Last week's Collier Citizen feature, "Arthrex Machinist Program Helping The Immokalee Foundation (TIF) Students Realize Their Potential," highlights the Arthrex Manufacturing Apprentice Program (AMAP) and former TIF program participant-turned recent AMAP graduate Johnnie Gonzalez.

Director of Human Resources and Organizational Development Mike Boose shares about Johnnie in the article, "He was the type of student we were looking for. He is a hard worker, with a lot of talent and potential to be an employee who could succeed in the company. He learned the skill set to be competitive in manufacturing.”

Nearly 18 months ago, management of the AMAP program transitioned to the AMI Operations department, with Operations Managers Aaron Wilson and Jon Borgognoni assuming responsibility for the program's intensive manufacturing technical training.

Four students are accepted into the AMAP program each year. At any given time, there are as many as 16 apprentices learning to operate machinery to manufacture medical devices and products for use in orthopaedic surgical procedures. Over the four years of training, students spend 8,000 hours of on-the-job training, and each week, they spend six hours in class, learning everything from manufacturing math skills to machining principles.

Mike says, “We invested four years in Johnnie Gonzales’ growth and development, so we think this is a really good partnership with The Immokalee Foundation. It suggests that the efforts of the foundation helped prepare him for success in his role here. Arthrex has sponsored the foundation for a number of years. We’ve been supportive of the work they do. It’s good for the community, in terms of helping kids reach their full potential, and it is an opportunity for us to recruit great talent."

Arthrex employees showed their commitment to promoting a heart-healthy community by wearing red on February 3, 2017, in support of the Go Red For Women® movement. The company has been a local sponsor of the Southwest Florida Chapter of the American Heart Association for more than ten years, and proudly supports the Santa Barbara, CA chapter as well. National Wear Red Day exists to raise awareness about heart disease being the number one killer of women, and the American Heart Association’s actions to change that.

This year, hundreds of Arthrex employees dressed in red to raise awareness and do their part in creating stronger, healthier communities. From California to Florida, Team Arthrex has heart!

Source: Naples Daily News, February 8, 2017 

We are honored to be recognized as the Healthcare Networker of the Year for our support of the children of Collier County. Arthrex received the award earlier this month from the Healthcare Network of Southwest Florida (HCN) for our sponsorship of its Ronald McDonald Care Mobile program.

HCN Development Director Andrea Diehl said, "Thank you so much for helping HCN reach so many kids in Collier County. Without Arthrex's tremendous support since 2008, the Care Mobile would be unable to see such a large volume of children, leaving thousands of underserved area children without the vital care they so need. We couldn’t do what we do without you!”

Sr. Director of Corporate Communications Dennis O'Keefe accepted the award on behalf of Arthrex and had the opportunity to introduce attendees to Arthrex innovations such as Synergy MSK Ultrasound, JumpStart™ and our patient-education website OrthoIllustrated.com.

As a Senior Quality Control Inspector, Jeff Cherney stands by the quality of Arthrex’s products. Little did he know when he started with the company almost three years ago, he’d soon be more dependent on that quality than he would have ever realized.

In his 30s, Jeff injured his right shoulder playing volleyball. “At that age, you really think everything’s just going to heal and you don’t really worry about it, but over the years, I started getting a ratcheting in my shoulder,” he says. “I had two surgeries about thirty years ago to remove some cartilage that was torn and broken off but it got to the point where I was bone on bone (had no cartilage) and osteoarthritis set in. They just couldn’t do anything else for me. Everything I enjoyed, I couldn’t do anymore. I couldn’t throw a ball with my grandson, I couldn’t even cast a fishing rod and I loved to fish. I loved riding motorcycles and I couldn’t even hold onto the handlebars.” 

When Jeff started working for Arthrex, he realized there was hope for getting his quality of life back. “I had really never heard of a total shoulder replacement before I got to Arthrex. I always said I hope they can fix this shoulder one day like they do with the knee and when I started working here, I realized they actually could.”

Last May, Jeff had total shoulder arthroplasty surgery, implanting Univers™ Apex in his right shoulder. He says, “The day after surgery I had less pain than I had experienced for many years and now I don’t have any, which is amazing!  My whole life changed when I got the shoulder replacement, I’m doing everything I love again. It’s just great!” 

