Newsletter  |  March 2019


ADAPT for Gamma3

ADAPT’s software is designed to provide 3-dimensional guidance for implant placement based on x-ray images and offers precision where it matters most, an adaptive workflow and is designed for consistent results with Distal Targeting support. This software can eliminate the need for certain hardware instrumentation while enabling surgeons to guide implant alignment, lag screw length determination, lag screw positioning and distal targeting. Explore the resources below to learn more about ADAPT for Gamma3.

Precise lag screw placement with the use of a novel computer assisted surgery system during cephalomedullary nailing.


T2 Alpha

T2 Alpha is the result of Stryker’s latest technological advancements in both implant and instrumentation design delivering a comprehensive intramedullary nailing system designed for intuitive use and a streamlined procedure. T2 Alpha delivers a comprehensive implant portfolio to meet the diverse anatomical needs of patients with nails designed for preferred entry (greater trochanteric or piriformis fossa), length-dependent radius of curvature, and added locking configurations both proximally and distally.

T2 Alpha introduces a new screw option called the Advanced Locking Screw designed for added axial and angular stability. The Advanced Locking Screw is designed to limit relative motion between the nail and screw while maintaining bi-cortical purchase1,2. With the ability to thread and lock into any round 5mm hole of T2 Alpha nails, Advanced Locking Screws allow surgeons to choose when additional stability is needed. In addition, T2 Alpha allows for guided distal screw locking with dedicated distal targeting devices for both femur and tibia.  Distal targeting devices are designed to provide surgeons with a reproducible and consistent procedure for distal screw locking while may reduce X-ray exposure and improve OR efficiency3


Plating

Over the past decade we have continued to expand our comprehensive plating portfolio by releasing over 35 new products. This year Stryker maintains its position as the market leader in titanium plating by providing innovative solutions to treat periprosthetic fractures. The new AxSOS 3 Variable Angle Extension Arm provides the ability to avoid a prosthetic implant with variable angle locking. The AxSOS 3 cable plug provides stable positioning of cerclage cable on a plate. These periprosthetic plate attachments, when used independently or together, allow for multiplanar fixation around an intramedullary implant.

Visit our website to learn more about how Stryker continues to provide unmatched instrumentation, data driven plate design, and innovative solutions to solve complex cases.


ReUnion S

Current short stem designs have presented higher rates of humeral stem complications such as bone resorption and radiolucencies. This may be due to over shortening, increased proximal bulk, and poor implant alignment.4, 5 This latest technology focuses on bone preservation, alignment and stability, which is designed to be the ideal length for use with the ReUnion Shoulder Arthroplasty System. These are intended for patients that may be considered for shoulder arthroplasty. By utilizing the Stryker Orthopaedics Modeling and Analytics (SOMA) database and software, study findings have allowed to the development of a more anatomically relevant length stem. These findings and the new stem have led to:  

Bone preservation: ReUnion S preserves more bone mass proximally and distally compared to competitive stems.6 By keeping the wedge shape proximal body, soft-tissue management preference is that of the user, not limited by the stem design. Reduced stem length was determined through our SOMA analysis; identifying a humeral transition point and alignment length.7

Alignment: By extensively studying the cross-sectional geometry of the humeral canal with SOMA, a unique transition point was identified where the flare of the metaphysis tapers to the more regular, cylindrical shape in the diaphyseal region. With the transition point identified, our target alignment zone was identified to avoid varus/ valgus placement of the stem.7

Stability: The enhanced medial sweep of the stem avoids distal engagement while the alignment focused length and incremental distal sizing options prevent canal migration. The S stem is designed to retain the alignment and stability benefits of a longer humeral stem prosthesis.7

Register for our upcoming webinar, The Science of Stem Length in Shoulder Arthropolasty' featuring Joaquin Sanchez-Sotelo, M.D., Ph.D. and Mark Mighell, M.D. They will present topics related to optimal stem length selection.
 
This session will highlight the recent trend of shorter stems in shoulder arthroplasty, the risks presented by stems that are too short or lead to adverse bone reaction such as stress-shielding, and an overview of a study used to determine the ideal length humeral stem.


References:

  1. T2-WP-6, 07-2018     
  2. T2 Alpha Femur Antegrade GT/PF Nailing System Operative Technique, T2-ST-17_Rev-4, 09-2018
  3. Adam et al. External distal targeting device for safe insertion of distal locking screws when performing long Gamma Nail: Comparison with the freehand technique. Bone and Joint. Vol 94-B Supp XXXVII. 14 Sep 2012
  4. Gilot G, Alcareaz-Pinzon AM, Wright TW, Flurin PH, Krill M, Routman HD, Zuckerman JD. The incidence of radiographic aseptic loosening of the humeral component in reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2015 Oct;24(10):1555-9. Epub 2015 May 7     
  5. Morwood MP, Johnston PS, Garrigues GE. Proximal ingrowth coating decreases risk of loosening following uncemented shoulder arthroplasty using mini-stem humeral components and lesser tuberosity osteotomy. J Shoulder Elbow
    Surg 2017;26:1246-52    
  6. Internal document: A0042705
  7. Internal document: A0042660