Driving innovation with the latest technological products and procedures to treat a variety of foot and ankle conditions.

Brostrom repair with the InternalBrace™ procedure provides additional fixation of the repaired ligament back down to bone during the healing process, allowing early mobility during recovery and a quicker return to activity.1 The InternalBrace 2.0 surgical technique provides surgical versatility with added size and material options. It comes with a talus offset guide that allows for reproducible anatomic placement of the talus SwiveLock® anchor. Surgeons can drill, tap, and implant the SwiveLock anchor through the guide. The InternalBrace technique allows the surgeon to support the primary Brostrom repair of soft tissue to bone for lateral or medial ankle instability repair and can be used for chronic ankle injuries and revisions.
References
1. Kulwin R, Watson TS, Rigby R, Coetzee JC, Vora A. Traditional modified Broström vs suture tape ligament augmentation [published online ahead of print, 2021 Jan 23]. Foot Ankle Int. 2021;1071100720976071. doi:10.1177/1071100720976071

InternalBrace™ Technique for Brostrom Repair

The Arthrex MIS product portfolio continues to grow with the introduction of the Minimally Invasive Bunionectomy System. This trajectory system helps achieve correction and fixation placement using a percutaneous approach. Designed to work with this specific system, the beveled fully threaded screws are angled to provide zero-profile fixation. Additionally, a dedicated power unit and instrumentation are available. The MIS line is further supported by Medical Education courses focused on minimally invasive techniques.

Minimally Invasive Surgery

The Ankle Fracture Management System was developed to be the most comprehensive set available for the treatment of ankle fractures. All fibula plates are engineered to work seamlessly with our proven Syndesmosis TightRope® implants.
The set includes:
<ul>
 <li>3.5 mm locking one-third tubular plates</li>
 <li>3.5 mm locking straight plates (reconstruction plates)</li>
 <li>Fracture-specific plates: locking medial hook plates, locking lateral hook plates, and anatomic distal fibular plates</li>
</ul>
The system can also be customized to include the FibuLock® fibular nail (an MIS solution for ankle fractures), posterolateral fibula plates, and/or 2.7 mm cortical screws depending on the surgeon’s preferences.

Ankle Fracture Management System

The MaxForce MTP plates use two modes of compression to help provide maximized compression of the arthrodesis site. In addition to a standard oblong compression hole with eccentric drilling, these plates use a unique compression mechanism that allows surgeons to manually dial in compression for MTP fusions. The teeth in the plate align with the teeth on the compression device to work like gears. As the compression device is turned clockwise, the plate shifts proximally, compressing the MTP joint.
In addition, the new flat head cortical screws create a zero profile when seated fully into the plate, dramatically reducing hardware prominence.
Combined with an array of plate lengths and curvatures, the new MaxForce MTP plating system has been designed to offer surgeons the most comprehensive, compressive and lowest profile construct on the market today.

MaxForce™ MTP Plates

The DX Knotless FiberTak® suture anchor provides the combined benefits of all-suture anchors with knotless soft-tissue fixation. A tensionable, suture-locking mechanism allows users to control the repair tension under direct visualization and the ability to interconnect anchors for bridging techniques. This anchor is ideal for small areas where minimal bone removal and knotless fixation are desired.

DX Knotless FiberTak®

The Arthrex SpeedBridge repair is an innovative soft-tissue fixation device used in the treatment of Achilles injuries. While standard anchor fixation of the tendon creates only a single point of compression directly over the anchor, the SpeedBridge repair enables an hourglass pattern of FiberTape® suture to be laid over the distal end of the tendon. This 4-anchor construct enables a true knotless repair and a greater area of compression for the Achilles tendon on the calcaneus, improving stability such that immediate postoperative weightbearing and range of motion is possible. 1
Reference
1. Journal of Foot and Ankle Surgery. 2013;52(5):575-579. doi:10.1053/j.jfas.2012.11.004.

Achilles SpeedBridge™ Repair

Foot and Ankle 

You might be trying to access information for a product that is not cleared for sale in the selected country.

Visit <a href="/corporate/contact-us">Contact Us</a> for additional assistance.