He began to wonder if he had any involvement in the manufacturing process of the implant he received and realized he had been working in the Total Joint Quality Control area a year prior. He asked his surgeon for the part number and began searching records. What he learned next was truly mind blowing.  

“I started looking at the paperwork and on the front page of the in-process sheet were my initials accepting the first piece inspection of the Apex production lot! Oh wow! Not only did my surgeon save me the lot numbers to the shoulder part he used, he saved the numbers for the drills that Arthrex made, too. I did another document search and saw my initials again! I actually inspected those parts, too. So it’s not just the joint, I was a part of everything he used on me.”

When he shared this revelation with his surgeon, he said, “Well, I guess we both did a good job, didn’t we?”

Jeff says he’s never had a job so rewarding. “I feel a closer connection to our quality and have a lot of pride for the work I do. I wanted to share my story with everyone who played a part. There are so many people in this company who don’t touch the product but are part of the product. I have personally thanked and shook the hands of the employees that were involved in the manufacturing of my implant and showed them pictures. I saw a lot pride in their reactions and I think it drove home that the work we’re doing is making people better.”

“I can now say that Arthrex will always be a PART of me forever!” he beamed.

*Patient images, videos, and/or testimonials used with written authorization of the patient or their legal guardian.

Well-being is reaching new heights at Arthrex, a global leader in orthopaedic product development and medical education for orthopaedic surgeons. The Naples-based company recently became a Blue Zones Project Approved™ worksite, joining more than 54 Southwest Florida businesses engaged in the Blue Zones Project® movement—a community-by-community, well-being improvement initiative designed to support longer, better lives through permanent changes to environment, policy, and social networks.

To become a Blue Zones Project Approved worksite, Arthrex created a wellness committee with representation from all departments. The company also developed a campaign to educate employees about the benefits of Blue Zones Project’s Power 9® principles—habits shared by the world’s longest living people. Those principles include moving naturally, eating with a plant slant, and having a healthy social circle. Lastly, Arthrex exceeded its employee pledge goal, with an individual commitment from hundreds of employees to live a healthier lifestyle.

In addition to the awareness campaign, Arthrex hosted a bimonthly farmer’s market on site on to make healthy, fresh produce accessible to employees. The company also worked with its culinary staff at all locations to serve a plant-based meal once a week and plans to start Walking Moais®, small groups of individuals who walk together to remain active.

"As a Blue Zones Project Approved worksite, Arthrex is proud of its employees who have committed to this community effort,” said John Schmieding, Senior Vice President, General Counsel at Arthrex. “There are obvious commonalities between the Blue Zones principles and Arthrex’s community mission of Making People Better. We are internally-focused on giving our employees the most effective and innovative wellness opportunities, and also helping our community in general to live better. The science-based Blue Zones principles are focused on helping people live better, happier lives without diseases, not simply just living longer. This is synergistic with our goals, and we fully support the community’s efforts at Blue Zones adoption.”

Wellness Coordinator Monica Dubroja added, “After receiving the American Heart Association’s Platinum Award for being a fit-friendly worksite for the last several years, this was the natural next step. We’ve created a culture of health in the workplace through progressive leadership and employee wellness initiatives and we look forward to further aligning our efforts with the community.”


Brought to Southwest Florida by NCH Healthcare System, in collaboration with Healthways®, Inc. and Blue Zones®, LLC, Blue Zones Project is a vital part of Southwest Florida’s well-being improvement initiative that encourages changes to the community that lead to healthier options. For more information about Blue Zones Project - Southwest Florida, visit southwestflorida.bluezonesproject.com.

Please join us in welcoming Mark Ferguson, MD, to the Arthrex Medical Education Team! We are excited to announce Dr. Ferguson will be assuming the role of Director of Medical Education, Asia-Pacific (APAC) Region. Dr. Ferguson will be responsible for directing all Arthrex Medical Education programs and events throughout the APAC Region, with special focus on providing surgical skills training at the Arthrex ArthroLab in Singapore.

Dr. Ferguson has worked closely with the Arthrex Medical Education and Product Management Teams since 1997. Through the years, we have enjoyed an outstanding working relationship strengthened by our mutual commitment to helping surgeons treat their patients better. Over the past 20 years, Dr. Ferguson has traveled the world instructing orthopaedic surgeons, which has earned him an outstanding reputation as a highly-respected authority in sports medicine and minimally invasive orthopaedics.

