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ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE PowerPoint PPT Presentation


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ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE. LIGA-FIBA ISO-TOGGLE PROSTHESIS. 250 lb Liga-Fiba. Toggle. Tie-down button. Threading needle with nylon loop. Demonstration on Plastic Model. Drilling the femoral isometric tunnel. Demonstration on Plastic Model.

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ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE

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ISO-TOGGLE SYSTEM FOR THE MANAGEMENT OF CRUCIATE RUPTURE


LIGA-FIBA ISO-TOGGLE PROSTHESIS

250 lb

Liga-Fiba

Toggle

Tie-down

button

Threading needle with nylon loop


Demonstration on Plastic Model

Drilling the femoral isometric tunnel


Demonstration on Plastic Model

Drilling the tibial isometric tunnel


Demonstration on Plastic Model

The implant: 250 or 500lb LIGAFIBA; UHMWPE

(ultra high molecular weight polyethylene) buttons

Push- Pull graft passer or threading needle is used to pass the graft


Demonstration on Plastic Model

A 250lb LIGAFIBA loop secured over an UHMWPE toggle on the medial aspect of the femur


Demonstration on Plastic Model

A 250lb LIGAFIBA loop tied over an UHMWPE button on the medial aspect of the tibia. Note that the loop can either pass over or under the LDE.


Demonstration on Plastic Model

x

Note the orientation of the 250lb LIGAFIBA loop

Compression of the LDE tendon (X) is a theoretical problem and placing the material under the tendon is an alternative


ISO-TOGGLE SYSTEM USING250 lb LIGA-FIBA

Pointer on

the lateral

fabella

Lateral parapatellar approach with reflection of the fascia.


2.5-3.0mm drill bit and drill guide positioned on

the femoral ISOMETRIC point, which is just cranial to the distal pole of the lateral

fabella

Drilling the femoral tunnel from the femoral isometric point

Lateral view of the stifle


2.5-3.0mm drill bit from

the femoral ISOMETRIC point emerging on the medial side of the femur under the caudal edge of the medial vastus muscle

Cranial view of the stifle on completion of the femoral tunnel


The pointer is on the cranial aspect of the tibial extensor fossa.

Identifying the tibial isometric point on the lateral

aspect of the tibia


2.5-3mm drill bit and drill guide positioned on

the tibial ISOMETRIC point, which is the tubercle on the cranial aspect of the extensor fossa

Drilling the tibial tunnel from the isometric point


2.5-3mm drill bit from

the tibial ISOMETRIC point, directed in a lateral to medial direction emerging on the medial aspect of the proximal tibial

Cranial view of the stifle on completion of the tibial tunnel


Long threading needle and nylon loop used to pass the prosthesis through the tibial tunnel

Cranial view showing the start of threading the 250 lb Liga-Fiba loop

starting on the medial aspect of the tibia


Cranial view showing the 250 lb Liga-Fiba loop

threaded through the tibial tunnel in a medial to lateral direction


Tie-down button

Threading

needle

Cranial view showing the 250 lb Liga-Fiba loop

threaded through the femoral tunnel


Threading

needle removed.

Toggle to be inserted

Cranial view showing completion of inserting the 250 lb Liga-Fiba loop

but before insertion of the toggle and tensioning.


Toggle

inserted

Cranial view showing the insertion of the toggle and the start of

tensioning the 250 lb Liga-Fiba loop.


Lateral view showing the isometric position of

the 250 lb Liga-Fiba loop before and after tying off.


Tie-down

button

Medial view of the tibia showing the

the 250 lb Liga-Fiba loop being tensioned prior to tying down


Medial view of the tibia showing the

the 250 lb Liga-Fiba loop secured by tying over the button

and the ends cut


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