Foot and Ankle

Product

Procedure

View Foot and Ankle Homepage

Arthrex offers minimally invasive and specialty solutions to address the bony and soft-tissue injuries of ankle fractures.
<ul>
 <li>FibuLock® Fibular Nail System</li>
 <li>Ankle Fracture Management System</li>
 <li>Titanium Ankle System</li>
 <li>Syndesmosis TightRope® XP Implant System</li>
 <li>AiTFL InternalBrace™ Ligament Augmentation</li>
</ul>

Ankle Fracture

Ankle arthritis is most commonly the result of a prior injury to the ankle joint. In patients who sustain an injury such as an ankle fracture, the cartilage may be damaged and lead to accelerated arthritis. When the ankle is injured, it is also susceptible to an injury called osteonecrosis. When osteonecrosis occurs as the result of an ankle injury, a portion of the bone has damage to its blood flow. Osteonecrosis can also lead to ankle arthritis.

Ankle Osteoarthritis

Ankle articular cartilage problems are very common. Painful osteoarthritis develops when this smooth, gliding surface on the end of the bone has lost its cushioning, deformity develops, and bone rubs on bone.

Chondral Defect

The deltoid ligament is primary responsible for stabilizing the medial side of the ankle joint. It is fairly complex ligament consisting of both superficial and deep fibers. Injuries to the deltoid ligament can occur in multiple settings including simultaneous lateral ankle sprains, ankle fractures or posterior tibial tendon deformities. Chronic injuries to the deltoid ligament can lead to laxity of the medial side of the ankle or ankle valgus. Typically, these chronic injuries require surgical intervention.

Deltoid Instability

Equinus contracture is a common condition that can lead to a cascade of pathologies if left untreated. Patients who do not respond to conservative treatment may require surgical correction. Arthrex has developed a state of the art, minimally invasive Endoscopic Kit for Endoscopic Gastroc Recession to safely and effectively restore a normal level of dorsiflexion with minimal morbidity and immediate weightbearing postoperatively.1
Reference:
1. Phisitkul P, Rungprai C, Phreutthiphat O, Femino J, Amendola A. Outcomes of open and endoscopic gastrocnemius and gastrosoleus lengthening: a comparative study. Arthroscopy. 2015;31(6, suppl):e19. doi: 10.1016/j.arthro.2015.04.051.

Equinus Contracture

Due to lateral ankle injuries sometimes ligaments will stretch out, partially tear, or tear completely in the middle of the ligament. These chronic sprains can lead to a weakening or laxity to the ligaments leaving an unstable ankle.

Lateral Ankle Instability

The Syndesmosis TightRope® XP implant system features a unique delivery mechanism that allows surgeons to insert the implant without pulling a needle through the medial skin. Tensioning handles and a new trocar-tipped drill bit have been added to the implant system.
Advantages of the Syndesmosis TightRope XP implant system include:
<ul>
 <li>Improved reduction when compared to syndesmosis screws1</li>
 <li>Improved maintenance of reduction when compared to syndesmosis screws2</li>
 <li>No need for routine implant removal</li>
 <li>Supports early weightbearing and accelerated rehabilitation1</li>
 <li>Allows for physiologic motion of the syndesmosis following reduction and fixation</li>
 <li>Improved patient outcomes compared to syndesmosis screws3-5</li>
</ul>
References
1. Naqvi GA, et al. Am J Sports Med. 2012;40(12):2828-2835. doi:10.1177/0363546512461480.
2. Cottom JM, et al. J Foot Ankle Surg. 2009;48(6):620-630. doi:10.1053/j.jfas.2009.07.013.
3. Laflamme M, et al. J Orthop Trauma. 2015;29(5):216-223. doi:10.1097/BOT.0000000000000245.
4. Shimozono Y, et al. Am J Sports Med. 2018 Nov 26:0363546518804804 [Epub ahead of print]. doi:10.1177/0363546518804804.
5. Andersen MR, et al. J Bone Joint Surg Am. 2018;100(1):2-12. doi:10.2106/JBJS.16.01011.

