New Bunion “Tight-Rope”

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Looks pretty slick.... thoughts? 2 point “fixation”.

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Guess foot & ankle hardware companies are like Hollywood... can't come up with anything new so lets just remake old gimmicks.
 
There's a "PI" type chapter on the internet discussing an old study where they were performed. 18 patients, 21 feet. 4 2nd metatarsal stress fracture.
 
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1668716430445.png

Correction doesn't look very good but maybe the patient loves it.
 
Yah that 2nd met “giving in” seemed suspect to me. Short term solution it sounds like.
 
No no no no no...

Don't do it.
 
This has been done again and again and again... nothing new.

First it was the "rope a dope" with just suture... very dumb, at least it was cheap.

Then, it was Arthrex mini tightrope for HAV about 15 years ago... fail. Recurrences, 2nd met fx, varous FAILs.

Now some small time maker is thinking it'll work? Leave it to podiatry to "adopt it." Uff da.

Utvolsdpm said:
My initial thoughts are - how is this any different than the bunion tight rope from a decade or 2 ago?
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It was from both 4 and 2 decades ago. Fail and fail again. Same for MIS and MPJ implants and many other "new" things. Funny how that stuff works 🙂
 
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Feli said:
This has been done again and again and again... nothing new.

First it was the "rope a dope" with just suture... very dumb, at least it was cheap.

Then, it was Arthrex tightrope for HAV about 15 years ago... fail.

Now some small time maker is thinking it'll work? Leave it to podiatry to "adopt it." Uff da.


It was from both 4 and 2 decades ago. Fail and fail again. Same for MIS and MPJ implants and many other "new" things. Funny how that stuff works 🙂
Click to expand...
I feel like bunion surgery in school is more taught as a list and a recital than as any sort of commentary on effectiveness.

Everyone is open to their own experience but I have never seen a patient who received an opening or closing base wedge who was happy. In fact these patients have often described themselves as ruined / scarred for life etc after surgery. The procedure never works. Strangely they routinely complain of permanent nerve problems / numbness. Yet this is taught in school as just another technique.
 
heybrother said:
I feel like bunion surgery in school is more taught as a list and a recital than as any sort of commentary on effectiveness.

Everyone is open to their own experience but I have never seen a patient who received an opening or closing base wedge who was happy. In fact these patients have often described themselves as ruined / scarred for life etc after surgery. The procedure never works. Strangely they routinely complain of permanent nerve problems / numbness. Yet this is taught in school as just another technique.
Click to expand...
Oh ****, don't remind me about base wedges. I still remember the first couple of years in practice when I used to do those. Brrrrrrrr. All the proper indications were there, I made the textbook bone cuts, sent the screw(s) just right, then a little ways into their post-op course they asked why their foot looked so funny. 💩👎🤦‍♂️
 
NatCh said:
Oh ****, don't remind me about base wedges. I still remember the first couple of years in practice when I used to do those. Brrrrrrrr. All the proper indications were there, I made the textbook bone cuts, sent the screw(s) just right, then a little ways into their post-op course they asked why their foot looked so funny. 💩👎🤦‍♂️
Click to expand...
Lol. That was my residency timeline. We had so many attendings at our hospitals that only a few of mine were adopting Lapidus at the time I trained. Even West Penn (who basically popularized Lapidus in podiatry) or Hyer and Kaiser were still playing around with crescenterics and silly HAV stuff I'm sure they've 99% abandoned now.

Me: "Should we try that Lapidus idea from the new journal articles for that high IM bunion instead of a base wedge?"
"Noooo... base wedge good, but we now have this newfangled OPENING base wedge plate. Opening wedge better. Lapidus sound like trubble."

...base wedge seemed limited (maybe a terrible HAV kid that can't wait for Lapidus). I decided I would just do Austins and Lapidus. Then, I got clever and tried a few Maus... blah, done with that within a few years. Now, I do Lapidus >>> MPJ 1 fusion > Austin >> anything else. I'm sure the SCARF-is-a-miracle crowd can chime in to put the discussion on HAV to rest 🙂
 
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Feli said:
Lol. That was my residency timeline. We had so many attendings at our hospitals that only a few of mine were adopting Lapidus at the time I trained. Even West Penn (who basically popularized Lapidus in podiatry) or Hyer and Kaiser were still playing around with crescenterics and silly HAV stuff I'm sure they've 99% abandoned now.

Me: "Should we try that Lapidus idea from the new journal articles for that high IM bunion instead of a base wedge?"
"Noooo... base wedge good, but we now have this newfangled OPENING base wedge plate. Opening wedge better. Lapidus sound like trubble."

...base wedge seemed limited (maybe a terrible HAV kid that can't wait for Lapidus). I decided I would just do Austins and Lapidus. Then, I got clever and tried a few Maus... blah, done with that within a few years. Now, I do Lapidus >>> MPJ 1 fusion > Austin >> anything else. I'm sure the SCARF-is-a-miracle crowd can chime in to put the discussion on HAV to rest 🙂
Click to expand...
Yep, live and learn.
 
I remember a couple attendings trying a tight rope to fix a hallux varus. It would fail and then get fused. This would be the same. It would look better for a little and then fail then need something else done.
 
LMAO...what's old is new again. There's a reason it went away. And was done again. And went away again. Kinda like the resurgence of MIS. Should never be. Don't do it. Evolve. You don't want a revolution on this case.
 
PlainsPod said:
The 1st MPJ arthrodesis is a lot like pizza. Even when it comes out bad it’s still pretty good.
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I don't know, man...I've had a lot of really bad pizza. Not since moving back to the South Jersey area , though.
 
NatCh said:
After having done first ray surgery for over twenty years now I’ve come to LOVE the predictability of the 1st MTP arthrodesis.
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Seriously. I offer this to all my male patients whom don't mind not wearing high heels, or female patients over 50/60. Lapidus for the young and very active. Distal osteotomy for the few that want a fast recovery and walking on it right away.
I made a surgery explanation sheet that listed the above 3 bunion surgeries. Anybody that wants something outside of these three will get referred out.
 
You are all SO old school. I don’t need no stinkin’ tight rope, Lapiplasty, Lapifuse, Wright MIS sets, Arthrex MIS sets, Austin’s CBWs, OBWs, fusions, etc.

This is ALL you need and BAM it’s fixed.

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