1、Intrafix 背景,谁发明了Intrafix?Joseph Sklar, MDSpringfield, MA, USAPublished research partner of Charlie Brown, MD.对T-Fix 半月板修复 and EndoButton 股骨端固定技术有贡献,Intrafix 背景,为什么发明 Intrafix?因为没有针对软组织移植物的坚强的，牢固的隧道内固定装置。Intrafix 什么时候问世的?1999年第四季度在美国有限量的推出。被Mitek并构时中断。1999年6月起有临床报道。,BTB Segment:BiocrylAbsoluteST Segm
2、ent:IntrafixRIGIDfixLinx HTBiocrylAbsolute,定位,定位,“Hamstring 固定。”固定强度 than BTB, 金标准。,特征:30mm 4 根凹槽的鞘。统一标准30mm 锥形螺钉6-8mm7-9mm8-10mm,Intrafix 胫骨固定,Intrafix 胫骨固定,其他工具:拉紧器 separates sheath placement and compatible w/ any ST GraftsModular ACL 手柄 植入用30mm Hex 螺丝刀 和 Absolute 30mm螺丝刀一样 9” x .045 合金导针 防止螺钉偏移，促
3、进鞘的膨胀,Intrafix 设计原理,软组织胫骨固定:胫骨骨密度不均匀 经典的干扰固定力量较小。不带骨的肌腱较滑。不带骨的肌腱质量较小。关节线固定在软的松质骨上。远端皮质骨的固定突出。悬吊费用较高。,这些研究表明有关 Intrafix?,这是一种新的为软组织移植物设计的胫骨端固定标准，和最好的股骨端固定一样。固定强度。移植物硬度高。分离移植物，促使四周愈合。临床表明，膝关节有和BTB重建类似的强度。,Intrafix 技术as described by J. Sklar, M.D.,用#2 Ethibond缝线编织移植物的两头。,Intrafix 技术,胫骨导向器用40-50o 通常 35-
4、45mm 长。,Intrafix 技术,钻孔，扩隧 隧道=移植物 简单T=G 使隧道较紧，很多医生喜欢用。医生根据不同的螺钉尺寸调整。,Intrafix 技术,把缝线编成2个圈 ， 把线圈套在拉紧器上，施加拉力。,Intrafix 技术,插入 Sheath Trial 对肌腱加压，准备植入鞘的路径。重要!隧道 8mm 植入移植物前先用trial。,Intrafix 技术,插入鞘(tab 置于12点钟的位置)。插入鞘，直到接触皮质骨，不要超过。,Intrafix 技术,屈膝至 10-40o (医生偏好）重要: 植入时保持拉力器和螺钉的压力。把螺钉置入鞘内。螺钉接触皮质。,Intrafix 技术,
5、修剪多余的鞘和移植物。完成!简单固定牢“No profile”,Intrafix 尺寸选择参考,Intrafix Pearls,Dilation is goodIf the tunnel is 6 months post-opSuccessful ACL Surgery KT 1000 5mmLachman82% negative,ACL Biomechanics Graft Strength,ACL BiomechanicsGraft Fixation Strength,Intrafix provides strength equal to femoral fixation,Intrafix
6、 Tibial Stiffness Compared to Femoral Fixation,Brown & Sklar, human cadaver knees,Sheep Histology, 12 Weeks, Sklar,Bone ingrowth,Graft tissue,Intrafix Tissue to Bone Healing,Easy revision,Graft strands are compressed against bone Sheath comes out in one pieceVascularization can be seen,Intrafix Quot
7、es from Orthopedic Surgeons,Richmond “Intrafix has given me results at least equal if not better than prior bioabsorbable screw with secondary fixation around the post, while eliminating hardware problems”Simonian “I used to use a belt and suspenders system. Intrafix . allows for secure intratunnel
8、fixation on its own and therefore shortens the points of fixation at the same time does not require a back-up device”Friedman “I think the learning curve is easy, it is important to aggressively debride the tibial tunnel for visualization,Intrafix Quotesfrom Orthopedic Surgeons,Burks “Intrafix gives
9、 me 1mm better KT-1000 scores than my old fixation”Lintner “I switched to Intrafix because of the superior strength, the ability to obtain equal tension on all four of the graft strands, and circumferential fill of the tunnel. The tensioner can look cumbersome but in fact, after a few cases it becomes quite simple. My KT-1000 results show excellent results.,ACL Assault Plan,RIGIDfixTM IntrafixTM,Dont sell onewithout the other!,
