1. Synthes
1st Tomofix Master Symposium
Osteotomies around the knee
10 years of TomoFix (1999 - 2009)
Friday, June 26, 2009
Mövenpick Zürich Airport
Zürich, Switzerland
www.synthes.com

2. 09.30
Welcome with „Kafi and Gipfeli“
10.00 – 10.10
Chairman`s Introduction

3. Good morning ladies and gentleman,
dear colleagues
On behalf of the Knee Expert Group (KNEG) of the AO - Foundation and of
the Synthes Company, I would like to welcome you to the 1st TomoFix
Master Symposium.
I am Alex Staubli, today Senior Consultant at different hopitals in the central
part of Switzerland and former Chief of the Department of Orthopedics at
the Kantonsspital Luzern, where we started 1999 the TomoFix project.
A special welcome and thanks to my colleagues in the faculty and in the
KNEG especially Prof. Lobenhoffer it`s Chairman, our guest speaker
Dr. Hilaire Jacob and my long standing friend Peter Holzach of the
Sportclinic Zürich which is also promoting this meeting.
We are pleased so many of you could join us.
Thanks to you all for making todays program a priority and a success.

4. Startbild TomoFix 1999

5. Scientific activities of the KNEG
~ 20 published articles – 2 books

6. Faculty
Chairman: Staubli Alex E., CH
alex.staubli@sonnmatt.ch
Holzach Peter, CH
pholzach@sportclinic.ch
Lobenhoffer Philipp, G
HPLobenhof@aol.com
van Heerwaarden Ronald, NL
vanheerwaarden@yahoo.com
AO-KNEG: Norris Brent, USA Teitge Robert, USA

7. 51 participants
34 Orthopaedic Surgeons from 3 continents
17 participants from Synthes Company
Thanks to Synthes Company
Thomas Fuchs / Toru Fischbach
Millie Calderón
Brigitte Baumgartner
Monika Fischer
Marcel Rettenmund
to my secretary: Susanne Colombi

8. The participants:
Name list and highest mountains of their country
• Spain Teide
Switzerland Matterhorn
• Colombia Sierra Nevada
• France Mont Blanc
• Japan Fujiyama
• USA Mount McKinley • Germany Zugspitze
• Belgium Botrange • Poland Rysy
• Austria Grossglockner
• UK Scafell Pike
• Finland Halti
• Netherlands Vaalserberg
• Sweden Kebnekaise

9. Welcome
Mrs. Elvira Montañez Heredia
Mr. Gaspar de la Herran Nuñez
Spain

10. Welcome
Mr. José Eduardo
Quintero Gil
Colombia

11. Welcome
Mr. Takeshi Sawaguchi
Mr. Takeuchi Ryohei
Japan

12. Welcome
Mr. Gregory Montalbano
Mr. James Stannard
USA

13. Welcome
Mr. Peter Verdonk
Belgium

14. Welcome
Mr. Martin Gruber
Mr. Martin Pietsch
Mr. Alexander Spatschil
Mr. Peter Zenz
Austria

15. Welcome
Mr. Jussi Elo
Finland

16. Welcome
Mr. Bengt Horn
Sweden

17. Welcome
Mr. Roger Berbig
Mr. Thomas Henkel
Mr. Frank Gebhard
Switzerland

18. Welcome
Mr. Sylvain Gueriot
France

19. Welcome
Mr. Thomas Bacher
Mr. Florian Gebhard
Mr. Etienne Heijens
Mr. Peter Keppler
Germany

20. Welcome
Mr. Michal Panasiuk
Poland

21. Welcome
Mr. Matthew Dawson
Mr. Paul Rae
Mr. Adrian Wilson
United Kingdom

22. Welcome
Mr. Robert Gaasbeek
Netherlands

23. • After 10 successful years with TomoFix in osteotomies around the knee,
it is time to reflect on the concept and its importance for the preservation
of the natural joint especially in monocompartmental gonarthrosis and in
many other osteotomy cases around the knee and its competitive
advantage in the market place.
• Your personal participation is of special interest to us, as you are one of
the experts in the field of osteotomies around the knee and have
experience with the TomoFix system. Your ideas and suggestions are very
valuable to us.
• Together with you, we intend to spread the philosophy of long-lasting joint
preservation, ideally avoiding joint replacement completely, world-wide.
• This exciting intellectual and practical process we will continue in the
future with regular TomoFix-UPDATE meetings.
At this symposium we want to give you the word!

24. Average 7 min presentation
7 min discussion
15 min
It is important for us to allow also
ample time for discussion.
Personal short CV of each presenter!

