253110 CA5528 Mitek OMNISPAN Surgical Technique 901086

User Manual: 253110

Open the PDF directly: View PDF .
Page Count: 4

OMNISPAN™ Applier w/ Malleable Graft Retractor 228143

OMNISPAN Meniscal Repair System 0° (Straight) 228140

OMNISPAN Meniscal Repair System 12° 228141

OMNISPAN Meniscal Repair System 27° 228142

Arthroscopic Pusher/Cutter 228302

Meniscal Rasp Up 45° 253110

Meniscal Rasp Up 90° 253111

Meniscal Rasp Straight 90°, calibrated 253112

Meniscal Probe 253113

Meniscal Depth Probe 228001

#2/0 ORTHOCORD®with Double-arm Meniscal Needles 228144

#2/0 ORTHOCORD (three free strands) with Meniscal Needle 228145

CHIA PERCPASSER®Suture Passer (5/box) 214101

* PDS is a trademark of Ethicon, Inc.

** ULTRA FAST-FIX is a registered trademark of Smith & Nephew, MAXFIRE is

a registered trademark of Biomet Sports Medicine, and CROSSFIX is a

registered trademark of Cayenne Medical.

1 A. Barber, Arthroscopy, September 2009.

Ordering Information

Prominent in Strength,

Subtle in Profile

1-800-382-4682 | www.depuy.com

©DePuy Mitek, Inc. 2010. All rights reserved. Printed in the USA.

Dyneema®Purity is a registered trademark of Royal DSM N.V.

P/N 901086 Rev. A 5/10

Select the needle most appropriate for

the tear you are repairing. Attach the

needle to the OMNISPAN applier by

lifting the lock lever on top of the applier

to expose the connector (figure 1).

The OMNISPAN™Meniscal Repair System from DePuy Mitek is designed to provide optimized

all-inside meniscal repairs. The system consists of a low profile needle, pre-loaded with two

PEEK backstops and ORTHOCORD®suture, which are delivered using the OMNISPAN applier.

No Hard Bodies on the Surface of the Meniscus: OMNISPAN repairs leave no hard bodies making

contact with the femoral chondyles. Even the knot has been moved to the backside of the meniscus,

leaving a just low profile double span of #2/0 ORTHOCORD suture.

Excellent Strength1:Testing has shown OMNISPAN provides outstanding strength compared to

competitive all-inside devices. Single pull to failure testing (table 1) in porcine menisci resulted in over 177

N of strength, while cyclic testing (table 2) in porcine menisci resulted in 204 N of strength.

Less Mass Postoperatively: While providing an excellent strength profile, #2/0 ORTHOCORD is

composed of 55% PDS™* and 45% High Molecular Weight Polyethylene. As a result, the suture’s PDS

component is resorbable and will result in less suture mass on the surface of the meniscus over time.

Active Deployment: The active deployment provided by the OMNISPAN applier allows you decide when and

where the backstops are ultimately deployed behind the meniscus – no plunging and relying on friction.

1

Push the proximal end of the needle onto

the connector until it clicks on securely

(figure 2).

2

Close the lock lever to secure the connection

(figure 3).

3

Needle must always be connected to

the applier with the needle slot facing

up (figure 4).

4

Use the Malleable Graft Retractor

packaged with the applier to protect

the implants and suture from getting

caught on soft tissue and the fat pad,

during insertion into the knee. Once

inside the joint space, remove the

Malleable Graft Retractor (figure 5).

5

TIP: When completing repairs in the

posterior 1/3 of the meniscus, use the

arthroscopic portal on the same side.

When completing repairs in the middle

and anterior 1/3 of the meniscus, use

the arthroscopic portal on the opposite

side (figure 6).

6

Surgical Technique

Meniscal Repair System

Table 1

The OMNISPAN™Meniscal Repair System consists of a single-patient, multi-use

applier and needles with pre-loaded implants in 0º (straight), 12º, and 27º options.

Fig.1

Fig.2

Fig. 3

Fig. 5

Fig. 6

Fig. 4

Posterior

Lateral

Lateral Portal Medial Portal

Medial

Anterior

OMNISPAN

Single Destructive Pull Data1**

ULTRA FAST-FIX®

MAXFIRE®

CROSSFIX®

0 50 100

Newton’s Force

150 200

177

121

130

77

Table 2

OMNISPAN

Cyclic Load Data1**

ULTRA FAST-FIX

MAXFIRE

CROSSFIX

0 50 100

Newton’s Force

150 250200

204

110

132

95

Release the lever and remove the applier

and needle from the joint space (figure 13).

13

Keeping the free suture leg as perpendicular

to the repair as possible, pull the free suture

leg slightly to identify the first loop that

moves. Capture that loop with the probe

and pull until the other loop lies tight

against the meniscus. Remove the probe

and pull the free suture leg to tighten the

second loop. Then complete the repair until

the desired tension is achieved against the

tissue surface

(figures 14, 15, and 16).

14, 15, 16

Continue to implant devices as determined

by the tear. Cut each suture leg with the

DePuy Mitek Arthroscopic Pusher/Cutter

by advancing the Pusher/Cutter until

flush with the surface of the repair,

maintaining moderate tension on the

free suture leg, and pressing the silver

cutting trigger on the Pusher/Cutter

(figures 17 and 18).

17, 18

Penetrate the meniscal tissue to the

desired depth. The silicone tube on

the needle provides a “soft stop” at

approximately 13mm. The OMNISPAN™

needle is also laser marked at 10mm,

15mm (double line), and 20mm (figure 7).

7

Once at the desired depth, squeeze the

large dark gray lever to deliver the first

implant to the back of the meniscus

(figures 8 and 9).

NOTE: There will be a slight pushback on

the deployment gun while the implant

goes through the tissue. Provide the

necessary counter resistance to ensure

that needle depth is maintained.

8, 9

Fig. 13

Fig. 19

Fig. 15

Fig. 14

Fig. 16

Fig. 9

Fig. 8

Fig. 18

Fig. 7

10mm

13mm

15mm 20mm

Final repair showing vertical horizontal

and oblique repairs (figure 19).

19

Keeping the large grey lever squeezed

when exiting the tissue will help to ensure

that the suture stays out of the barrel of

the needle, and the second implant

remains in its intended position. Remove

the needle from the tissue and maintain

visualization of the tip of the needle to

ensure the second implant maintains the

proper position (figure 10).

10

Pull the small red loading trigger until

you hear a click. This will move the second

implant into a position on the needle

from which it can be deployed (figure 11).

If needed, you can pull the red trigger

multiple times to ensure the second

implant is in the firing position.

11

Maintain a span of 6-10mm between the

first and second implants. Repairs can be

done in horizontal, vertical, or oblique

configurations. Penetrate the meniscal

tissue to the desired depth and squeeze

the large, dark grey lever to deliver the

second implant to the back of the

meniscus (figure 12).

12

Fig. 11

Fig. 10

Fig. 12

Fig. 17

Surgical Technique (Cont.)

#2/0 ORTHOCORD (three free strands) with Meniscal Needle 228145

Meniscal Rasp Up 45° 253110

Meniscal Rasp Up 90° 253111

Meniscal Rasp Straight 90°, calibrated 253112

Meniscal Probe 253113

Arthroscopic Pusher/Cutter 228302

#2/0 ORTHOCORD®with Double-arm Meniscal Needles 228144

A Range of Additional Solutions for Meniscal Repair

CHIA PERCPASSER®214101