update tomofix 2009
TRANSCRIPT
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Osteotomies around the knee10 years of TomoFix (1999 - 2009)
Friday, June 26, 2009Mövenpick Zürich Airport
Zürich, Switzerlandwww.synthes.com
Synthes1st Tomofix Master Symposium
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09.30
Welcome with „Kafi and Gipfeli“
10.00 – 10.10
Chairman`s Introduction
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Good morning ladies and gentleman, dear colleagues
On behalf of the Knee Expert Group (KNEG) of the AO - Foundation and of the Synthes Company, I would like to welcome you to the 1st TomoFix Master Symposium.
I am Alex Staubli, today Senior Consultant at different hopitals in the central part of Switzerland and former Chief of the Department of Orthopedics at the Kantonsspital Luzern, where we started 1999 the TomoFix project.
A special welcome and thanks to my colleagues in the faculty and in the KNEG especially Prof. Lobenhoffer it`s Chairman, our guest speaker Dr. Hilaire Jacob and my long standing friend Peter Holzach of the Sportclinic Zürich which is also promoting this meeting.
We are pleased so many of you could join us. Thanks to you all for making todays program a priority and a success.
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Startbild TomoFix 1999
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Scientific activities of the KNEG
~ 20 published articles – 2 books
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Faculty
Chairman: Staubli Alex E., CH [email protected]
Holzach Peter, [email protected]
Lobenhoffer Philipp, [email protected]
van Heerwaarden Ronald, [email protected]
AO-KNEG: Norris Brent, USA Teitge Robert, USA
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51 participants
34 Orthopaedic Surgeons from 3 continents
17 participants from Synthes Company
Thanks to Synthes CompanyThomas Fuchs / Toru Fischbach
Millie CalderónBrigitte Baumgartner
Monika FischerMarcel Rettenmund
to my secretary: Susanne Colombi
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The participants: Name list and highest mountains of their country
• Spain Teide • Colombia Sierra Nevada • Japan Fujiyama
• USA Mount McKinley
• Belgium Botrange
• Austria Grossglockner
• Finland Halti
• Sweden Kebnekaise
Switzerland Matterhorn
• France Mont Blanc
• Germany Zugspitze
• Poland Rysy
• UK Scafell Pike
• Netherlands Vaalserberg
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WelcomeMrs. Elvira Montañez HerediaMr. Gaspar de la Herran Nuñez
Spain
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Welcome Mr. José Eduardo
Quintero GilColombia
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Welcome Mr. Takeshi Sawaguchi Mr. Takeuchi Ryohei
Japan
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Welcome Mr. Gregory Montalbano
Mr. James StannardUSA
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Welcome Mr. Peter Verdonk
Belgium
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WelcomeMr. Martin Gruber Mr. Martin Pietsch
Mr. Alexander SpatschilMr. Peter Zenz
Austria
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Welcome Mr. Jussi Elo
Finland
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Welcome Mr. Bengt Horn
Sweden
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Welcome Mr. Roger Berbig
Mr. Thomas Henkel Mr. Frank Gebhard
Switzerland
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Welcome Mr. Sylvain Gueriot
France
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Welcome Mr. Thomas BacherMr. Florian GebhardMr. Etienne Heijens
Mr. Peter KepplerGermany
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Welcome Mr. Michal Panasiuk
Poland
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Welcome Mr. Matthew Dawson
Mr. Paul RaeMr. Adrian Wilson
United Kingdom
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Welcome Mr. Robert Gaasbeek
Netherlands
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• After 10 successful years with TomoFix in osteotomies around the knee, it is time to reflect on the concept and its importance for the preservation of the natural joint especially in monocompartmental gonarthrosis and in many other osteotomy cases around the knee and its competitive advantage in the market place.
• Your personal participation is of special interest to us, as you are one of the experts in the field of osteotomies around the knee and have experience with the TomoFix system. Your ideas and suggestions are very valuable to us.
• Together with you, we intend to spread the philosophy of long-lasting joint preservation, ideally avoiding joint replacement completely, world-wide.