25. Below we have listed a selection of current topics that we would like
to discuss. The faculty has collected everyone’s suggestions and added
contributions from members of the AO KNEG
• 1) Where are the limits of osteotomies around the knee in cases of uni-
compartmental gonarthrosis? When is uni-compartmental joint
replacement the better option? Can both treatment options be used
in a time-shifted manner?
• 2) My best indications, my patient selection, the optimal time frame, my
need for additional imaging and special examinations for the decision-
making process.
• 3) Can bone healing time in open-wedge high-tibial osteotomy be
enhanced? What to do if there are signs of delayed-union or
pseudoarthrosis?
• 4) Femur osteotomies, double osteotomies, and patellar realignment
procedures are moving more and more into the focus of interest.

26. Below we have listed a selection of current
topics that we would like to discuss.
• 5) Versatility of Tomofix system: where do you use Tomofix, apart from the
standard cases?
• 6) Biomechanics of osteotomies around the knee with the Tomofix system
– what can be improved?
• 7) Knee osteotomies are becoming more and more common, and
consecutive total knee prostheses, too.
What is your experience with this?
• 8) Which intra- and extra-articular combined procedures
are most important for you?
• 9) New devices, new implants, new instruments
(also with contributions of KNEG).
• 10) Summary of published Tomofix results, biomechanical studies, on-
going and planned clinicalstudies (also with contributions of KNEG).

27. Introduction of the
Guest Speaker: Dr. Hilaire Jacob
• Dr Hilaire Jacob was head of the Biomechanics Unit of the Department of Orthopaedic
Surgery, Balgrist, University of Zurich. He remained head of the Unit up to his
retirement in 2003.
• Dr. Jacob has designed many clinically successful implants and prostheses, amongst
which is the unconventional Thrust Plate Hip Prosthesis, and is author or co-author of
several books, book chapters, and of over 150 scientific publications in international
journals.
• And, very recently, in 2008, he has been given the “Georg Hohmann - Plaque of Merit”
in acknowledgement of the several contributions he has made to orthopaedics; this
also from the German Society of Orthopaedics and Traumatology.
• Even now, 6 years after retirement, he continues to take a deep interest in orthopaedic
biomechanics and still collaborates in research projects.
• By the way he is my personal biomechanical and English grammatical conscience and I
am very grateful that is joining us today, his short lecture on the well known Mikulicz
line is an ideal introduction to our meeting.
• Handout

28. Guest Speaker: Hilaire A.C. Jacob, Zürich
hilaire.jacob@bluewin.ch
• 10.10 – 10.22
„Biomechanics: The Mikuliczline“
• 3 min Q and A period.

29. 1. Knee-Osteotomies vs. UNI`s 1
Results
• Lobenhoffer Philipp: Chairman
HPLobenhof@aol.com
Steinfelder Nicole 10.25 – 10.35
AO TomoFix TM retro:
„Functional outcome assessment in patients treated
with Open-wedge high tibial osteotomy (HTO)
for knee osteoarthritis using TomoFix“

30. 1. Knee-Osteotomies vs. UNI`s 2
• Verdonk Peter: 10.35 – 10.45
pverdonk@yahoo.com
„The limits of osteotomies around the knee in cases
of uni-compartmental gonarthrosis“
• Heijens Etienne : 10.45 – 10.55
Heijens@Gelenkzentrum-wiesbaden.de
„UCG (Uni-compartmental-gonarthrosis) Score,
a tool for preoperative decision: HTO or UNI“

31. 1. Knee-Osteotomies vs. UNI`s 3
• Montalbano Gregory: 10.55 - 11.05
admin1@regionalorthopaedics.com
„US – Contribution“
• Bacher Thomas: 11.05 – 11.15
thomas.bacher@hellersen.de
„Limits of osteotomies around the knee“
Discussion: 11.15 – 11.40

32. 2. Bone healing enhancement in
HTO Open-wedge
• Horn Bengt: 11.40 – 11.50
bengt.horn@lio.se
„Bone healing enhancement
in Open-wedge HTO“
• Staubli Alex E.: 11.50 – 12.00
alex.staubli@sonnmatt.ch
„Personal experience: N = 500 Open-wedge HTO-
without solid interposition“
- KNEG recommendations
Ev. Discussion

33. Snack - Lunch : 45 min.
12.00 – 12.45

34. 3. Open- vs. Closed-wedge HTO
• Montanez Heredia Elvira: 12.45 – 12.55
elvira0512@gmail.com
„Open- vs. Closed-wedge HTO“
Discussion: 12.55 – 13.05
Indication for Closed-wedge HTO