Dr. Ferguson obtained his medical degree from the University of Stellenbosch before completing his orthopaedic residency at the University of the Witwatersrand, Johannesburg. Following his residency, he completed a sports medicine fellowship under the direction of Dr. Clive Noble.

After completing his training, Dr. Ferguson traveled to the U.S. to gain additional experience at some of the country’s most recognized orthopaedic institutions: the Hospital for Special Surgery, Southern California Orthopedic Institute and Salt Lake City Hospital. In 1994, Dr. Ferguson returned to South Africa with a new clinic concept designed to provide a multi-disciplinary approach to sports injury management. With the assistance of Dr. Clive Noble and Evan Speechly, physiotherapist, Dr. Ferguson founded the Centre for Sports Medicine in Johannesburg and, until his recent departure, served as a principal surgeon.

Throughout his career, Dr. Ferguson has treated patient athletes at amateur, national and international levels. He has always been at the forefront of providing the most advanced, innovative therapies for his patients. Dr. Ferguson was one of the first surgeons outside the U.S. to incorporate the Surgical Outcomes System™ (SOS™) global registry into his practice, representing his commitment to patient reported outcomes research and quality assurance.

Arthrex is making headlines after Abigail, the pit bull injured in a dogfighting ring, visited its Naples headquarters to meet the Arthrex employees who helped with her recovery. Abigail wagged her tail happily as she jumped up to meet members of the Medical Education, Orthobiologics and Vet Systems teams last month. Her foster family and veterinarian brought her by to say thank you for donating JumpStart™, the antimicrobial bandage that played a crucial role in Abigail’s treatment. Local television, newspaper and radio stations picked up the story and applauded Arthrex and its employees for the thoughtful donation.
 
Arthrex Clinical Specialist Michelle Chargot, MD, first saw Abigail’s story on the local news last November and coordinated the JumpStart™ donation. Michelle was heartbroken when she saw the images of Abigail’s injury—her ear and half of her face were torn off after she was likely used as a bait dog in a Miami dogfighting ring. Now, nearly three months later, Michelle was thrilled to meet Abigail for the first time and see how well she’s doing.

Dr. T.J. Jackson of Pets First Wellness Center says Abigail has completely recovered and there is no long-term wound care management. He praised JumpStart™ and said in Abigail’s case he was “blown away” because healthy tissue appeared within just 48 hours and he was able to do a skin graft.

Five days after surgery, Abigail smiled for the first time, a moment captured in this portrait given to Arthrex.
 
Foster mom, Victoria, says Abigail will soon be “ready for her forever” home. First, she has to be spayed and then can be adopted. Victoria says Abigail will always have a special place in her heart and her story deserves the happiest of endings. 

Plus, for the latest information, follow Arthrex Vet Systems on Facebook and Twitter.

With a focus on exploring and defining collaborative innovation initiatives, the Michigan State University College of Engineering department visited Arthrex Inc. earlier this month to highlight the university’s commitment to advancing science in orthopaedics. Over their two-day visit, MSU Provost, College of Human Medicine Dean, College of Engineering Dean and Engineering Department Chairs from Mechanical Engineering, Electrical and Computer Engineering, Biomedical Engineering and Computational Math and Science Engineering toured the Arthrex campus and presented the resources each of their departments are equipped with and how they could be an asset to Arthrex’s own developmental efforts.
 
“This innovate partnership could be a win-win for MSU’s engineering students and Arthrex’s efforts in future product development,” said Vice President of Engineering Ricardo Albertorio. “Collaboration would expose MSU students to real-world engineering challenges, and would allow Arthrex access to cutting-edge technologies in the fields of sensors, computation and biomedical simulation.”

Director of Research Josh Karnes added, “MSU Leadership was appreciative of our co-op program where students have the opportunity to attain hands-on experience in our research facilities. Furthermore, we at Arthrex were impressed with the technical capabilities of the MSU staff and student body, and we are hopeful for future collaborations.

