ORTHOPLASTY
Subchondral bone plasty
ORTHOPLASTY is a disposable device for treating subchondral bone lesions.
The subchondral bone plasty procedure is a minimally-invasive, fluoroscopically-assisted procedure that identifies and repairs subchondral bone defects, also named Bone Marrow Lesions (BMLs). The procedure is carried out with a minimally-invasive approach under fluoroscopy guidance along with arthroscopy, to target and manage of findings inside the joint.
The pathology is classified as a SIFK (Subchondral Insufficiency Fracture of the Knee) and in the initial stages of SONK (Spontaneous Osteonecrosis of the Knee). The patient that presents with this pathology, suffers from relatively early osteoarthritis and consults the clinical specialist as a result of intense pain that does not correspond to a significantly compromised radiographic scenario.
In fact, these lesions are not visible under X-Ray and only a diagnostic confirmation using MRI reveals a hyper-intense uptake signal in sequences sensitive to T2 fluids (hydrogen) and in STIR sequences.
The objective of the method is to reinforce subchondral bone lesions using the same principal as vertebroplasty and involves the percutaneous insertion into the bone rarefaction site, of an appropriate bone substitute or of an autologous bone graft enhanced with a concentrate of mesenchymal stromal cells.
ORTHOPLASTY BENEFITS
FIELDS OF APPLICATION
about the product
MEDICAL PROFESSIONALS
ORTHOPLASTY The subchondral bone plasty procedure is a minimally-invasive, fluoroscopically-assisted procedure that identifies and repairs subchondral bone defects, also named Bone Marrow Lesions (BMLs).
Reduced risk of infections
- Ready-to-use bone substitute
- no preparation needed
- Hardening in wet environment only: no time pressure during application
- Truly biologic: composed by a micro-crystalline, calcium deficient hydroxyapatite – major bone constituent
- High load sharing properties (up to 45 MPa)
- Radio-opaque paste: clearly visible under fluoroscopy and X-rays
- Bioresorbable during bone remodeling
SURGICAL TECHNIQUE
COMPONENTS
– WORKING CANNULA with trocar tip stylet
made by an external cannula with ultrasharp crown tip used as working channel and an internal stylet with trocar tip to access the subchondral bone. The needle has a plastic handle.
– DRILL STYLET
composed by a metal part with distal bone drill (screwed terminal portion) and a plastic handle. This device is used to dig into the bone to target the area to be treated.
– DIRECTABLE BONE FILLER
is a cement infusion cannula (often referred to as the “filler” cannula) and consists of a steel cannula with a plastic handle, equipped with a pusher stylet. The lateral holes in the cannula allow a directable injection of the bone cement in the area to be treated. The plastic handle has a universal luer lock connection for filling the cannula with bone cement. Also dedicated injection syringes with luer lock connection are present in the kit.
– BIOLOGICAL CEMENT (optional)
- truly biological
- ready-to-use: “tooth paste” consistence
- no time pressure: “infinite” working time
- hardening in wet environment only
- radio-opaque
- bioresorbable
SURGICAL TECHNIQUE
Identify the Bone Marrow Lesion (BML) using a fat-suppressed MRI (T2) and choose the optimal approach and trajectory.
Through intraoperative fluoroscopy, target the defect associated with Bone Marrow Lesion (BML) linked to the MRI results.
Access the bone defect using Orthoplasty access tools kit.
Fill bone defect with bone substitute under fluoroscopic guidance.
Alternatively, BML defects can be filled with Marrow-Stem kit, using the creeping substitution technique and marrow mesenchymal stem cells instead of a bone substitute.
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Subchondral bone plasty
ORTHOPLASTY
ORTHOPLASTY is a disposable device for treating subchondral bone lesions.
Download fileSUPPORTING EVIDENCE
ORTHO & SPORT MEDICINE APPLICATIONS
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