suture anchors for veterinary use - synthes.vo.llnwd.netsynthes.vo.llnwd.net/o16/llnwmb8/us...

technique Guide

Suture anchorS for VeterinarY uSeFor Joint Stabilization and Ligamentous andTendon Injury Repairs in Cats and Dogs

Mini QUICKANCHOR® Plus Anchor

GII® QUICKANCHOR® Plus Anchor

Super QUICKANCHOR® Plus Dual Suture Anchor

HEALIX TRANSTEND™ Ti Anchor

4.5 HEALIX Ti™ Dual Threaded Suture Anchor

Suture Anchors for Veterinary Use Technique Guide DePuy Synthes Vet

introduction

technique

product information

quicKanchor® and heaLiX anchors™ 2

orthocord® Suture 3

indications 4

quicKanchor Suture anchors 5 preloaded with orthocord Suture

quicKanchor Suture anchors 8 with threader tabs

heaLiX anchors with orthocord Suture 11

instruments and implants 12

taBLe of contentS

1 DePuy Synthes Vet Suture Anchors for Veterinary Use Technique Guide

quicKanchor® and heaLiX anchorS™

Multiple Optionsrange of suture anchor sizes from mini quicKanchor (1.8 mm) to Super quicKanchor anchors (2.9 mm)

Sliding SutureSuture passes smoothly through the anchor eyelet to accommodate different knotting techniques

featureS and BenefitS of quicKanchorS anchorS

mini quicKanchor plus anchor (1.8 mm)

Super quicKanchor plus dual Suture anchor (2.9 mm)

Gii quicKanchor plus anchor (2.4 mm)

Thread Pattern dual-thread pattern independently engages both cortical and cancellous bone

Cannulationcannulation channels blood to the surface

Hex Driverdeep hex recess for optimal torque transmission

featureS and BenefitS of heaLiX anchorS

heaLiX tranStend™ ti anchor (2.9 mm)

4.5 heaLiX ti™ dual threaded Suture anchor

Threader Tabsprovides fl exibility for different suture size and material

Suture Anchors for Veterinary Use Technique Guide DePuy Synthes Vet 3

featureS and BenefitS of orthocord SutureS

orthocord® Suture

ORTHOCORD Suture Featuresx high tensile and knot strengthx Balance of knot slide ability, knot security, stiffness,

and elastic tensionx Less likelihood of abrasion to surrounding tissues

or surgeon’s hands1

x Small knot profi lex Less susceptible to bacterial adherence2

concLuSion: the knot break strength of orthocord #2 Suture is higher than the knot break strength of fiberwire #2 Suture.

concLuSion: orthocord #2 Suture is 45% less stiff than the fiberwire #2 Suture.

StiffneSS compariSon3

0

1

2

3

4

orthocord #2Suture

fiberwire® #2

1.8 3.1

gram

s fo

rce

0

10

20

30

40

orthocord #2Suture

fiberwire #2

19.6 18.5poun

ds

Knot tenSiLe StrenGth4

1. wust dm, meyer dc, favre p, Gerber c. mechanical and handling properties of braided polyblend polyethylene sutures in comparison to braided polyester and monofi lament polydioxanone sutures. Arthroscopy. 2006;22(11):1146-1153.

2 . masini B, Stinner d, waterman S, et al. Bacterial adherence to high-tensile strength sutures. Arthroscopy. 2011;27(6):834-838.

3. results of Stiffness analysis test tm007-03 performed by ethicon, inc. cpc. data on fi le.

4. data on fi le at DePuy Synthes Mitek Sports Medicine.

orthocord Suture is a partially absorbable suture made of a unique combination of polyethylene and polydioxanone (pdS). it has been engineered to balance strength, abrasion, cut resistance, and fl exibility.


indicationS

the DePuy Synthes Mitek Sports Medicine Suture anchors with orthocord Sutures are indicated for:*x medial shoulder instabilityx coxofemoral dislocation (iliofemoral suture and

capsulorrhaphy)x collateral ligament injuries of the carpus and tarsus

* the surgeon must be thoroughly knowledgeable on the medical and surgical aspects of these indications. the surgeon is advised to adequately protect the surgical repair and to properly advise owners on the importance of postoperative instructions.

refer to the relevant package insert for appropriate indications.


technique

quicKanchor Suture anchors preloaded with orthocord Suture

Note: Photos in this section depict the Super QUICKANCHOR Anchor, but technique is similar for the Mini and GII QUICKANCHOR Suture Anchors.