Last fall, Arthrex President and Founder Reinhold Schmieding was honored as one of Michigan State University’s (MSU) Most Distinguished Alumni. The award honors MSU Spartans who strive to address the world’s most pressing problems. With this partnership, we look forward to collaborating with MSU Engineering for years to come.

It’s easier than ever to get the latest information about our orthopedic innovations on Arthrex.com’s newly redesigned homepage. The enhanced layout, created with surgeons' needs in mind, includes consistently refreshed information with new sections for the most-searched products and top-trending procedures, making our comprehensive orthopedic resources quick and easy to find.

Explore new and updated features such as:

• “What Procedures Are Surgeons Talking About” – Procedures of most interest each month.
• “What Products Are Surgeons Searching For” – The most searched products on Arthrex.com each week.
• What’s New in SOS Research – Highlights the latest Surgical Outcomes Systems’ clinical reports and surgeons’ positive feedback using the global data registry.
• What’s New in Patient Education – Features OrthoIllustrated.com treatment animations, surgeon testimonials and newly added procedure pain scale data averages from SOS.

Plus, be sure to visit often to stay up to date on our latest “What’s New” innovations, with new product and procedure features highlighted 365 days a year.

Our wealth of Arthrex.com content is just a click or tap away on any device, any time, thanks to our streamlined homepage.

“My son and I just returned from an amazing trip to the Riviera Maya in Mexico, staying at the Occidental at Xcaret resort for eight days. We had the chance to tour the Chichen Itza ruins and swim in some of the sacred cenotes. We also spent a few days at the Xcaret eco-archaeological Park, snorkeling in underground rivers and living the Mayan culture. Zip lining through the jungle was the highlight of our trip and a wonderful adventure.Thank you so much to Reinhold and Arthrex for this vacation and making it possible for my son and I to share this unforgettable experience.”

One of Arthrex’s most distinctive and valued recognition programs is the Years of Service Awards and “Trip of a Lifetime” program. Employees who achieve milestone years of service anniversaries with Arthrex are eligible for a company paid trip just like Diana’s to the destination of their choice and an extra 40 hours of Paid Time Off (PTO) in which to take the trip. This “Trip of a Lifetime” benefit is awarded for every five years at increasing reimbursement increments. Employees look forward to this generous benefit to create a lifetime of special memories.

“My wife and I and the Arthrex traveling flag just returned from a trip through the Panama Canal on a 10-night Caribbean cruise on Holland America. The highlighted spot was the Panama Canal with additional stops in the Bahamas, Aruba, Curacao and Costa Rica. Our sincere thanks to Mr. Reinhold Schmieding and Arthrex for what was definitely a trip of a lifetime!”

One of Arthrex’s most distinctive and valued recognition programs is the Years of Service Awards and “Trip of a Lifetime” program. Employees who achieve milestone years of service anniversaries with Arthrex are eligible for a company paid trip just like Charlie’s to the destination of their choice and an extra 40 hours of Paid Time Off (PTO) in which to take the trip. This “Trip of a Lifetime” benefit is awarded for every five years at increasing reimbursement increments. Employees look forward to this generous benefit to create a lifetime of special memories.

Q: At the last Faculty Forum meeting, you presented on your concept of ACL Preservation. Can you discuss what you mean by this?

A: ACL Preservation refers to my approach to the treatment of ACL injuries. It is a novel and progressive approach that focuses on trying to save as much of the native ligament remnant as possible. The current standard of care is reconstruction that generally resects the ligament remnant and reconstructs the ligament with one of multiple graft choices. With my approach, I use reconstruction as a last resort. For many of my patients I am able to save most, or all, of their native ligament with several techniques that I have developed in collaboration with Arthrex. (1, 2)

Q: In your last blog entry you updated us on your ACL Primary Repair technique. Can you discuss the augmentation technique that you use?

A: My approach of preserving the native ACL tissue started with my work on ACL Primary Repair (1) for proximal avulsion tears. As my skills and results improved, I became frustrated that I couldn’t repair more tears. Far more tears are proximal 20% tears, than are avulsion tears, and after attending ArthroLondon in 2012 and hearing Dr. van der Merwe’s lecture on Biologic ACL Reconstruction, I had an epiphany. It dawned on me that I could combine his technique of augmenting the ligament with my technique of repairing the remnant to avoid the rather high rate of Cyclops lesions (a ball of scar tissue created by the sagging ligament remnant that blocks knee extension and can cause pain) that can complicate standard augmentation techniques. The resultant technique is called ACL Primary Repair with Central Augmentation and the technique video can be viewed on Arthrex.com (2).

