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Wright Medical Technology
ORTHOSPHERE® Foot Surgical Technique ? SO036?103

ORTHOSPHERE® Foot Surgical Technique ? SO036?103

Product catalog summary

Introduction
The ORTHOSPHERE® Interpositional Arthroplasty Implant is designed for treating degenerative joint disease of the midfoot, particularly when nonoperative methods fail. It offers an alternative to arthrodesis, preserving lateral column motion necessary for normal foot biomechanics.

Surgical Technique

Step 1: Make a dorsolateral incision over the 5th metatarsal and cuboid area.
Step 2: Expose the lateral two tarsometatarsal (TMT) joints, retract extensor tendons, debride osteophytes, and perform synovectomy.
Step 4: Use a starter burr to create a center hole in the articular surfaces of each lateral TMT joint.
Step 5: Create semispherical recesses with oscillating burrs, preserving a cortical rim.
Step 6: Insert trial sizing tools to ensure adequate sphere size, typically size 11, for joint distraction and motion.
Step 7: Insert the ORTHOSPHERE® implant, verify stability, approximate soft tissues, and apply a splint.

Postoperative Course
Immobilization and weightbearing depend on additional procedures. For isolated lateral column arthroplasty, non-weightbearing is advised for two weeks, followed by full weightbearing in a walker boot. At six weeks, an accommodative shoe with arch support is recommended.

Instrument Set
The ORTHOSPHERE® Instrument Set includes oscillating burrs, implant sizers, rotary starter burrs, insertion forceps, a burr cleaning brush, and power adapters. Implant sizes range from 9mm to 14mm.

Manufacturer Information
Wright Medical Technology, Inc. provides the ORTHOSPHERE® implant, with contact details for both the US and Europe included.

Catalog excerpts

ORTHOSPHERE® Foot Surgical Technique ? SO036?103-1

Tarsometatarsal Interpositional Arthroplasty SURGICAL TECHNIQUE

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-2

ARTHROPLASTY IMPLANT

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-3

ORTHOSPHERE® INTERPOSITIONAL ARTHROPLASTY IMPLANT ORTHOSPHERE® tarsometatarsal INTERPOSITIONAL ARTHROPLASTY Surgical Technique as described by Robert Anderson, MD Degenerative joint disease of the midfoot is not uncommon | FIGURE 1 and may be associated with inflammatory conditions such as gout or pseudogout. When nonoperative modalities (i.e. shoe modifications) fail to provide relief of activity-related discomfort, surgery may be considered. While arthrodesis provides good results with medial column involvement, it limits compensatory motion at the lateral column (4/5 tarsometatarsal joints)...

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-4

ORTHOSPHERE® INTERPOSITIONAL ARTHROPLASTY IMPLANT STEP 4 | Once exposure is achieved and utilizing fluoroscopic confirmation, the small starter burr is used to create a center hole in the opposing articular surfaces of each lateral TMT joint | FIGURE 4. STARTER BURR STEP 5 | While preserving a cortical rim, semispherical recesses are created using the implant sized oscillating burrs | FIGURE 5. NOTE | The TAVA hand power loaner system for the oscillating burrs may be ordered from Wright. The kit number is TAVA KIT1. FINISHING BURR

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-5

ORTHOSPHERE® INTERPOSITIONAL ARTHROPLASTY IMPLANT STEP 6 | The trial sizing tools are inserted to ensure the sphere size is adequate (typically size 11) and will provide mild joint distraction and free motion | FIGURE 6. STEP 7 | Once the size is determined, the ORTHOSPHERE® Interpositional Arthroplasty implant is inserted with planar flexion applied to the metatarsal | FIGURE 7. Stability is verified through the ranges of motion. Overlying soft tissues are approximated and a splint is applied.

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-6

ORTHOSPHERE® INTERPOSITIONAL ARTHROPLASTY IMPLANT postoperative COURSE The period of immobilization and protected weightbearing after interpositional arthroplasty is dictated by concomitant procedures (i.e. medial column arthrodesis). In the event that an isolated lateral column arthroplasty is performed, the patient is immobilized and instructed non-weightbearing for two weeks. They then progress to full weightbearing in a removable walker boot. An accommodative shoe with an arch support device is then utilized at six weeks. Postoperative x-rays show placement of implants | FIGURE 8A, 8B.

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ORTHOSPHERE® Foot Surgical Technique ? SO036?103-8

The ORTHOSPHERE" Instrument Set includes 6 oscillating burrs, 6 implant sizers, 2 rotary starter burrs, insertion forceps, burr cleaning brush, and power adapters. The implant sizes are as follows: CATALOG* SPHERE SIZE Wright Medical Technology, Inc. Wright Medical Europe SA Commerce Pare Gebouw B, 6th Floor Krijgsman I 82006, Wright Medical Technology, Inc. All Rights Reserved. SO036-103 ORTHOSPHERE" is a registered mark of Wright Medical Technology, Inc. Rev' 2-06 Caution: Federal (United States) law restricts this device to sale by or on the order of a physician.

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*Prices are pre-tax. They exclude delivery charges and customs duties and do not include additional charges for installation or activation options. Prices are indicative only and may vary by country, with changes to the cost of raw materials and exchange rates.

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