• This exciting intellectual and practical process we will continue in the
future with regular TomoFix-UPDATE meetings.
At this symposium we want to give you the word!
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Average 7 min presentation
7 min discussion
15 min
It is important for us to allow also ample time for discussion.
Personal short CV of each presenter!
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Below we have listed a selection of current topics that we would like to discuss. The faculty has collected everyone’s suggestions and added
contributions from members of the AO KNEG
• 1) Where are the limits of osteotomies around the knee in cases of uni-compartmental gonarthrosis? When is uni-compartmental joint replacement the better option? Can both treatment options be
used in a time-shifted manner?• 2) My best indications, my patient selection, the optimal time frame, my
need for additional imaging and special examinations for the decision- making process.
• 3) Can bone healing time in open-wedge high-tibial osteotomy be enhanced? What to do if there are signs of delayed-union or pseudoarthrosis?
• 4) Femur osteotomies, double osteotomies, and patellar realignment procedures are moving more and more into the focus of interest.
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Below we have listed a selection of current topics that we would like to discuss.
• 5) Versatility of Tomofix system: where do you use Tomofix, apart from the standard cases?
• 6) Biomechanics of osteotomies around the knee with the Tomofix system – what can be improved?
• 7) Knee osteotomies are becoming more and more common, and consecutive total knee prostheses, too. What is your experience with this?
• 8) Which intra- and extra-articular combined procedures are most important for you?
• 9) New devices, new implants, new instruments (also with contributions of KNEG).
• 10) Summary of published Tomofix results, biomechanical studies, on-going and planned clinicalstudies (also with contributions of KNEG).
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Introduction of the Guest Speaker: Dr. Hilaire Jacob
• Dr Hilaire Jacob was head of the Biomechanics Unit of the Department of Orthopaedic Surgery, Balgrist, University of Zurich. He remained head of the Unit up to his retirement in 2003.
• Dr. Jacob has designed many clinically successful implants and prostheses, amongst which is the unconventional Thrust Plate Hip Prosthesis, and is author or co-author of several books, book chapters, and of over 150 scientific publications in international journals.
• And, very recently, in 2008, he has been given the “Georg Hohmann - Plaque of Merit” in acknowledgement of the several contributions he has made to orthopaedics; this also from the German Society of Orthopaedics and Traumatology.
• Even now, 6 years after retirement, he continues to take a deep interest in orthopaedic biomechanics and still collaborates in research projects.
• By the way he is my personal biomechanical and English grammatical conscience and I am very grateful that is joining us today, his short lecture on the well known Mikulicz line is an ideal introduction to our meeting.
• Handout
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Guest Speaker: Hilaire A.C. Jacob, Zürich [email protected]
• 10.10 – 10.22
„Biomechanics: The Mikuliczline“
• 3 min Q and A period.
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1. Knee-Osteotomies vs. UNI`s 1 Results
• Lobenhoffer Philipp: Chairman [email protected]
Steinfelder Nicole 10.25 – 10.35 AO TomoFix TM retro:
„Functional outcome assessment in patients treated with Open-wedge high tibial osteotomy (HTO)
for knee osteoarthritis using TomoFix“
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1. Knee-Osteotomies vs. UNI`s 2
• Verdonk Peter: 10.35 – 10.45 [email protected]
„The limits of osteotomies around the knee in cases of uni-compartmental gonarthrosis“
• Heijens Etienne : 10.45 – [email protected]
„UCG (Uni-compartmental-gonarthrosis) Score, a tool for preoperative decision: HTO or UNI“
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1. Knee-Osteotomies vs. UNI`s 3
• Montalbano Gregory: 10.55 - [email protected]
„US – Contribution“
• Bacher Thomas: 11.05 – [email protected]
„Limits of osteotomies around the knee“
Discussion: 11.15 – 11.40
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2. Bone healing enhancement in HTO Open-wedge
• Horn Bengt: 11.40 – [email protected]
„Bone healing enhancement in Open-wedge HTO“
• Staubli Alex E.: 11.50 – 12.00 [email protected]
„Personal experience: N = 500 Open-wedge HTO- without solid interposition“ - KNEG recommendations
Ev. Discussion
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Snack - Lunch : 45 min.