Q: Are there any differences between augmentation and reconstruction besides preserving the remnant?

A: Yes, augmentation is a more conservative approach than reconstruction in many ways. Preserving the remnant maintains the native ligament tissue, nerve endings and blood supply with obvious benefit. Thus, it is not necessary to use such a large graft like is used in the typical reconstruction. Typical reconstructions create 10 mm tunnels in the femur and tibia to place the graft into. Using a 7 or 8 mm graft in a reconstruction generally makes the surgeon somewhat nervous about the graft not being strong enough, however, this is routine in an augmentation. Maintaining the remnant obviates the need to use such a large graft and conserves bone.

Q: For what percentage of your patients are you able to use your ACL Preservation approach?

A: Currently, my ACL Preservation approach encompasses ACL Primary Repair and ACL Repair with Central Augmentation as mentioned. Using this approach, I am able to save most, or all, of the native ligament for approximately 50% of my patients. This, to me, is a tremendous advantage over the standard reconstructive approach in that native tissues are preserved with all of the concomitant benefits. At the same time, very few surgical bridges are burned, such that revision surgery, when needed, is almost like performing a primary reconstruction.

Q: Have you noticed a difference in the postoperative course and rehab with augmentation versus reconstructions?

A: Interestingly, I have. At first, I didn’t think that there would be much of a difference between the two techniques since tunnels were being drilled in both cases. However, anecdotally, I have definitely noticed that the augmentations seem to have less pain and swelling and a more stable/normal knee subjectively and objectively in follow-up. I explain to my patients that instead of having a “one size fits all” approach to ACL surgery that is currently the standard of care in my mind, I offer a customized approach to ACL injury. I utilize small (repair), medium (augmentation) and large (reconstruction) surgeries, depending on the nature of the ligament injury and the quality of the remnant tissue. For each patient, the final decision as to which procedure is best suited for them is made on the table when the tear type and tissue quality are determined intraoperatively.

Q: As ACL Preservation seems like a rather intuitive approach to ACL injury, why do you think such an approach wasn’t adopted historically?

A: The answer to that question is best summed up by the old saying “hindsight is 20/20.” Original attempts at repair were performed open, on all injury types and heterogeneous patient populations that yielded mixed results, at best. This led some authors to move towards augmentations that actually had somewhat more predictable results, even when done open. However, at right about the same time, arthroscopy was coming to the forefront, and in the early days of arthroscopy the technology, the instruments and the surgical skills were not sophisticated enough to preserve the remnant. I like to say that the first surgeon to look good performing an arthroscopic ACL reconstruction was the first surgeon to resect the entire ligament so that they could see what they were doing. Once that bridge was burned there was very little discussion about remnant preservation in the literature for the ensuing 25 years or so. Current imaging technology, anatomic and biologic understanding, and both surgical technology, and skill, have enabled us to reinvigorate the discussion of what was, in my mind, the right idea at the wrong time.

References:
1. ACL Preservation: Early Experience Presentation Video
2. ACL Preservation with Central Augmentation Using the FlipCutter® and TightRope® RT Presentation

Q: Performing a Radial Collateral Ligament (RCL) reconstruction with InternalBrace augmentation with the 3.5 DX SwiveLock SL is a new variation on what you have done in the past. Can you give us a brief overview of what you were doing and how you are changing your technique?

A: I was using the Arthrex 3 x 8 mm tenodesis screws with a palmaris graft for my reconstructions of both the radial and ulnar collateral ligaments of the thumb MCP joint. I still think that technique is solid and works well but have found a few differences that highlight some of the advantages of the new DX SwiveLock SL. 