Mini QUICKANCHOR Anchor (1.8 mm)

212038 mini quicKanchor plus with #0 orthocord

211069 2.0 mm drill Bit (comes packaged with 212038)

213072 mini drill Guide

GII QUICKANCHOR Anchor (2.4 mm)

222983 Gii quicKanchor plus with #2 orthocord

211093 Gii drill Bit 2.4 mm

213207 Gii/Super/rc Slotted drill Guide

Super QUICKANCHOR Anchor (2.9 mm)

222984 Super quicKanchor plus with #2 orthocord dual Suture

211113 Super/rc drill Bit 2.9 mm


Note: All QUICKANCHOR Suture Anchor designs use barbs for retention in bone. Once set, these anchors cannot be removed or reoriented. If needed, another anchor can be placed adjacent to the first. Refer to next section for adjacent anchor placement guidance.

1. drill to shoulder using appropriate drill bit (figures 1a and 1b).

figure 1b

drill Bit Shoulder

drill Bit Shoulder

figure 1a

drill Bit Shoulder


quicKanchor Suture anchors with orthocord Suture

2. insert anchor (figure 2) by pushing into bone until fully seated (until inserter shoulder contacts bone). a mallet may be needed to fully insert anchor.

Warning: Anchor MUST be inserted to shoulder depth to prevent suture damage.

Note: Do not attempt to twist or bend handle during insertion.

3. pull back on inserter handle until anchor has disengaged from inserter (figure 3). there will be a slight resistance as handle is disengaged due to suture spool inside inserter handle.

4. Slide the suture cover back and remove suture.

Warning: Needles are attached to suture for Mini QUICKANCHOR Suture Anchor, GII, and Super QUICKANCHOR Suture Anchor Systems. Take precautions when removing suture.

5. pull on both ends of suture to set anchor.

if it becomes necessary to slide suture through anchor eyelet after insertion, avoid contact between suture and bone by holding suture in-line with anchor, as shown in figure 4. do not attempt to slide the suture through the eyelet, as shown in figure 4a, as suture damage may occur.

figure 2: anchor during insertion, not yet seated.

figure 3 figure 3a: open Suture cover

inserter Shoulder

figure 4a: Incorrect orientation of suture when sliding it through anchor eyelet.figure 4: correct orientation of suture when sliding it through anchor eyelet.


Placing adjacent QUICKANCHOR Suture Anchors

Note: When placing adjacent anchors it is important to note the orientation of the barbs on the QUICKANCHOR Suture Anchor designs, as this will dictate minimum distance between anchors (see table below).

quicKanchor Suture anchors with orthocord Suture

the tables above based on preserving at least 3 mm of bone stock between adjacent quicKanchor Suture anchors and preventing interference between anchors.

mini quicKanchor plus anchor

Super quicKanchor plus dual Suture anchor

Gii quicKanchor plus anchor

AnCHOr spECIFICAtIOns

Mini QUICKAnCHOr GII QUICKAnCHOr super QUICKAnCHOr

Body diameter 1.8 mm 2.4 mm 2.9 mm

dist across Barbs 4.4 mm 5.9 mm 6.5 mm

rECOMMEnDED DIstAnCE BEtWEEn AnCHOrs

Mini QUICKAnCHOr GII QUICKAnCHOr super QUICKAnCHOr

Barbs parallel 4.8 mm 5.4 mm 5.9 mm

Barbs perpendicular 7.5 mm 9 mm 10 mm


technique

quicKanchor Suture anchorS with threader taBS

the mini quicKanchor, Gii, and Super quicKanchor anchors are also available without preloaded inserter handles or suture. refer to instructions below to load free anchors onto their respective inserters.

