and cut on the line indicated just below the reference number that indicates seven, nine, 11, 13, or 15 settings. For this demonstration, I'll say our Caitlin needs to be cut to a nine centimeters length. I'll simply take my cannula and take my scissors and cut on the line that's located just below the reference number on the cannula. I'll cut as straight as possible following that line. Next, I'll take my obturator and adjust that down to a nine centimeters length. I'll lock it in place. I'll simply take my cannula and load my obturator through the middle, engaging some grooves on the back of the proximal end of the cannula with the teeth on the obturator. To ensure in my twisting motion the cannula stays in place. I'll simply insert the cannula over top of my switching stick. And I'll push it through the soft tissues until I reach the threaded portion of the cannula. The threads have been increased slightly over our traditional cannulas, and hold exceptionally well in the soft tissues to avoid the cannula being removed during suture passing and instrument motion during the procedure. You'll simply twist in the cannula through the threaded portion until the soft edge is then inserted into the joint space. You'll then remove your switching stick, remove your obturator, and your TRIM-IT cannula is now inserted through the joint. The soft edge of the TRIM-IT cannula is very atraumatic on the articular surfaces of the hip joint.

TRIM-IT™ Custom Hip Cannula

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Videos - OP-Anleitung (1)

Arthroscopic Capsular Closure of the Hip Featuring the CapsuleClose Scorpion™ Suture Passer

Broschüren (2)

Trim-It™ Custom Hip Cannula

If You Treat Hips Arthroscopically...Think Arthrex

Kataloge (1)

Hip Next Generation in Soft-Tissue Repair and Reconstruction

Operationsanleitungen (1)

Hip Labral Repair Using the Knotless SutureTak® Anchor Surgical Technique

Presentation Videos (1)

Hip Preservation Product Updates

Produktdemonstrationen (2)

Trim-It™ Custom Hip Cannula

Trim-It™ Custom Hip Cannula

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