• On the radial side, I can incorporate 1.5 mm LabralTape as an InternalBrace augmentation for my biologic graft repair.
• I like the idea of not having any suture left behind on the ulnar side as I would normally have with using a 3 x 8 mm tenodesis screw technique. The blind tunnel technique of the 3.5 SwiveLock eliminates any concern I had about irritation from the small strand of suture left behind in the pull-through tenodesis technique.
• If LabralTape is used as an InternalBrace, you do not have to whipstitch or suture your graft. In addition to saving time, LabralTape gives the immediate strength to the construct while the soft tissue repair heals and incorporates.
• Lastly, there is no need to measure the graft length as is necessary with the standard tenodesis screw reconstruction technique. Tension is achieved by grabbing the tendon with the forked eyelet and bringing it down into the unicortical hole. Any remaining tendon can be cut flush to the bone.

Q: InternalBrace has been gaining popularity for a variety of techniques. Are you changing your post-op protocol to reflect the extra stability?

A: There were times in the past when I was concerned about repair strength or patient compliance and I would temporarily place a K-wire across the MCP joint to help protect the repair for a short period of time. These new techniques and anchors from Arthrex have allowed me to eliminate the need for a K-wire by internally bracing the repairs using 1.5 mm labral tape from Arthrex.

Q: Are there any other procedures that you see the 3.5 DX SwiveLock SL being used for?

A: The new 3.5 DX SwiveLock has allowed me to explore improving current techniques that we are using in the upper extremity. Recently, I had a perilunate dislocation with obvious scapholunate ligament rupture. Although I acutely repaired the ligament through drill holes using FiberWire, I worried that my repair might not heal or may not be strong enough. The amount of force per unit area that the ligament and joint see is extremely high and likely accounts for the high rate of failure for many of the techniques that we are trying to utilize to reconstruct and repair this ligament.

I repaired the ligament back to the footprint on the lunate through drill holes. I then protected my repair by internally bracing using 1.5 mm LabralTape from Arthrex. I utilized the new 3.5 DX SwiveLock by placing one in the superior proximal pole of the scaphoid, one in the lunate, and then finally one in the very distal, dorsal aspect of the scaphoid. By linking the two bones in this manner with an internal brace I hope to protect the repair long after I remove the K wires that were placed. 

Q: Do you have anything further to add regarding the new 3.5 DX SwiveLock anchor from Arthrex?

A: It is nice to have the product on the shelf as a bailout option to help me if I run into trouble in a procedure. For instance, although I have not had to have the need to use it in this circumstance, there are definitely some people that are using the new anchor for CMC arthroplasty procedures. I certainly could see the anchor being useful if I had a catastrophic failure during my FCR tendon transfer. One could easily use a free graft and back it up with an internal brace in order to perform a suspensionplasty in that circumstance by utilizing the new Arthrex 3.5 DX SwiveLock anchor.

Q: What made you want to use the Mini TightRope for something other than thumb basal joint arthritis?

A: I treat many high-level athletes in my practice, including competitive athletes. One day, I got a call that an athlete sustained a Bennett fracture-dislocation of his right (dominant) thumb. The Bennett fragment was very small. He begged me to do something to allow him to get back to playing earlier than the usual six weeks. Normally, I would have pinned the fracture and the CMC joint and then placed the thumb into a cast for four weeks before allowing him to move the thumb. One would expect the usual downsides of this option: risk of pin site infection, disuse atrophy, stiffness, etc. I’ve become very familiar with the Mini TightRope, which I’ve used for my revision thumb CMC joint arthroplasties; I’m still a fan of the LRTI technique with tenodesis screw for my primary arthroplasties. The Mini TightRope does such a good job of suspending the thumb metacarpal after excision of the trapezium, so why not use this for cases of thumb CMC joint instability? So I offered this option to the player and he jumped at this option before I could even explain it to him!

Q: Can you tell us about the surgery?

It’s the same approach and technique as the suspensionplasty for thumb CMC joint arthritis, except the trapezium is retained. I first passed a #2 FiberWire suture around the base of the thumb metacarpal, essentially lassoing the fragment to reduce it into place. The knot was tied dorsally and buried in the thenar muscles. However, there was still some instability at the CMC joint, so I proceeded with placing the Mini TightRope across the bases of the thumb and index metacarpals, and this gave excellent stability to the thumb CMC joint. I then imbricated the dorsal capsuloligamentous complex and closed the incision.

What happened postoperatively?

Due to the stability of the joint following the Mini TightRope, I allowed him to start moving his thumb within a few days.

Can you discuss any other cases where you have used the Mini TightRope for a similar indication?