General Instructions for Loading Suture onto Free QUICKANCHOR Suture Anchor:1. insert approximately 50 mm of suture through metal

threader loop (figure 1).

2. withdraw threader loop from anchor to transfer suture to anchor eyelet (figure 2).

3. center anchor on suture strand by pulling suture, as shown in fig 3. do not attempt to slide suture, as shown in fig 3a, as suture damage may occur.

NOTE: The maximum suture size for Mini QUICKANCHOR Suture Anchor is #0; for GII and Super QUICKANCHOR Suture Anchor the maximum suture size is #2. Super QUICKANCHOR Suture Anchor can accommodate 2 strands of #2 suture.

threader tab

Suture threader Loop

figure 1: 50 mm of suture loaded through threader loop.

figure 2: Suture transferred to anchor eyelet.

figure 3a: Incorrect orientation of suture when sliding it through anchor eyelet.figure 3: correct orientation of suture when sliding it through anchor eyelet.


quicKanchor Suture anchors with threader tabs

instructions for attaching loaded anchor onto inserter:

Threader Tab Instruments for Mini QUICKANCHOR Suture Anchor:

210366 mini anchor, threader tab (5/box)


211083 mini drill Bit, 2.1 mm

223124 orthocord #0, 36 inches, taper, 22.2 mm, 1/2 circle (12/box)

212123 mini Syringe inserter

1. Before attaching anchor to mini Syringe inserter, retract plunger by pulling back slider until it snaps into place (figure 4). attach loaded mini quicKanchor Suture anchor to plunger end of Syringe inserter.

Note: Mini QUICKANCHOR Suture Anchor barbs will slide into one pair of body slots; the suture will slide into the other pair of slots (Figure 5).

2. pull both ends of suture tight to hold anchor in place, then wrap ends of suture under rubber ring on slider. Suture should be routed through slots in slider flange (figure 6).

3. insert anchor by placing tip into pre-drilled 2.1 mm hole and pushing on slider until anchor is fully inserted.


4. pull on both ends of suture to set anchor in the bone.

Slider Body Slots

plunger(shown extended)

figure 4: mini Syringe inserter.

figure 5: mini quicKanchor anchor loaded on mini Syringe inserter.

figure 6: Suture ends secured under rubber ring.


quicKanchor Suture anchors with threader tabs

figure 7 figure 7a: anchor properly attached to Super inserter (similar for Gii.)

inserter Shoulder

inserter endThreader Tab Option for GII QUICKANCHOR Suture Anchor

210393 Gii anchor with threader tab (5/box)

210493 Gii anchor with threader tab (1/box)

211093 Gii drill Bit, 2.4 mm

212094 Gii inserter

223111 orthocord Blue (without needles) (12/box)

Threader Tab Option for Super QUICKANCHOR Suture Anchor

210309 Super anchor with threader tab, (5/box)


211113 Super/rc drill Bit, 2.9 mm

212114 Super/rotcuff inserter

223111 orthocord Blue (without needles) (12/box)

1. attach anchor (with suture) to distal end of Gii or Super quicKanchor Suture anchor inserter.

2. to secure anchor on inserter, pull both ends of suture proximally, then slide suture ends through slots in inserter handle (figure 7). if anchor does not fit snugly into end of inserter, check inserter end for possible damage (figure 7a).

3. fully insert anchor into predrilled hole (until inserter shoulder contacts bone). a mallet may be needed to fully insert anchor.

– 2.4 mm hole for Gii anchor – 2.9 mm hole for Super quicKanchor anchor

4. pull on both ends of suture to set anchor in the bone.

Warning: Anchor MUST be inserted to shoulder depth to prevent suture damage. If excessive resistance is felt during anchor insertion, check inserter end for damage (Figure 7a).



