Osteotomies around the knee10 years of TomoFix (1999 - 2009)

Friday, June 26, 2009Mövenpick Zürich Airport

Zürich, Switzerlandwww.synthes.com

Synthes1st Tomofix Master Symposium

09.30

Welcome with „Kafi and Gipfeli“

10.00 – 10.10

Chairman`s Introduction

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.

Startbild TomoFix 1999

Scientific activities of the KNEG

~ 20 published articles – 2 books

Faculty

Chairman: Staubli Alex E., CH alex.staubli@sonnmatt.ch

Holzach Peter, CHpholzach@sportclinic.ch

Lobenhoffer Philipp, GHPLobenhof@aol.com

van Heerwaarden Ronald, NLvanheerwaarden@yahoo.com

AO-KNEG: Norris Brent, USA Teitge Robert, USA

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

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

WelcomeMrs. Elvira Montañez HerediaMr. Gaspar de la Herran Nuñez

Spain

Welcome Mr. José Eduardo

Quintero GilColombia

Welcome Mr. Takeshi Sawaguchi Mr. Takeuchi Ryohei

Japan

Welcome Mr. Gregory Montalbano

Mr. James StannardUSA

Welcome Mr. Peter Verdonk

Belgium

WelcomeMr. Martin Gruber Mr. Martin Pietsch

Mr. Alexander SpatschilMr. Peter Zenz

Austria

Welcome Mr. Jussi Elo

Finland

Welcome Mr. Bengt Horn

Sweden

Welcome Mr. Roger Berbig

Mr. Thomas Henkel Mr. Frank Gebhard

Switzerland

Welcome Mr. Sylvain Gueriot

France

Welcome Mr. Thomas BacherMr. Florian GebhardMr. Etienne Heijens

Mr. Peter KepplerGermany

Welcome Mr. Michal Panasiuk

Poland

Welcome Mr. Matthew Dawson

Mr. Paul RaeMr. Adrian Wilson

United Kingdom

Welcome Mr. Robert Gaasbeek

Netherlands

• 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!

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!

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.

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).

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

Guest Speaker: Hilaire A.C. Jacob, Zürich hilaire.jacob@bluewin.ch

• 10.10 – 10.22

„Biomechanics: The Mikuliczline“

• 3 min Q and A period.

1. Knee-Osteotomies vs. UNI`s 1 Results

• Lobenhoffer Philipp: Chairman HPLobenhof@aol.com

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“

1. Knee-Osteotomies vs. UNI`s 2

• Verdonk Peter: 10.35 – 10.45 pverdonk@yahoo.com

„The limits of osteotomies around the knee in cases of uni-compartmental gonarthrosis“

• Heijens Etienne : 10.45 – 10.55Heijens@Gelenkzentrum-wiesbaden.de

„UCG (Uni-compartmental-gonarthrosis) Score, a tool for preoperative decision: HTO or UNI“

1. Knee-Osteotomies vs. UNI`s 3

• Montalbano Gregory: 10.55 - 11.05admin1@regionalorthopaedics.com

„US – Contribution“

• Bacher Thomas: 11.05 – 11.15thomas.bacher@hellersen.de

„Limits of osteotomies around the knee“

Discussion: 11.15 – 11.40

2. Bone healing enhancement in HTO Open-wedge

• Horn Bengt: 11.40 – 11.50bengt.horn@lio.se

„Bone healing enhancement in Open-wedge HTO“

• Staubli Alex E.: 11.50 – 12.00 alex.staubli@sonnmatt.ch

„Personal experience: N = 500 Open-wedge HTO- without solid interposition“ - KNEG recommendations

Ev. Discussion

Snack - Lunch : 45 min.

12.00 – 12.45

3. Open- vs. Closed-wedge HTO

• Montanez Heredia Elvira: 12.45 – 12.55elvira0512@gmail.com

„Open- vs. Closed-wedge HTO“

Discussion: 12.55 – 13.05Indication for Closed-wedge HTO

4. DFO and TomoFix MDF 1

• Van Heerwaarden Ronald: 13.05 – 13.15 Chairman

vanheerwaarden@yahoo.com

„Development of new DFO technique and TomoFix MDF plate“

• Gaasbeek Robert: 13.15 – 13.25rda.gaasbeek@meandermc.nl

„Femurosteotomies“

4. DFO and TomoFix MDF 2

• Heijens Etienne : 13.25 – 13.35Heijens@Gelenkzentrum-wiesbaden.de

„4 failures with TomoFix MDF - salvage, outcome and personal conclusions“

• Bacher Thomas: 13.35 – 13.45 thomas.bacher@hellersen.de

„Femur and Double osteotomies, case reports“

Discussion: 13.45 – 14.00

5. Navigation 1„ Nice to have vs. must to have“

• Keppler Peter: 14.00 – 14.10peter.keppler@uniklinik-ulm.de

„Navigated Double LevelOsteotomies around the Knee“

• Gebhard Florian: 14.10 – 14.20 florian.gebhard@uniklinik-ulm.de

„CAS and HTO (CSEG Study)“

5. Navigation 2„ Nice to have vs. must to have“

• Heijens Etienne: 14.20 - 14.30Heijens@Gelenkzentrum-wiesbaden.de

„Use of navigation in HTO: Results and perspectives“

• Staubli Alex E.: 14.30 – 14.40alex.staubli@sonnmatt.ch

“Precision and intraoperative control of osteotomies around the knee – my navigation for daily use”

Discussion : 14.40 – 15.00

Intermission: 15.00 – 15.15

5. Versatility of the TomoFix System 1

• Holzach Peter: 15.15 - 15.25 Chairman

pholzach@sportclinic.ch

„Re-knee-osteotomies in failed cases“

• Elo Jussi: 15.25 – 15.35jussi.elo@pshp.fi

„Proximal tibial osteotomies in knee stability“

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 take0822@hotmail.com

„Bilateral Open-wedge HTO and interpositional grafting“

5. Versatility of the TomoFix System 3

• Dawson Matthew: 15.55 – 16.05matt.dawson@ncumbria-acute.nhs.uk

„Versatility of the TomoFix System“

• Norris Brent: 16.05 – 16.15brent.norris@otsok.com

„Versatility of the TomoFix System:Fracture work“

6. Case presentations Chairman Sawaguchi Takeshi

• Quintero Gil Jose Eduardo: 16.15 – 16.25Jose.quinterogil@aoalumni.org

„My best case, woman, 28y, correction of bilateral valgus deformity“

Ev. DiscussionSimultaneous bilateral Osteotomies

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

7. Present and futurescientific activities

• Lobenhoffer Philipp: 16.25 – 16.40 HPLobenhof@aol.com

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

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!

For all participants we have prepared a handout of all

presentations

„Es gilt das gesprochene Wort“

•Folien: Introduction

• Chaosplakat• From Team to Team• Best Joke Videos

• Fotosession 10 Jahre TomoFix

• 1. Operationsschritte• Targetfoto• Announcements