Syndesmosis Injury

 Ankle

The ankle joint is made up of articulations between the tibia, fibula and talus bones. Sometimes referred to as the ankle “mortise” analogous to how bricks fit perfectly together, this joint can tolerate little incongruity. The ankle joint allows for plantar flexion and dorsiflexion of the foot and is responsible for transferring the force of the muscles of the leg into the foot for ambulation. The main ligaments that support the lateral ankle are the anterior talofibular ligament and calcaneofibular ligament. The former being the most significant to resist anterior translation of the talus. The medial ankle supporting ligaments are collectively referred to as the deltoid ligament. This six ligament complex consists of two layers of three ligaments each.&nbsp; The deep deltoid layer is considered the most important. &nbsp;

Ankle

Primary (B)

A bunionette is also known as a Tailor’s Bunion. It is a painful lateral bony prominence of the 5th metatarsal head resulting in a widened forefoot. A bunionette can be caused by a large 5th metatarsal head (Type I), lateral bowing of the 5th metatarsal shaft (Type II), or an increase in the 4th and 5th intermetatarsal space (Type III). Bunionettes can often be treated conservatively by selecting shoes with a wide toebox. When conservative treatment fails, surgeons have the option to perform a simple lateral condylectomy or a distal 5th metatarsal osteotomy. In the case of a Type III deformity, the surgeon may choose to do a proximal 5th metatarsal osteotomy. Arthrex makes a variety of products in metal and bioabsorbable materials designed to provide fixation for these osteotomies.

Bunionnette

Arthrex’s contribution to fracture management innovation starts with our unique mission of helping trauma surgeons treat their patients better. When trauma surgeons ask for our assistance in solving posttraumatic surgical problems, Arthrex responds with cutting edge technology, creative innovation, and a sense of urgency as trustworthy partners in evidence-based treatment solutions that make a difference.
Metatarsal fracture repair, Jones fracture repair (using the Jones Fracture Screw) and the Phalangeal fracture repair procedures all aid in the effective treatment of the majority of fracture patterns found within the forefoot. Arthrex has developed the Ankle Fracture Management System to be the most comprehensive set available for the treatment of forefoot injuries.&nbsp;

Forefoot Fractures

Hallus Rigidus and Hallus Limitus, degenerative arthritis and stiffness due to bone spurs affecting the MTP joint at the base of the hallux can be treated using a variety of procedures including OATS, Moberg, Arthroplasty and MPJ Arthrodesis.

Hallux Rigidus/Hallux Limitus

Arthrex offers a multitude of fixation options to correct hallux valgus (bunion) deformities.
In the presence of 1st TMT joint hypermobility, surgeons have the option use either the plantar lapidus plate or a traditional dorsal medial lapidus plate. The advantages of the plantar approach include strong and stable tension-side fixation that spares the tibialis anterior tendon.
For patients with a stable 1st TMT joint, surgeons may take a minimally invasive approach using Arthrex's MIS power unit and instrumentation to create the percutaneous incisions for the osteotomy. Fixation is achieved with Compression FT screws.
For surgeons that prefer an open approach to correct the deformity, Arthrex offers the versatile proximal 1st metatarsal osteotomy plate and proximal opening wedge plates.
Finally, if an Akin osteotomy is needed, Arthrex offers DynaNite® Nitinol staples for a stable and reproducible fixation option. Surgeons that would like to take an MIS approach can use Arthrex Compression FT or PT screws to achieve fixation.
References
1. Klos K, Simons P, Hajduk A-S, et al. Plantar versus dorsomedial locked plating for lapidus arthrodesis: a biomechanical comparison. Foot Ankle Int. 2011;32(11):1081-1085. doi:10.3113/FAI.2011.1081.
2. Arthrex, Inc. LA1-00068-EN. Naples, FL; 2018.

Hallux Valgus

Hallux varus is a varus deformity of the first metatarsal phalangeal joint.&nbsp; The lateral joint capsule is attenuated or absent while the medial side is contracted.&nbsp; This deformity can be caused by direct trauma.&nbsp; However, it is most often seen as an iatrogenic (sometimes unavoidable) complication of bunion surgery where aggressive medial eminence excision and soft tissue balancing techniques were performed. &nbsp;If the condition is addressed before the onset of arthritis, the surgeon may choose to realign the joint using capsular repair techniques and a Mini TightRope device along the lateral collateral ligaments to support the joint while it heals.&nbsp; If the joint is already arthritic, the surgeon may choose to perform a first MTP joint arthrodesis.&nbsp; &nbsp; &nbsp; &nbsp;

Hallux Varus

Hammer toe is a flexible or rigid flexion deformity of the proximal interphalangeal (PIP) joint of the lesser toe. A similar deformity that also involves the distal interphalangeal (DIP) joint is known as claw toe. These deformities result from an imbalance in the dynamic flexion and extension forces that cross the lesser MTP, PIP, and (in the case of claw toe) DIP joints. Surgical treatments of lesser toe deformities have historically been based on altering the relative lengths of the toe and its tendons. Options have included PIP joint resection arthroplasty, PIP joint fusion, tendon transfers, tendon lengthening, and metatarsal shortening.

