Quote from: Highest on March 17, 2022, 11:24:07 AMAm I understanding that this is a full weight bearing nail? As in no Walker or crutches required? Stryde nail was 115 kg post operative weight bearing and this is damn close. How is this not major news?
Quote from: Franz on March 17, 2022, 10:55:41 AMFitbone is a motorized lengthening nail developed in Germany and in use since 1997.
Prof R Baumgart is the inventor.
Thousands of these nails have been implanted.
They were originally only available for limited use and were distributed by Wittenstein-Intens.
Recently Orthofix have acquired the rights to manufacture and distribute the device. It has become more widely available.
Quoted weight limitation is 100kg.
https://www.orthofix.com/ifus/fitbone/
Please note: this is for information only. I have no financial interest in the nail or the relevant companies.
Hi Dr Franz,
It is quite confusing actually, as they are mentioning two type of nails I guess based on the patient weight (which is like you said 100 kg) but at the same time in their catalogue mentioned and I quote the follwoing :
"During the active phase and the initial healing phase, the weightbearing capacity of the intramedullary lengthening nail is limited to
partial weight-bearing of 20 kg"
Here is the catalogue :
https://www.orthofix.com/wp-content/uploads/2020/03/Clinician-Guide_FITBONE-TAA_USA-en_Version-012.pdf
Maybe it is them being extra cautious in case any accidental weight bearing and accidental nail breakage so they won't be hold accountable.
appreciate if I can get your thoughts on that
Dr Franz Birkholtz - CLL in Stellenbosch, South Africa
Yes, I had spoken to a doctor in Europe who said the company officially does not recommend weight bearing.
If I may add, Fitbone is usually put in retrograde in the femurs which is not great for the knees.
I guess weight bearing is a relative concept. I still let the patient use crutches, but we allow as much weight as the pain will allow.
There is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.
Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.
Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.
Quote from: Franz on March 17, 2022, 01:28:50 PMThere is the guideline that the company gives.
Then there is the guideline that the doctor gives.
Then there is what the patient actually does.
Often these three are not aligned. Having said that, these nails do allow more weight than the original Precice nails and, with the Stryde not currently available to my patients, these nails give a good alternative option.
Fitbone nails are often implanted retrograde for alignment reasons, but can be implanted antegrade as well. The same is true for Precice: they can be inserted either antegrade or retrograde.
Do surgeons need special training or permission to use fitbone? Given the amount of patients putting off the surgery until Stryde returns it seems odd more surgeons aren't using this fitbone nail if they can weight bear as tolerated using it.
Why can't surgeons get antegrade insertion to give as good an alignment as retrograde? From what I've read the main issue with retrograde is splitting the patellar tendon which can cause ongoing knee pain.
Due to the anatomy of the femur it is not really possible to lengthen along the mechanical axis using an antegrade technique.
Fitbone does need surgeons to be trained.
Just for clarification:
Fitbone allows more weight bearing than the original Precice.
Caution is advised during distraction.
Stryde of course allows unrestricted weight bearing.
It is important to consider that due to pain considerations, full weight bearing during distraction may be difficult anyway.
We need more ethical doctors like you, very good you are doing this again to prevent the disasters we have seen
Where do your patients typically stay during distraction?
any fears with osteolysis as I understand that Fitbone is stainless steel , won't have a similar problem like the stryde ?
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