167 posters, 28 videos, 9 topics, 12 sessions, 337 authors, 160 institutions

ISMICS 2023 Annual Meeting

31 May - 3 June, 2023 | Boston, MA

PC32

Sternal Closure Using Rigid Plate Fixation: Design Improvements For Enhanced Patient Recovery

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Poster Presenter

Keith Allen

Authors

Keith Allen, Marc Gerdisch, Val Jeevandam, Isaac George

Affiliations

St. Luke's Hospital, The Mid America Heart Institute, St. Luke's Hospital, The Mid America Heart Institute, Kansas City, MO, Franciscan Health, Indianapolis, IN, The University of Chicago, Chicago, IL, New York Presbyterian Hospital, Columbia University Medical Center, New York, NY

Part of Topic

Education, Imaging and Facilitating Technologies

Objectives

In a multicenter randomized trial, sternotomy closure using rigid plate fixation (RPF) showed1,2

•improved bone healing

•reduced sternal complications

•improved postoperative quality of life

•decreased pain scores

•RPF was cost neutral compared to wire cerclage through 6-month follow-up.

This bench top study evaluated the biomechanical properties and innovations of a next generation RPF system.

Methods

Biomechanical bench testing in a simulated sternotomy model compared the threshold for failure of an RPF that incorporates an integrated amorphous cable (SternaLock XP, Zimmer Biomet, Jacksonville, FL) to the legacy plating system (SternaLock Blu, Zimmer Biomet, Jacksonville, FL). The amorphous band increases surface area and resist pull through (Figure 1).

•Lateral stiffness/fatigue tests were performed by applying cyclic load in a uniaxial direction for 200K cycles

•Failure of the test constructs was defined as lateral distraction exceeding 2mm sternal displacement

•Design improvements that improve ease of use and facilitate faster screw delivery and better screw engagement were also evaluated (Figure 2).

Results

SternaLock XP with an integrated amorphous cable cerclage performed significantly better and was 50% stronger compared to the legacy RPF system alone (Fig 3). SternaLock EZ compared to the legacy RPF system was 15% stronger and should be easier to use with faster implants and better screw engagement through its enhanced implant instruments and features (Fig 4).

Conclusions

Design enhancements over a current legacy RPF system which incorporate an integrated amorphous cable with the plate

provides a significantly stronger construct making it suitable for patients who require a very robust construct (morbidly obesity/dense bone). In addition, new innovations such as EZ Driver and screw caddies may make RPF easier and faster