Hammer Toe/Claw Toe

The plantar plate is made of a 2 - 5 mm thick layer of connective tissue originating on the plantar aspect of the distal metatarsals and inserting on the plantar base of the proximal phalanx. This stout structure serves as the main stabilizer supporting the MTP joints. Through chronic microtrauma or dynamic imbalance, this tissue can become inflamed, attenuated, tear or rupture. This results in pain, MTP joint instability, crossover toes, or dislocations.

Plantar Plate Tears

Forefoot

The forefoot extends anteriorly from the tarsometatarsal (Lisfranc) joint.&nbsp; It consists of the five metatarsals and five phalanges.&nbsp; The first three tarsometatarsal joints have little motion due to “tight” articulations and strong ligamentous connections.&nbsp; These articulations and the Roman Arch configuration of the proximal second metatarsal is responsible for forming and maintaining the transverse arch of the foot.&nbsp; The fourth and fifth metatarsals heads have more motion at the Lisfranc joint to aid in balance.&nbsp; The plantar aspect of the first and fifth metatarsals make up the medial and lateral legs of the weight bearing “tripod”. &nbsp;

It is characterized by pain over boney prominences or spurs located at the posterior superior aspect of the calcaneus.&nbsp; Arthrex has developed the Achilles SpeedBridge, Achilles SutureBridge,&nbsp;and Bio-Tenodesis techniques&nbsp; to address this type of pathology.&nbsp;&nbsp;

Achilles Insertional Tendinopathy

Achilles tendon ruptures are common in the elite and recreational athlete and most often occur in the non-insertional region of the tendon complex. Arthrex has developed the Percutaneous Achilles Repair System (PARS). This allows less dissection, faster technique, less wound issues, and preservation of the blood supply to the peritenon. This technique utilizes #2 FiberWire.

Achilles Rupture

Ankle arthritis is most commonly the result of prior trauma to the ankle joint. Ankle fractures and other injuries may damage the cartilage, which leads to accelerated arthritis. Patients with ankle injuries are also susceptible to osteonecrosis, a condition where blood flow is decreased to a portion of the bone. Osteonecrosis can also lead to ankle arthritis.

Ankle Arthritis

Calcaneal fractures are typically the result of high-energy mechanisms such as a fall from a height or an automobile accident. Arthrex offers many solutions for these injuries, including:
<ul>
 <li>Calcaneal Fracture Management System (Includes perimeter and percutaneous plates)</li>
 <li>5.0/7.0 mm Compression FT Screws</li>
 <li>4.5/6.7 mm LPS Cannulated Screws</li>
 <li>Trim-It™ Pins - Bioabsorbable PLLA Pins</li>
</ul>

Calcaneal Fracture

Adult acquired flatfoot deformity results from a progressive degeneration of the posterior tibial tendon, ultimately leading to arch collapse on the medial side of the foot. This deformity is characterized by a number of stages from I-IV ultimately describing the severity of the pathology. Over time, if left untreated, the deformity can advance into arthritis at the associated joints in the midfoot and hindfoot thus creating the need for fusions of those joints.
Arthrex has developed a comprehensive line of products to help surgeons treat their patients through all the major operative stages of flatfoot deformity, Stages II-IV. From soft-tissue procedures, to osteotomies, and ultimately fusions, Arthrex has flatfoot deformities covered.

