Transcript iso-toggle system for the treatment of cruciate rupture

ISO-TOGGLE SYSTEM FOR
THE MANAGEMENT OF
CRUCIATE RUPTURE
LIGA-FIBA ISO-TOGGLE
PROSTHESIS
250 lb
Liga-Fiba
Toggle
Tie-down
button
Threading needle with nylon loop
Demonstration on Plastic Model
Drilling the femoral isometric tunnel
Demonstration on Plastic Model
Drilling the tibial isometric tunnel
Demonstration on Plastic Model
The implant: 250 or 500lb LIGAFIBA; UHMWPE
(ultra high molecular weight polyethylene) buttons
Push- Pull graft passer or threading needle is used to
pass the graft
Demonstration on Plastic Model
A 250lb LIGAFIBA loop secured over an UHMWPE
toggle on the medial aspect of the femur
Demonstration on Plastic Model
A 250lb LIGAFIBA loop tied over an UHMWPE button
on the medial aspect of the tibia. Note that the loop
can either pass over or under the LDE.
Demonstration on Plastic Model
x
Note the orientation of the 250lb LIGAFIBA loop
Compression of the LDE tendon (X) is a theoretical
problem and placing the material under the tendon is
an alternative
ISO-TOGGLE SYSTEM USING
250 lb LIGA-FIBA
Pointer on
the lateral
fabella
Lateral parapatellar approach with reflection of the fascia.
2.5-3.0mm
drill bit and
drill guide
positioned on
the femoral
ISOMETRIC
point, which
is just cranial
to the distal
pole of the
lateral
fabella
Drilling the femoral tunnel from the femoral isometric point
Lateral view of the stifle
2.5-3.0mm
drill bit from
the femoral
ISOMETRIC
point
emerging on
the medial
side of the
femur under
the caudal
edge of the
medial vastus
muscle
Cranial view of the stifle on completion of the femoral tunnel
The pointer is
on the cranial
aspect of the
tibial extensor
fossa.
Identifying the tibial isometric point on the lateral
aspect of the tibia
2.5-3mm drill
bit and drill
guide
positioned on
the tibial
ISOMETRIC
point, which
is the tubercle
on the cranial
aspect of the
extensor
fossa
Drilling the tibial tunnel from the isometric point
2.5-3mm drill
bit from
the tibial
ISOMETRIC
point,
directed in a
lateral to
medial
direction
emerging on
the medial
aspect of the
proximal tibial
Cranial view of the stifle on completion of the tibial tunnel
Long threading needle
and nylon loop used to
pass the prosthesis
through the tibial
tunnel
Cranial view showing the start of threading the 250 lb Liga-Fiba loop
starting on the medial aspect of the tibia
Cranial view showing the 250 lb Liga-Fiba loop
threaded through the tibial tunnel in a medial to lateral direction
Tie-down
button
Threading
needle
Cranial view showing the 250 lb Liga-Fiba loop
threaded through the femoral tunnel
Threading
needle removed.
Toggle to be inserted
Cranial view showing completion of inserting the 250 lb Liga-Fiba loop
but before insertion of the toggle and tensioning.
Toggle
inserted
Cranial view showing the insertion of the toggle and the start of
tensioning the 250 lb Liga-Fiba loop.
Lateral view showing the isometric position of
the 250 lb Liga-Fiba loop before and after tying off.
Tie-down
button
Medial view of the tibia showing the
the 250 lb Liga-Fiba loop being tensioned prior to tying down
Medial view of the tibia showing the
the 250 lb Liga-Fiba loop secured by tying over the button
and the ends cut