I performed this technique in the dominant thumb of a professional athlete as well. He had a larger Bennett fragment that was amenable to screw fixation, but due to some persistent instability at the thumb CMC joint following the fracture repair, I added the Mini TightRope as well.

by John K. Morris, MD, Alexander E. Weber, M., Mark S. Morris, MD
Department of Orthopedics, University of Michigan Medical Center, Ann Arbor, MI and the Section of Orthopedics, St. Joseph Mercy Hospital, Ann Arbor, MI

Large chondral injuries without attached bone are uncommon. We report the case of a 14-year-old who developed a stress reaction between the bone and overlying articular cartilage predominantly of the anterior lateral femoral condyle during a week-long basketball camp, resulting in complete displacement of a 2.5 × 2.5-cm full-thickness articular cartilage lesion.

Three weeks after the initial injury the patient was brought to the operating room for a diagnostic arthroscopy and open arthrotomy at which time the cartilage-free fragment was returned to its donor site and fixed with poly-L-lactic acid (PLLA) Arthrex chondral darts. Considerable de-lamination of the shoulders of the defect was noted on the pre-op MRI and at the time of surgery, suggesting a prodromal stress reaction. A V-shaped area of undermined cartilage in the central trochlea was too thin for dart fixation so the cartilage was excised and the area microfractured. Four darts secured the main fragment and one dart was inserted in an undermined area medially.

Despite no underlying subchondral bone on the free cartilage fragment, the injury healed. The patient had return of full knee motion and strength. Three-month post-operative magnetic resonance imaging demonstrated healed cartilage.

At one year of clinical follow-up the patient had no clinical sequelae from the initial injury and had returned to competitive basketball.

The current case demonstrates a unique presentation of an isolated chondral injury successfully managed with Arthrex PLLA chondral darts. The chondral darts worked well, allowing a large full-thickness piece of articular cartilage to be successfully repaired back to its origin. Important characteristics of this implant that lead to successful healing include the ease of implantation, the flushness of the head to the articular surface, the security of the dart without implant back out, and the lack of biologic reactivity. Biologic reactivity to biodegradable implants and leaving the implant proud or backing out of the implant head have all led to iatrogenic damage and poor outcomes with previous implants. Lastly, the chondral dart does not require an additional surgery for implant removal. The Arthrex chondral dart was an invaluable resource that allowed a successful outcome for our patient.

In celebration of the past year of Arthrex innovations, our fourth annual anniversary editions of our "What's New" email newsletters will highlight the top 12 features over the past year, including our most popular surgical technique videos, presentations and demonstrations by leading orthopaedic surgeons from around the world. The year’s top 12 features have been selected based on the number of visits these assets obtained throughout the year by your peers.

Our newsletter family of What’s New emails specifically focus on content in the areas of arthroscopy and sports medicine, arthroplasty, hand and wrist surgery, foot and ankle surgery, orthopaedic imaging technology, endoscopic imaging technology, orthobiologics and research and education. If you’re not already subscribed to What’s New or would like to update your subscription preferences per specialty, click here.

You can also stay up to date on our innovations by:

• Visiting the front page of Arthrex.com for new features daily

• Following us on Twitter @ArthrexWhatsNew

• Subscribing to our What’s New in Orthopaedics Top Tending Videos YouTube Channel

Stay tuned for even more exciting technology updates from Arthrex in 2017, continuing our mission of "Helping Surgeons Treat Their Patients Better™" through innovations in orthopaedics!

As a lifelong athlete, 35-year-old Derrick Richardson was devastated when he heard “You’re done. You can’t throw a ball anymore” from the first surgeon who looked at his injured shoulder in the summer of 2015. “It was one of the most emotional moments of my life. I was in tears, thinking that I’d never be able to play catch with my kids,” Derrick said. 

From the time he was 15 years old he had played baseball, football and even swam competitively. Being an athlete was a big part of his life. Unfortunately, so were the injuries that came with it. At 25 years old, he had already had two shoulder surgeries and started noticing arthritis. Soon after, he cut back on the sports he played and focused instead on coaching high school baseball.

