Year in Review: Fixation 2011

2011 was a year of mergers & acquisitions ultimately making the most headlines in the world of foot and ankle fixation news. This all started with the monster mega merger between Depuy Orthopedics and Synthes back in April. Before the dust even had a chance to settle, the acquisition of MMI by Stryker and then Ascension Orthopedics by Integra LifeSciences made headlines. Zimmer made a splash by acquiring the external fixation line ExtraOrtho and finally Wright Medical also joined in the fun by agreeing to carry ArthroCare's Opus Knotless suture fixation technology. The acquisition of these new technologies and expansion of the product lines certainly has influenced the playing field among the "Big" companies who are vying for the majority of the Foot & Ankle market share. Only time will tell who the winners and losers are by how the market responds to these changes and particularly where surgeon loyalty falls.

In light of last years chess match between some of the largest medical device companies, out of the ashes came a handful of new companies and product lines…

For starters, Arrowhead Medical Device Technologies brought forth the Arrow-Lok hammertoe implant. This implant eliminates the need for external k-wire fixation nor does it need any form of temperature control prior to or after insertion of the implant. The company is currently in the process of developing their next foot and ankle implant. Other companies new to the foot and ankle market include Solana Surgical, whose focus in currently on 1st MPJ implants; Nextremity Solutions, who is in the process of bringing forth the Nextra Hammertoe Correction System, and Paragon 28, who will be offering a complete line of forefoot, midfoot and hindfoot plates.

Some of the new products to hit the market this past year introduced traditional concepts with a new twist. The Stryker (formerly MMI) Anchorage CP Plate was the first plate of it's kind, allowing surgeons

the ability to introduce an interfragmental compression screw actually through a dedicated screw hole. The new plates were specifically designed for a 1st MPJ Arthrodesis and Lapidus Arthrodesis. The Arrow-Lok implant previously mentioned takes the traditional buried k-wire fixation concept and augments it with the added benefit of greater pullout strength from the double-ended arrow tips. Other new products to highlight the year include the Pro-Toe VO

& Inbone II Total Ankle Replacement by Wright Medical, the BME Speed, the Integra U-Shaped Plate, and the Arthrosurface HemiCap Talar Resurfacing Implant (which at this time is still not yet available for use in the U.S.) As new products hit the open market, there was a trend in that Ankle Implants and Hammertoe Implants were definitely the hottest fixation of 2011

Probably the most exciting news though of 2011 for foot and ankle surgeons was the inaugural year of FootandAnkleFixation.com! No longer will surgeons have no place to look for updated and relevant foot and ankle surgery information for your daily practice and patients. Too many other orthopedic websites focus on the corporate aspect of medical device information, where our information is dedicated to the driving force behind it all, the actual fixation devices and how it relates to the surgeon's practice. By surgeons, for surgeons.

So what's on the horizon for 2012? Stay tuned to FootandAnkleFixation.com to keep up with the latest unbiased foot and ankle fixation news.

Another Review on MMi Anchorage Plates

Podiatry Today has released their July issue and they showcase the improved stability and compression yielded by the new MMi Anchorage locking plates. The new plates offer cross joint fixation through the plate without the need for a separate transverse screw. The plates are geared towards 1st MPJ arthrodesis and Lapidus Arthrodesis.

Read more about the new plates and how to apply them here, on their indivual product pages:
MMi: Anchorage Plating System: Lapidus CP Plate
MMi: Anchroage Plating System: MTP CP Plate

MMI Anchorage CP MPJ and Lapidus Plates Video

If you are interested in checking out a closer look at the MMI Anchorage CP Plates for MPJ and Lapidus Arthrodesis, there is about a 5 minute video over at PodiatryLive.com that demonstrates the in's and the out's of the new plates. As previously mentioned in this blog, the new CP plates are a new version of locking plates in that they incorporate an interfragmental compression screw directly in the plate. Pretty cool stuff.

Stryker to Acquire Memometal Technologies (MMI)

As reported on www.ryortho.com, Stryker has announced an agreement to acquire France-based extremity product developer, Memometal Technologies (MMI)  for $150 million in cash, with up to an additional $12 million in milestone payments. This merger follows in the heels of the Synthes and Depuy merger just over a month ago; the second major merger to affect foot and ankle surgeons. 


This merger was probably only a matter of time for MMI, as they have shown significant advances in the foot and ankle device market. With the success of thier nitinol products (see MMI: Smart Toe Intramedullary Shape Memory Implant), and the recent release of their 2nd generation locking plating system (see MMI: Anchorage Plating System: MTP CP Plate), MMI has shown continued ingenuity in the development of foot and ankle implants


You can see all of the Memometal Technologies (MMI) foot and ankle implants at www.footandanklefixation.com

First Experience with MMI Anchorage Cross Plates for 1st MPJ Arthrodesis

While using the MMI Anchorage Cross Plate (CP) for a 1st MPJ arthrodesis this am, all I could think about was how much easier the plate was making the case for me. I performed the typical joint resection and preparation for fixation application, however, this time I didn't have to worry about trying to place an interfragmental screw with the chance of interfering with one of the locking screws from the plate. The design of the plate made it very simple and straight forward.

Once the plate was positioned to my liking and secured with a guide pin, the plate was removed leaving the guide wire in place. This is where the bone was reamed out to make room for the recessed portion of the plate. This was easily accomplished by hand. Afterwards, the plate fit snuggly into place and was secured using two olive wires that came with the set. My only recommendations here are that (when positioning the plate in reference to the fusion site) you leave yourself enough room on the metatarsal head to create a large enough shelf of bone so that after the dorsal bone is reamed, you do not break out the distal dorsal cortex while inserting the interfrag screw. This did not happen in the case today, as the interfrag screw compressed the joint significantly but it could easily happen if the plate is applied to distal overall. From there on out it was smooth sailing and the remainder of the locking screws were inserted using standard technique and were easily accepted by the plate.

This plate offers something new that is not currently offered by any other company. The plate was not excessive and the design has clearly been thought out well as it was very easy to apply. It was very nice to watch as the the arthrodesis site compressed together with every turn of the compressive screw and with the plate already in position and secured, all I had to do was put in the remaining screws. Like fish in a barrel.

MMI Anchorage Cross Plates for MPJ and Lapidus Arthrodesis

MMI has posted online their new Anchorage Cross Plating System for 1st MPJ arthrodesis and Lapidus arthrodesis. These plates are the first of their kind that incorporate the ability to place a lag compressive screw through the plate when performing an arthrodesis. As one high executive put it, "these plates are a game changer in the field of foot and ankle surgery."

I don't know about you, but I'm eager try out these new plates to see if they work as good as they look. It will be nice to have a guided compressive screw without the constant problem of interfering with crossing screws that are placed through the plate, as is the case with the current plating options.

You can read more about these new plates as well as other products offered by MMI at the following links:
Anchorage MTP CP Plate, Anchorage Lapidus CP Plate, All MMI Products.