Flatfoot

Hindfoot

The bones of the hindfoot are the talus and calcaneus.&nbsp; Anteriorly these bones articulate respectively with the navicular and cuboid bones of the midfoot at the transverse tarsal joint.&nbsp; This joint is also known as Chopart’s joint.&nbsp; The calcaneus is the largest bone in the foot and articulates with the talus above.&nbsp; It is the main weight bearing structure of the foot and makes up the posterior point of the weight bearing “tripod”.&nbsp; The Achilles tendon inserts on the posterior process of the calcaneus and is responsible for the majority of dorsiflexion strength needed for the push-off phase of ambulation.&nbsp; The talus articulates with the calcaneus below and the ankle mortise above.&nbsp; This dense bone is responsible for ankle motion in ambulation. &nbsp;

A Jones fracture is a break at the metaphyseal-diaphyseal junction at the base of the 5th metatarsal. Arthrex's 5th Metatarsal Fracture System is a comprehensively designed screw and plate system that offers surgeons a variety of options to efficiently and effectively treat complex fractures. The robust, solid titanium screws (4.5 mm, 5.5 mm, and 6.0 mm) range in size from 40 mm to 65 mm, offering more options to the surgeon. The screws feature a small, low-profile head so there is less likelihood of soft-tissue irritation postoperatively. The system contains cannulated drills and taps for fast, reproducible results. The ergonomic drill guides are designed to achieve the “high and tight” starting position on the 5th metatarsal base.
Another option is the low-profile hook plate designed for more comminuted proximal 5th metatarsal fractures. It features a compression hole and 2.4 mm variable-angle locking screws. The plate is appropriately sized and contoured for the 5th metatarsal bone, which is beneficial in difficult revision surgeries where a solid screw may no longer be a good option.

Jones Fracture

Lisfranc’s joint refers to the tarsometatarsal joint. Lisfranc’s ligament is a stout structure that runs from the medial cuneiform to the base of the second metatarsal. The low energy type Lisfranc injury (sprain) occurs commonly in field sports when a player’s foot is stepped on while running. High energy Lisfranc fractures/dislocations often occur in falls from a height or in head-on motor vehicle accidents.

Lisfranc Dislocation

Navicular fracture repair, lisfranc fracture repair, and midtarsal fracture repair are all common procedures in the effective treatment of the majority of fracture patterns within the midfoot. The Ankle Fracture Management System was developed to be the most comprehensive set available for the treatment of midfoot fractures using improved basic small fragment implants and instrumentation, anatomic plates, and locking screw technology. For more information on midfoot procedures and techniques, view “educational resources” below.

Midfoot Fractures

Pes cavus (high arch) is when the sole of the foot is distinctly hollow when bearing weight. Pes cavus is often a sequela of lower extremity nerve disorders from neurologic disease or stroke. Often patients will have foot drop and an equinus deformity. Treatment consists of tendon transfers and bony structural changes to form a stable plantigrade foot for weightbearing.
Arthrex has developed a comprehensive line of products from the EndoBlade™ system to treat equinus deformity, tendon transfers with Tenodesis screws and InternalBrace™ ligament augmentation, multiple diameters of Headless Compression FT and PT Screws, BioSync® wedges for Cotton/Evans osteotomies, and an extensive line of plates and screws in the Comprehensive Foot System.

Pes Cavus

The Centerline™ System offers a minimally invasive endoscopic plantar fascia release technique for patients diagnosed with plantar fasciitis. The Centerline System raises the bar for endoscopic soft tissue procedures by increasing safety, visualization, ergonomics and reducing the possibility of mechanical failures.

Plantar Fasciitis

Midfoot

The bones of the midfoot include the medial, intermediate and lateral cuneiform, the navicular, and the cuboid. Posteriorly the navicular and cuboid bones articulate respectively with the talus and calcaneus bones of the hindfoot at the transverse tarsal joint. This joint is also known as Chopart’s joint. Anterior, the three cuneiform and cuboid bones articulate with the five metatarsals at the tarsometatarsal joint. This joint is also known as Lisfranc’s joint. The midfoot is an area of “tight” articulations and little motion. It is designed to maintain the arches of the foot and provide a stable platform for weight bearing and ambulation.

Foot and Ankle

InternalBrace™ Technique for Brostrom Repair

Ankle

Forefoot

Hindfoot

Midfoot

Disclaimers

Disclaimers

What's New in Foot and Ankle

Foot and Ankle

InternalBrace™ Technique for Brostrom Repair

Anklechevron_right

Forefootchevron_right

Hindfootchevron_right

Midfootchevron_right

Disclaimers

Disclaimers

What's New in Foot and Ankle

Ankle

Forefoot

Hindfoot

Midfoot