But changing his activity level didn’t stop his pain. By the second year of coaching, Derrick started noticing daily pain in his shoulder and was waking up four to five times a night and sometimes his hand would be numb. He went to see a surgeon who gave him bad news. Derrick explained, “He said I was too young for a new shoulder and suggested rehab, cortisone shots and worst of all—told me I couldn’t throw ball with my kids.” That’s when Derrick sought out a different surgeon, Dr. Anthony Romeo, who had performed a previous surgery on him. And for the first time in a long time Derrick felt hopeful when Dr. Romeo told him, “We have a shoulder meant for guys like you. You’re not going to throw a ball like you used to but you’re going to be active again. You’re going to have a good life.”

That’s when Derrick first learned about the Univers™ Apex, a total shoulder replacement implant from Arthrex that is specially designed so the surgeon can more accurately recreate the patient’s normal shoulder position.

Dr. Romeo explained, "Patients like Derrick are often told they are too young for a shoulder replacement. They live with pain and a poor quality of life during some of the most important years of their young life. Fortunately, advances in shoulder replacement like the Univers Apex include the ability to remove the arthritis and replace the joint with a new ball and socket that works like a normal joint, helping the surrounding muscles and tendon heal and return to normal function. Arthrex innovation allows me to offer these fantastic solutions even at Derrick's young age."

So at almost 34 years old, Derrick had surgery in January of 2016 with his family supporting him every step of the way. His 8-year-old daughter helped him through six months of rehab by getting her own set of therapy bands and doing exercises with him. And his 4-year-old son checked his scar daily, telling him “It’s looking good.”

And today things are looking good for Derrick. He’s throwing a ball, coaching, playing with his kids and happy to share his story. In fact, he’s got a conversation starter right on his cell phone—his wallpaper is an x-ray of his implant. Derrick said, “I love talking to people about it. They can’t believe I’m back to doing what I’m able to do.”

Now looking back, he is happy at how his story ended, “The surgery emotionally saved my life, because I can do what I love to do and live the way I want to live without pain.”

The views expressed in this article reflect the experience and opinions of those involved and do not necessarily reflect those of Arthrex, Inc. This is not medical advice from Arthrex. Postoperative management is patient specific and dependent on the treating professional’s assessment. Individual results will vary and not all patients will experience the same postoperative activity level and/or outcomes. Patient photography is used with express, written consent of the patient or their legal guardian.

FOR IMMEDIATE RELEASE

Contact:

Lisa Gardiner, Communications Manager

239-643-5553 ·  Lisa.Gardiner@Arthrex.com   

NAPLES, FL – October 16, 2017 – Arthrex announced plans Monday to build a state-of-the-art surgical device and implant manufacturing facility in Anderson County, South Carolina.

Construction on the $30 million, 200,000-square-foot facility is scheduled to begin in the first quarter of 2018 with completion by early 2019.

“This investment is part of Arthrex’s global expansion plan to support the growth and development of new and innovative products that help surgeons treat their patients better,” said Andy Owen, Arthrex Vice President of Manufacturing. “It also represents our continued commitment to manufacturing quality products in the United States.”

The Anderson facility will be Arthrex’s fourth U.S.-based manufacturing facility. The others are located in Ave Maria, FL, Santa Barbara, CA and City of Industry, CA.

Arthrex plans to work with Tri-County Technical College in Anderson to develop a strong pipeline of qualified manufacturing personnel, utilizing their in-depth programs and long-standing relationships with institutions like Clemson University that are dedicated to supporting the manufacturing industry. 

“Arthrex is pleased to bring its innovative spirit and unique culture to South Carolina and we look forward to leveraging the outstanding work done in the area to prepare future employees for high-level manufacturing jobs,” Owen said.

The construction of the Anderson facility will not affect operations or employees in Southwest Florida or California, and Owen reiterated that Arthrex is committed to its future growth, job creation and investment in Southwest Florida. This includes a significant expansion project at its corporate headquarters in North Naples scheduled to begin in the first quarter of 2018, as well as partnering with community leaders to develop advanced manufacturing training programs in Collier County.

About Arthrex

Arthrex Inc., headquartered in Naples, FL, is a global leader in orthopedic product development and medical education for orthopedic surgeons. More than 11,000 products for arthroscopic and minimally invasive orthopedic surgical procedures have been developed by Arthrex and are currently marketed worldwide. For more information, visit www.Arthrex.com.

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