Issue Date: December 22, 2021
ANNOUNCEMENTS

This week the awards nominations will focus on the two hottest markets in all of foot and ankle: Rotational Bunion Systems and MIS.  Our email from last week was sent out to over 15,000 physicians and industry folks with an astounding 49.5% open rate.  Thank you to all who are reading and voting!

This week we have:

  • Comment of the Week

  • GOLDEN SAW BONE AWARD WINNERS (voted by you - the FANs)
  • INNOVATION in TAR
  • INNOVATION in Soft Tissue

  • GOLDEN SAW BONE AWARD Nominations:
  • INNOVATION in Rotational Bunion Systems
  • INNOVATION in MIS
FAN COMMENT OF THE WEEK
““How can we share this with our sales force?”

  • From a Super FAN Corporate Guy


HERE is a link to recent newsletters; thanks for helping to spread the word. I will not tell anyone you are trying to stuff the ballot box!


Please keep voting and continue to hit us up with any questions or comments at footandankleblog@gmail.com
Thank you to everyone who took the time to vote last week.
The response was excellent!
Innovation in TAR Award
and the WINNER is...
EXACTECH

Vantage PSI has arrived, and the FAN’s have spoken! Congrats to the team down in Florida for a big win. FDA approval for the cut through guides were announced a year ago and are now available for full commercial use. According to their website, it takes about 3 weeks from the time of scan submission. In doing a little diggin, the pre-surgical plans and guides are developed for Exactech by a contracted, outsourced specialist 3D Systems. 

The company has a long history in surgical planning with more than 10 years of expertise in craniomaxillofacial applications. To date, 3D Systems has worked with surgeons to plan and guide more than 140,000 patient-specific procedures.

Imitation is the sincerest form of flattery and GSA runner-up, Stryker has answered Exactech with a cut through version of their own that looks pretty slick. The real story to follow will be if the 3 new PSI systems can chip away at the massive amount of market share owned by Stryker and their TAR platforms. There is no real answer to the Inbone or Invision for true cases of massive deformity and revision situations. Will the GSA award next year go to a company offering a true competitor to these systems? 
Next award from last week's vote....

Innovation in Soft Tissue Award
and the WINNER is...

The state of Florida has swept last week’s awards. The Godfather of Soft Tissue fittingly takes home the GSA for their TENSION SLIDE TENO technique. Arthrex has a knack for taking what they have and adding to it to make it better. This seems to be the case with the tension slide. 

This concept was taken from years of use in the biceps with the thought being - if it worked with great success there, it would work distally in the foot as well. It is hard to catch up when the team down in Naples keeps pumping soft tissue, congrats! 

Artelon didn’t make it easy for Arthrex, and with their focus on soft tissue in the F&A space we expect them to make a push for next year’s GSA.
This week's GSA Awards Category and Nominees...

The Lapidus procedure has been a boon for the Foot and Ankle Market over the last few years with advent of proximal bunion correction systems. Companies have jumped on the band wagon and for now, these systems seem like they are here to stay. Some may say they are overpriced, and that a couple 4.0 cannulated screws and some surgical skill is all you need for adequate correction. However, some of the best surgeons will tell you the reproducibility of these systems is game changing technology in their hands. Wherever you fall, don’t hate…just vote!

ROTATIONAL BUNION PRODUCT of the Year
Nominees:
TREACE - LAPIPLASTY


Everyone needs to send John Treace a Christmas card this year thanking him for creating a massive market. It is remarkable that a company can go pubic on the success of a single system and a hell of a marketing plan. Direct to patient marketing is the future and Treace has set the precedent for how to do it. If you haven’t heard of Lapiplasty I am going to assume you live in a cave, but I will post the technique video HERE as a refresher for the rest of us. 

The Lapiplasty system has a massive following and a legion of die-hard fans. It has made a few upgrades and touts a mini-incision offering using the same equipment. The 90/90 plating has taken some heat from competitor’s in terms of the ability to compress as we will learn shortly. Cost is consistently brought up, but here’s the fact: all of these systems cost as much as the rep can get for them!  
STRYKER - LAPIFUSE


Wright Medical, now Stryker, launched the first major competitor to the rotational bunion game with their Lapifuse system. Developed by a collaboration of guys in Charlottle and Columbus, the system has some unique features to separate it from Lapiplasty:

  • Distal Reduction Clamp: Opposite of the Lapiplasty clamp, the Lapifuse reduction device was designed to stay away from the primary area in which you are operating. 
  • Compression: Lapifuse uses a 4.0 compression screw across the TMT to obtain compression and initial fixation. Several plating options are available for medial placement or a second screw can be thrown.
  • Avoidance of Cut Guides: System encourages use of osteotomes to remove cartilage and avoid shortening of first ray

Approval for the system was more made easier and available faster due to the contracting power of Stryker. This system is well thought out, and brings the Ortholoc technology of the WMT plates to the table, but is it better?
CROSSROADS – DYNABUNION 4D


Crossroads jumps into the game with their 4D DYNABUNION correction system. Using their unique plating staple compression technology brings this product into the 4th dimension! When Googling Lapiplasty, the DYNABUNION ad appeared, and they have also followed TREACE’s lead with an excellent direct to patient website.

