Polyaxial Locked Plate Gives Surgeons More Options For Hard-To-Treat Knee Fractures; 94 Percent Union Rate

Study Provides First Peer-Reviewed Clinical Data Documenting The Strength And Utility of These Devices For Treating Leg Fractures

Warsaw, IN – A technology used to treat fractured spines has shown to be an effective option for difficult-to-treat leg fractures around the knee, according to new research published in the Journal of Bone & Joint Surgery.

“This large, multi-center study demonstrates that polyaxial screw technology in locking plates can be used successfully in simple as well as complex periarticular fractures. This study reinforces our long-held confidence in the strength of this type of locking plate coupled with polyaxial locking screws,” said George Haidukewych, MD, lead author of the study, in an interview.

The POLYAX™ Locked Plating System’s screws can be positioned at customized angles best suited to each patient’s anatomy. Originally created to treat spinal fractures, the technology has in recent years been adapted for treating fractures around the knee, including complex fractures. According to a study published in the Journal of Bone & Joint Surgery,1 the POLYAX™ Plating System offers a 94 percent rate of union and more fixation versatility with no increase in complications. The study provides the first peer-reviewed clinical data documenting the strength and utility of these devices for treating leg fractures.

Researchers studied the POLYAX™ System (DePuy Orthopaedics, Inc.) in routine cases and in complex fractures. Researchers concluded that the POLYAX™ System is as strong as fixed-angle plates while allowing greater fixation versatility. The polyaxial system is useful in situations where surgeons encounter periprosthetic fractures around the knee or other barriers to optimum screw placement and periarticular fixation. In these instances, first-generation fixed-angle locked plates posed limitations that were addressed with the POLYAX™ System.

“The distinct advantage of polyaxial screws is their versatility. The ability to use the contour of the plate and to angle the multi-directional screws is a huge benefit to surgeons who want to avoid prosthesis or additional trauma fixation hardware that would otherwise prevent him or her from achieving good fixation of the fracture,” Dr. Haidukewych said.

The research is based on the use of the device in 54 patients with a total of 56 fractures, including 25 distal femoral fractures and 31 proximal tibial fractures. Cases were reviewed for changes in alignment, hardware breakage, and mechanical complications of the device. Function was assessed using Knee Society scores. The research reported that 94 percent of fractures united successfully. There were no mechanical complications and no evidence of varus collapse as a result of polyaxial screw failure. Complication rates were consistent with historical controls for fixed-angle locking plates. The researchers concluded that polyaxial locking plates offer more fixation versatility with no increase in complications or loss of reduction compared to first-generation fixed-angle locked plates.

As with any medical treatment, individual results with fracture surgery may vary. There are potential risks, and recovery takes time. Patients are encouraged to consult an orthopaedic surgeon.

About the POLYAX™ Periarticular Plating System

The POLYAX™ distal femoral plate contains a head with a central 8-mm fixed locking, cannulated screw. This central screw is surrounded by multiple 5.5-mm polyaxial screws with threaded bushings that allow a 30 cone of angulation. The POLYAX™ tibial plate has a proximal row of three 4.0-mm screws. In the neck of the plate are 5.5-mm solid polyaxial screws. The shaft portion of the plate also accepts fixed locking or standard nonlocking screws.