Finished Product

AR-8913DS

Human

Foot and Ankle

Product

Flexible fixation devices like the Knotless Mini TightRope implant afford surgeons an alternative to traditional rigid screw or screw-and-plate fixation for common foot and ankle pathologies, including hallux valgus, Lisfranc injuries, and hallux varus. The Mini TightRope system provides a strong and reproducible construct that stabilizes bones without overconstraining the joint,1 which can lead to early hardware failure and the need for a second hardware removal surgery.
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This knotless, tensionable technology reduces the required number of surgical steps, lowering the risk of soft-tissue irritation from knot stacks and eliminating variability in implant tensioning.
 
Reference
1. Arthrex, Inc. Data on file (APT-05278, APT-05279, APT-05280). Naples, FL; 2021.&nbsp;

Mini TightRope® Fixation System

Child (D)

Procedure

The Mini TightRope® is a low profile system designed to correct a number of forefoot deformities including hallux valgus, Lisfranc disruptions, Tailor’s bunion and hallux varus. Comprised of #2 FiberWire and two stainless steel buttons, this device improves foot and ankle patient care with its strength and versatility. A FiberWire and button construct (distal approach) or FiberWire and anchor construct (proximal) are placed across the first and second metatarsals. As the FiberWire is tightened, the IM angle is reduced to a normal value (less than 9-11 degrees). Using the button or anchor construct, the suture is tied over the button, maintaining a secure reduction of the deformity. Used alone or in conjunction with soft tissue repair, this technique affords a greater degree of strength and security than can be achieved with a soft tissue repair alone.

Mini TightRope® Technique for Hallux Varus

The Mini TightRope® procedure is useful as an alternative or adjunct method for reduction of the intermetatarsal angle. A FiberWire® and button construct is placed across (distally or proximally) the first and second metatarsals. Reduction of the IMA is obtained with a clamp. The Mini TightRope is tightened and tied. The reduced intermetatarsal angle is held at the desired degree of correction. Used alone or in conjunction another procedure, this technique affords a greater degree of strength and security than can be achieved with the soft tissue repair alone. Additionally, the Mini TightRope System provides a more technically straightforward method of maintaining the intermetatarsal angle than with conventional osteotomies while avoiding the complications associated with osteotomies. A buttress plate is available to be placed against the second metatarsal to spread the load of the Mini TightRopes more evenly.

Mini TightRope® Technique for Hallux Valgus

Low energy, purely ligamentous injuries of the Lisfranc joint are difficult to detect and require a high index of suspicion due to their subtle presentation, particularly in athletes. Weightbearing radiographs, in combination with CT and MRI, may be required &nbsp;for proper diagnosis. Any diastasis greater than 2 mm is considered a positive for Lisfranc injury. 

 
Traditional fixation methods using screws and/or plates provide a stable construct for the Lisfranc injury but may overconstrain the joint, resulting in the patient's inability to return to preinjury activity levels. Additionally, rigid fixation often requires a secondary surgery for hardware removal prior to full weightbearing and has the added risk of reduction loss. 

 
Flexible fixation devices such as the 2.7 mm Knotless Mini TightRope® implant and Lisfranc Fixation System for InternalBrace™ repair overcome the shortcomings of rigid fixation and provide a strong1,2 and reproducible construct to stabilize the Lisfranc joint.
 
References 

1. Arthrex, Inc. Data on file (APT-05278). Naples, FL; 2021.
2. Arthrex, Inc. Data on file (APT-05279). Naples, FL; 2021.

Mini TightRope Implant with Inserter

AR-8913DS

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