12.00 – 12.45
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3. Open- vs. Closed-wedge HTO
• Montanez Heredia Elvira: 12.45 – [email protected]
„Open- vs. Closed-wedge HTO“
Discussion: 12.55 – 13.05Indication for Closed-wedge HTO
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4. DFO and TomoFix MDF 1
• Van Heerwaarden Ronald: 13.05 – 13.15 Chairman
„Development of new DFO technique and TomoFix MDF plate“
• Gaasbeek Robert: 13.15 – [email protected]
„Femurosteotomies“
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4. DFO and TomoFix MDF 2
• Heijens Etienne : 13.25 – [email protected]
„4 failures with TomoFix MDF - salvage, outcome and personal conclusions“
• Bacher Thomas: 13.35 – 13.45 [email protected]
„Femur and Double osteotomies, case reports“
Discussion: 13.45 – 14.00
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5. Navigation 1„ Nice to have vs. must to have“
• Keppler Peter: 14.00 – [email protected]
„Navigated Double LevelOsteotomies around the Knee“
• Gebhard Florian: 14.10 – 14.20 [email protected]
„CAS and HTO (CSEG Study)“
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5. Navigation 2„ Nice to have vs. must to have“
• Heijens Etienne: 14.20 - [email protected]
„Use of navigation in HTO: Results and perspectives“
• Staubli Alex E.: 14.30 – [email protected]
“Precision and intraoperative control of osteotomies around the knee – my navigation for daily use”
Discussion : 14.40 – 15.00
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Intermission: 15.00 – 15.15
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5. Versatility of the TomoFix System 1
• Holzach Peter: 15.15 - 15.25 Chairman
„Re-knee-osteotomies in failed cases“
• Elo Jussi: 15.25 – [email protected]
„Proximal tibial osteotomies in knee stability“
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5. Versatility of the TomoFix System 2
• Sawaguchi Takeshi: 15.35 – 15.45„The new small stature TomoFix plate:
Japanese experience“
• Takeuchi Ryohei: 15.45 – 15.55 [email protected]
„Bilateral Open-wedge HTO and interpositional grafting“
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5. Versatility of the TomoFix System 3
• Dawson Matthew: 15.55 – [email protected]
„Versatility of the TomoFix System“
• Norris Brent: 16.05 – [email protected]
„Versatility of the TomoFix System:Fracture work“
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6. Case presentations Chairman Sawaguchi Takeshi
• Quintero Gil Jose Eduardo: 16.15 – [email protected]
„My best case, woman, 28y, correction of bilateral valgus deformity“
Ev. DiscussionSimultaneous bilateral Osteotomies
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Ev. Reserve: 7. SMS TomoFix : Audience
• Case discussions: 16.25 – 16.40
• Success stories • How to solve difficult cases • Proposal to solve a specific problem: Dr. Henkel, Zug• Management of post-op complications, • Handling a failed osteotomy• Early correction of the 1st osteotomy
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7. Present and futurescientific activities
• Lobenhoffer Philipp: 16.25 – 16.40 [email protected]
Outlook
Trends for the future
Activities of the KNEG
New implants, new instruments
Present and future scientific activities, education worldwide, documentation
Alex E. Staubli, Chairman: CLOSURE
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Closure:
Firstly, we want to thank you for taking the time to join us for this educational session
on TomoFix and we hope you found it helpful.
Secondly, we want to remind you to begin teaching your colleague surgeons. It is critical to get all competitive surgeons who had ever even potentially interested inTomoFix.
Thirdly, please inform us about your experiences, highlights and problems and especially about your scientific contributions in this field. It is the basis for the next meetings.
Have a good trip back home!
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For all participants we have prepared a handout of all
presentations
„Es gilt das gesprochene Wort“
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•Folien: Introduction
• Chaosplakat• From Team to Team• Best Joke Videos
• Fotosession 10 Jahre TomoFix
• 1. Operationsschritte• Targetfoto• Announcements