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. 2020 Sep 17;7(1):67.
doi: 10.1186/s40634-020-00284-0.

A novel press-fit minimally-invasive symphysiodesis technique

Sascha J Hopp  1   2 , Antonius Pizanis  1 , Jeremy Briem  1 , Jill Hahner  1 , Laura Mettelsiefen  1 , Steven C Herath  1 , Tina Histing  1 , Tim Pohlemann  1 , Tobias Fritz  3
Affiliations

A novel press-fit minimally-invasive symphysiodesis technique

Sascha J Hopp et al. J Exp Orthop. .

Abstract

Objective: Instability of the pubic symphysis often results in a poor outcome and reduced mobility of the patient. In some cases, an arthrodesis of the pubic symphysis is required. Until today, there is no data published how many of these procedures are performed annually and there is also no data about the outcome after this extensive surgery.

Methods: We developed a novel surgical technique to address the arthrodesis of the pubic symphysis in a minimally invasive approach. Therefore, we used for this purpose modified instruments and performed the transplantation of a cylindrical bone substitute into the pubic symphysis, without an extensive approach or dissecting the anterior or posterior symphyseal ligaments.

Results: Using this novel technique, a minimally invasive symphysiodesis was achieved in radiological findings, after the procedure.

Conclusion: Thus, this actually minimally invasive surgical technique seems to be a promising advancement for the arthrodesis of the pubic symphysis.

Keywords: Arthrodesis Symphysis; Non-union Symphysis; Pelvis; Pubic Symphysis; Symphysiodesis.

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Conflict of interest statement

There is no conflict of interest. The instruments for this article have been developed in collaboration with and provided by KARL STORZ, Tuttlingen, Germany. This study has not been funded.

Figures

Fig. 1
Fig. 1
The complete selection of instruments for the autologous transplantation of a bone cylinder. a Guidewire, b novel centering device for the bone harvester, c novel, modified bone harvester with centering fins with an inner diameter of 10 mm, d handle, e harvested bone remover, f bone harvester with an inner diameter of 10, 12, 14 mm, g hammer
Fig. 2
Fig. 2
a and b: Placement of the guidewire inside the pubic symphysis using inlet & outlet radiographs c Using the centering device across the guidewire and pushing it down onto the bony part of the symphysis d Using the novel modified bone harvester with fins, that is centered and driving it into the bone using a hammer e Inlet-radiograph, showing the correct positioning of the bone harvester, also leaving the caudal part and the caudal ligaments of the pubic symphysis intact f The harvested pubic symphysis inside the bone harvester with the guidewire inside the pubic symphysis
Fig. 3
Fig. 3
a The Synbone cylinder for transplantation inside the harvesting device. b Radiograph showing the Synbone cylinder being pushed press-fit into the pubic symphysis c & d: Radiograph showing the transplanted cylinder inside the pubic symphysis e After dissection of the cranial part of the soft tissue shows remaining anterior and posterior ligaments of the pubic symphysis. f Schematic drawing of the pubic symphysis with the ligaments anterior and posterior still intact with the bone cylinder press-fit inside the pubic symphysis
See this image and copyright information in PMC

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