35. 4. DFO and TomoFix MDF 1
• Van Heerwaarden Ronald: 13.05 – 13.15
Chairman
vanheerwaarden@yahoo.com
„Development of new DFO technique
and TomoFix MDF plate“
• Gaasbeek Robert: 13.15 – 13.25
rda.gaasbeek@meandermc.nl
„Femurosteotomies“

36. 4. DFO and TomoFix MDF 2
• Heijens Etienne : 13.25 – 13.35
Heijens@Gelenkzentrum-wiesbaden.de
„4 failures with TomoFix MDF -
salvage, outcome and personal conclusions“
• Bacher Thomas: 13.35 – 13.45
thomas.bacher@hellersen.de
„Femur and Double osteotomies, case reports“
Discussion: 13.45 – 14.00

37. 5. Navigation 1
„ Nice to have vs. must to have“
• Keppler Peter: 14.00 – 14.10
peter.keppler@uniklinik-ulm.de
„Navigated Double Level
Osteotomies around the Knee“
• Gebhard Florian: 14.10 – 14.20
florian.gebhard@uniklinik-ulm.de
„CAS and HTO (CSEG Study)“

38. 5. Navigation 2
„ Nice to have vs. must to have“
• Heijens Etienne: 14.20 - 14.30
Heijens@Gelenkzentrum-wiesbaden.de
„Use of navigation in HTO: Results and perspectives“
• Staubli Alex E.: 14.30 – 14.40
alex.staubli@sonnmatt.ch
“Precision and intraoperative control of osteotomies
around the knee – my navigation for daily use”
Discussion : 14.40 – 15.00

39. Intermission: 15.00 – 15.15

40. 5. Versatility of the TomoFix System 1
• Holzach Peter: 15.15 - 15.25
Chairman
pholzach@sportclinic.ch
„Re-knee-osteotomies in failed cases“
• Elo Jussi: 15.25 – 15.35
jussi.elo@pshp.fi
„Proximal tibial osteotomies in knee stability“

41. 5. Versatility of the TomoFix System 2
• Sawaguchi Takeshi: 15.35 – 15.45
„The new small stature TomoFix plate:
Japanese experience“
• Takeuchi Ryohei: 15.45 – 15.55
take0822@hotmail.com
„Bilateral Open-wedge HTO
and interpositional grafting“

42. 5. Versatility of the TomoFix System 3
• Dawson Matthew: 15.55 – 16.05
matt.dawson@ncumbria-acute.nhs.uk
„Versatility of the TomoFix System“
• Norris Brent: 16.05 – 16.15
brent.norris@otsok.com
„Versatility of the TomoFix System:
Fracture work“

43. 6. Case presentations
Chairman Sawaguchi Takeshi
• Quintero Gil Jose Eduardo: 16.15 – 16.25
Jose.quinterogil@aoalumni.org
„My best case, woman, 28y, correction
of bilateral valgus deformity“
Ev. Discussion
Simultaneous bilateral Osteotomies

44. Ev. Reserve:
7. SMS TomoFix : Audience
• Case discussions: 16.25 – 16.40
• Success stories
• How to solve difficult cases
• Proposal to solve a specific problem: Dr. Henkel, Zug
• Management of post-op complications,
• Handling a failed osteotomy
• Early correction of the 1st osteotomy

45. 7. Present and future
scientific activities
• Lobenhoffer Philipp: 16.25 – 16.40
HPLobenhof@aol.com
Outlook
Trends for the future
Activities of the KNEG
New implants, new instruments
Present and future scientific activities, education worldwide, documentation
Alex E. Staubli, Chairman: CLOSURE

46. Closure:
Firstly, we want to thank you for taking the time to join us for this educational
session on TomoFix and we hope you found it helpful.
Secondly, we want to remind you to begin teaching your colleague surgeons.
It is critical to get all competitive surgeons who had ever even potentially
interested inTomoFix.
Thirdly, please inform us about your experiences, highlights and problems
and especially about your scientific contributions in this field. It is the
basis for the next meetings.
Have a good trip back home!

49. For all participants we have
prepared a handout of all
presentations
„Es gilt das gesprochene Wort“

50. •
Folien: Introduction
• Chaosplakat
• From Team to Team
• Best Joke Videos
• Fotosession 10 Jahre TomoFix
• 1. Operationsschritte
• Targetfoto
• Announcements