Medline UNITE has received 510(k) clearance from the U.S. Food and Drug Administration for its REFLEX HYBRID Nitinol Implant System, expanding its portfolio of foot and ankle surgical solutions. The new system combines the dynamic compression capabilities of nitinol staples with the stability of locking plates, addressing a significant gap in current surgical options.
The REFLEX HYBRID system specifically targets MTP fusions and Lapidus procedures with indication-specific implants. When used with a cannulated screw featuring a Dynamic Disc or a REFLEX nitinol staple, the construct delivers dynamic biplanar compression and fixation throughout the healing process.
"REFLEX HYBRID further demonstrates our commitment to offering innovative solutions for foot and ankle surgeons. The first to market product addresses gaps in the current competitive landscape, including offering indication specific designs, intraoperative compression, and intraoperative adjustment with a nitinol implant," said Scott Goldstein, vice president of product management for Medline UNITE.
Addressing Limitations in Current Nitinol Technology
While nitinol staples have gained popularity in foot and ankle surgery, they are often used alongside static plates and screws for additional fixation. However, this combination typically neutralizes the compression benefits of nitinol implants. The REFLEX HYBRID system overcomes this limitation by maintaining dynamic compression while providing enhanced stability.
A key innovation in the system is its unique inserter design, which allows surgeons to expand the implant's legs for easier placement. Unlike traditional nitinol staples, the REFLEX HYBRID features both legs on the same side of the joint, giving surgeons flexibility to adjust placement during the procedure.
Natan Pheil, director of product development for Medline UNITE, highlighted another advantage: "With REFLEX HYBRID, the surgeon can drill eccentrically through the implant's compression ramp and place a non-locking screw to gain additional compression at the joint before deploying the compressive power of the nitinol implant."
Superior Biomechanical Performance
Dr. Jonathon Backus of the Steadman Clinic in Vail, Colorado conducted extensive biomechanical testing comparing the REFLEX HYBRID and cannulated screw construct against traditional fixation methods. The results showed statistically significant improvements in load to failure and gapping at failure compared to titanium plate and screw constructs.
"Historically, nitinol constructs have not performed better than traditional plate and screw constructs with such testing," noted Dr. Backus, who has received an investigator-initiated study research grant from Medline unrelated to this testing.
Growing Market for Nitinol Implants
The FDA clearance for Medline's system comes amid increasing adoption of nitinol technology in foot and ankle surgery. Just last month, Massachusetts-based Trax Surgical also received FDA 510(k) clearance for its LINKT Compression Staple System, which similarly utilizes nitinol staples for fracture repair, joint fusion, and osteotomy procedures.
The Trax system also features an adjustable inserter allowing surgeons to open and close the staple's legs for easier insertion, highlighting the industry trend toward more flexible and surgeon-friendly nitinol implant designs.
Clinical Implications
The development of hybrid nitinol systems represents a significant advancement in foot and ankle surgery. These technologies aim to combine the benefits of different fixation methods while eliminating their respective disadvantages.
For surgeons, the ability to achieve compression intraoperatively and maintain it dynamically throughout healing addresses a critical need in procedures like MTP fusions and Lapidus procedures, where proper compression and stability are essential for successful outcomes.
For patients, these advancements may potentially translate to improved healing rates and better long-term outcomes, though comparative clinical studies will be needed to fully evaluate these benefits.
Medline's REFLEX HYBRID Nitinol Implant System is now available as part of the company's comprehensive UNITE portfolio of foot and ankle surgical solutions.