As far the system goes, here is what it offers (full animation video here):
  • Cut Guide: Used for distal and proximal cuts with attachment to gain initial rotational correction
  • Distal Reducer: Once proper rotation is established the reduction clamp aids in closing and locking IM and rotational correction.
  • RAC Block – A unique reduction tool is fitted over the cut block wires to compress the TMT joint and temporarily fixate.
  • Anti-Drift Bolt – Optional Cannulated system for solid screw placement through the plate into the second met.

Overall, the system addresses compression and uses Crossroads unique platform to get the job done by offering upgrades not offered by other platforms. From a marketing standpoint, when I hear 4D bunion correction I cannot help but think of the 7-minute abs scene from Something About Mary. Good stuff!
PARAGON 28 – PROMO

Paragon offers a system that allows for derotation of the first metarsal with out fusion of the the first TMT. Using the IM angle, a table is used to determine the correction and cut. Instead of me explaining it, watch this 2-minute video, trust me it will be a better use of both of our time.

Instead of another jig, Paragon offers something a little different to address rotational correction. This system would seem to address the shorting issue often associated with first TMT fusion and spares the joint. Is this better? Not sure, but another option for your armamentarium in battling the war on bunions. 
CAST YOUR VOTE
Who should in the FAN Rotational Bunion Product of The Year Award?
TREACE - LAPIPLASTY
STRYKER - LAPIFUSE
PARAGON 28 – PROMO
CROSSROADS - DYNABUNION 4D
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Next Award...

MIS is back and has made waves with several options across all the major players in foot and ankle. We will focus on some of the newer innovations and to stay in line with the spirit of the topic, I will keep these nominations and this description short and to the point.


MIS PRODUCT of the Year
Nominees:
NOVASTEP – PECAPLASTY

NOVASTEP is back with another nomination, this week the PECAPLASTY MIS Bunion system is up for the GSA. PECAPLASTY is a first of its kind, external jig designed to shift and hold the osteotomy prior to k-wire placement. NOVASTEP has become a leader in the MIS space and has added to its already innovative portfolio. As we have seen with the previous GSA nominations, reproducibility can produce massive sales results. Hopefully the JIG catches fire across the industry and puts NOVASTEP on the map for good.  
CROSSROADS – MINIBUNION 3D

Crossroads offers some innovation on the MIS front with their MINIBUNION 3D. The system allows for an element of frontal plane rotation before final fixation with an intramedullary plate and screw combo. The skin incision is 1.5mm and does not require a burr for the osteotomy. Rather the system comes equipped with an osteotomy guide to aid in making the cut.  
STRYKER – PROSTEP BUNIONETTE

Stryker, nominated for a record 4th GSA, offers a plate very similar in design to CROSSROAD's however it is an option for the bunionette. A nice little product to help round out their MIS forefoot platform. The system comes sterile packed in three shaft diameter sizes (3,mm,4mm,5mm). Seems like a simple system that is ASC ready. Potentially a good starter procedure for those surgeons looking to dip their toe into the MIS waters.
PARAGON 28 – PHANTOM MIS LAPIDUS

Let’s move the MIS party a little more proximal and introduce the PHANTOM LAPIDUS NAIL. The system requires a total of 6 mini, 8 to 10mm incisions, 3 of which are optional.  The system comes equipped with a burr guide for accurate cartilage debridement of the first TMT. Correction is manually obtained and temporarily fixated with a couple of k-wires. After sizing and reaming dorsally from anterior to posterior across the TMT, a radiolucent outrigger is attached, and the nail is advanced. Additional compression is obtained externally through the jig. Paragon 28 ingenuity at its finest and a potential winner of a coveted GSA award. 

Looking to add a little stability to your arthroscopic ankle fusions? Extend your medial portal for your incision and add the Arthrex Mini Plate. Dr. Chris Coetzee has a great demonstration video with rational for the product, particularly for younger patients and conversion to fusion take down in the future. An interesting concept and first MIS plate for this indication. Paragon has recently announced that their version is coming, and we will cover that product in a coming newsletter. 
CAST YOUR VOTE
Who should in the FAN MIS Product of the Year Award?
NOVASTEP – PECAPLASTY
CROSSROADS – MINIBUNION 3D
STRYKER – PROSTEP BUNIONETTE
PARAGON 28 – PHANTOM MIS LAPIDUS
ARTHREX – MIS ANTERIOR ANKLE FUSION PLATE
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Foot and Ankle News is curated roundup of the most impactful news for Foot and Ankle Doctors, Rep’s, and Exec’s delivered weekly directly to your inbox.

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