Mini Tightrope Bunionectomy

[DPMer]

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Has any attending used this procedure and trained residents with it? Is there enought evidence based peer reviewed articles about this technique? Thanks.

http://www.youtube.com/watch?v=dX6WKjsPpVc

 

[NatCh]

I did a couple dozen cases about half a decade ago but learned my lesson and no longer do them. Phewww, thank god that's over.

http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=4681

 

[Podfather]

Has any attending used this procedure and trained residents with it? Is there enought evidence based peer reviewed articles about this technique? Thanks.

http://www.youtube.com/watch?v=dX6WKjsPpVc

I love how ideas recycle themselves. It was the Lepenhager?? suture a 100 years ago where someone would wrap suture around the metatarsal necks of 1 and 2. In the 80s it was the adductor tendon transfer through the first metatarsal neck. They never held up and quickly lost favor. Now it's a product that can be sold which acts exactly like the adductor tendon transfer. Second metatarsal fractures can occur and if some has a high IM just fix it please! If osteopenic then the tightrope will not hold either.

Now for hallux varus repair where a soft tissue fix will work the tightrope makes sense and spares the EHL (used for transfer) and the need for an IPJ arthrodesis,

 

[Ferocity]

I shadowed a very popular pod that performs his bunionectomies like this. I believe he uses Arthrex.

Subscribed.

 

[Podfather]

I shadowed a very popular pod that performs his bunionectomies like this. I believe he uses Arthrex.

Subscribed.

I am friends with many of the "popular pods" (sounds a little high school) and 10-1 your guy is an Arthrex consultant. Not judging someone has to do the research to show these either work or not. I'm just saying the procedure has been around in various forms for a long time and hasn't worked. IMO it doesn't even make scientific sense.

An equipment/implant company exec who wanted to hire me as aconsultant once said "if it's easy and billable podiatrists will use it" Sadly I must concur. The only good with that he also said the profits made on these things (after some is siphoned off) are used to create good products that are innovative and needed.

 

[Feli]

I did a couple dozen cases about half a decade ago but learned my lesson and no longer do them. Phewww, thank god that's over.

http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=4681

+1

I'd concur with PADPM and NatCh. I've seen and heard the f/u for miniTightRope HAV in the hands of skilled surgeons, and it's not pretty when compared to the alternatives. The main reasons I'd never consider for HAV correction it would be:
-severe complications (swelling +/- sterile abscess, 2nd met fx, implant failure - immediate or eventual with recurrence, etc)
-lack of long term osseous correction
-cost (plain jane k-wire or screws <<<< TightRope)
-many other more proven and time-tested quality alternatives for HAV (namely McBride, Austin, Lapidus, or MPJ1 desis)

...They can rep really anything and make it look like a miracle, but as PADPM mentioned, this is just recycling. Suture or pure soft tissue correction for moderate to severe HAV never caught on before, and there's a good reason for that: the EBM just isn't there. I think Tightrope's main indications are ankle syndesmotic injury (cost of HWR may justify using the implant) or possible hallux varus repair with the mini version.

 

[Podfather]

+1

I'd concur with PADPM and NatCh. I've seen and heard the f/u for miniTightRope HAV in the hands of skilled surgeons, and it's not pretty when compared to the alternatives. The main reasons I'd never consider for HAV correction it would be:
-severe complications (swelling +/- sterile abscess, 2nd met fx, implant failure - immediate or eventual with recurrence, etc)
-lack of long term osseous correction
-cost (plain jane k-wire or screws <<<< TightRope)
-many other more proven and time-tested quality alternatives for HAV (namely McBride, Austin, Lapidus, or MPJ1 desis)

...They can rep really anything and make it look like a miracle, but as PADPM mentioned, this is just recycling. Suture or pure soft tissue correction for moderate to severe HAV never caught on before, and there's a good reason for that: the EBM just isn't there. I think Tightrope's main indications are ankle syndesmotic injury (cost of HWR may justify using the implant) or possible hallux varus repair with the mini version.

That would be Podfather who said that. We are both old ( PADPM and Podfather) so I can see how you would mix us up.🙂

 

[PADPM]

That would be Podfather who said that. We are both old ( PADPM and Podfather) so I can see how you would mix us up.🙂

Old???? I'd say "mature".

 

[Podfather]

Old???? I'd say "mature".

Better: Sean Connery like looks and distinguished?

 

[PADPM]

Better: Sean Connery like looks and distinguished?

Now you're really depressing me. Sean Connery is old enough to be my father!! Jeez, it's a LONG time away for me (and you) to even qualify for an early bird special!

Come on, I'm still taking Flinstone vitamins.

 

[Feli]

That would be Podfather who said that. We are both old ( PADPM and Podfather) so I can see how you would mix us up.🙂

My mistake, sorry man.

Are you gonna be in Key West for the GTEF conf this weekend by any chance?

 

[NatCh]

Now you're really depressing me. Sean Connery is old enough to be my father!!

Ummmm...Kevin Bacon?