HEALIX TRANSTEND Ti Anchor (2.9 mm)

222260 heaLiX tranStend ti anchor with #2 orthocord

222281 heaLiX tranStend 2.2 mm drill Bit

4.5 HEALIX Ti Anchor (4.5 mm)

211026 panaLoK® drill Bit 3.5 mm

222253 4.5 heaLiX ti anchor with #2 orthocord dual Suture

222226 heaLiX cortical awl/tap 4.5 mm

1. pre-drill using appropriate drill bit.

x 2.2 mm drill bit for heaLiX tranStend ti anchorx 3.5 mm drill for 4.5 heaLiX ti anchor

Optional Technique: Use 4.5 mm Cortical Awl / Tap.

2. insert the anchor by turning clockwise (figure 1) until the anchor is fully inserted and the distal laser line on inserter is just below bone surface (figure 2).

Warning: Distal laser line should not be visible when anchor is properly inserted.

Note: Vertical line on inserter indicates the orientation of the sutures (Figure 3). The sutures are oriented in the same direction as the laser line and open slot on the driver.

3. pull up to disengage inserter from anchor.

4. open slider on handle and remove suture spool.

Note: When placing adjacent HEALIX Anchors, it is recommended to leave at least 5 mm of bone between them.

heaLiX anchorS with orthocord Suture

technique

figure 1 figure 2

figure 3


inStrumentS and impLantS

Ordering Information (call 800-255-2500 to order):

C O D E DEsCrIptIOn

212038 mini quicKanchor plus with #0 orthocord (oS-2), 2.0 mm drill Bit comes sterile packaged

211083 mini drill Bit, 2.1 mm


threader tab Option for Mini QUICKAnCHOr Anchor



212123 mini Syringe inserter


Additional Instruments

213072 mini drill Guide

C O D E DEsCrIptIOn

222984 Super quicKanchor plus with #2 orthocord dual Suture (cp-2 needles)

threader tab Option for super Anchor:



212114 Super/rotcuff inserter

223111 orthocord Blue (without needles), (12/box)


211113 Super/rc drill Bit 2.9 mm


399.41 mallet

Mini QUICKAnCHOr plus Anchor (1.8 mm)

C O D E DEsCrIptIOn

222983 Gii quicKanchor plus with #2 orthocord cp-2 needles

threader tab Option for GII Mini QUICKAnCHOr Anchor

210493 Gii anchor with threader tab, (1/box)

210393 Gii anchor with threader tab, (5/box)

212094 Gii inserter

223111 orthocord Blue (without needles), (12/box)


211093 Gii drill Bit 2.4 mm


GII QUICKAnCHOr plus Anchor (2.4 mm)

super Mini QUICKAnCHOr plus Anchor (2.9 mm)

C O D E DEsCrIptIOn

222260 heaLiX tranStend ti anchor with #2 orthocord dual Suture


222281 heaLiX tranStend 2.2 mm drill Bit

HEALIX trAnstEnD ti Anchor (2.9 mm)

C O D E DEsCrIptIOn

222253 4.5 heaLiX ti anchor with #2 orthocord

211026 panaLoK drill Bit 3.5 mm


222226 heaLiX cortical awl/tap 4.5 mm

4.5 HEALIX ti Anchor (4.5 mm)

to order in the U.s. call, Johnson & Johnson Health Care systems Inc. Customer support services at 800-255-2500.

to order in the U.s. call, Johnson & Johnson Health Care systems Inc. Customer support services at 800-255-2500.

not all products are currently available in all markets.

Depuy synthes Vet1302 wrights Lane eastwest chester pa 19380tel: (610) 719-5000

www.depuysynthes.com

© depuy Synthes Vet, a division of doi 2014. all rights reserved. dSuS/Vet/0814/0016 12/14

Distributed in the USA by: Depuy Mitek, Inc. 325 paramount drive raynham, ma 02767 uSa tel: +1 (800) 382-4682

suture anchors for veterinary use - synthes.vo.llnwd.netsynthes.vo.llnwd.net/o16/llnwmb8/us...

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