Lower Extremity
Innovative Care
That Starts From the Ground Up
VersaWrap® Hydrogel Sheet and VersaCoatTM Flowable Hydrogel preserve desired soft tissue gliding to allow early and active motion following foot and ankle procedures. The VersaWrap Hydrogel Sheet provides conformable, uniform coverage across planar and circumferential anatomy, while the VersaCoat Flowable Hydrogel allows precise, discrete application onto delicate, complex geometries, or approximated tissues.
Postoperative tethering between repaired tendons and ligaments, decompressed nerves, and surrounding tissue planes presents challenges to restoring full mobility. VersaWrap Hydrogel Sheet and VersaCoat Flowable Hydrogel deliver a sustained gliding surface that reduces friction between opposing tissues, prevents tethering, and fully bioresorbs throughout healing, leaving only the body’s natural tissues behind.
The following cases demonstrate clinical efficacy of VersaWrap Hydrogel Sheet and VersaCoat Flowable Hydrogel across a range of lower extremity procedures, from acute Achilles tendon repair to tarsal tunnel decompression and peroneal tendon reconstruction, in patients ranging from 20 months to 72 years of age.
Pediatric Extensor Hallucis Tendon Laceration
Patient/Injury
The patient is a 20-month-old male who sustained a clean laceration of the extensor tendon of his right great toe due to a shattered glass cookie jar lid. Initial emergency department care involved only superficial wound closure with three sutures. His parents later noted a complete absence of toe extension, altered gait, and impaired balance, prompting a consultation with orthopedic specialists. Ultrasound confirmed a full-thickness tendon laceration.
View Outcomes
Treatment
Tendon repair was performed three weeks post-injury. VersaWrap was applied in gel form (via syringe) to accommodate the limited operative space.
Results
At six weeks postoperatively, the patient was pain-free with restored toe extension. By two months postoperatively, his gait and balance had returned to normal, and he remained pain-free with full toe extension. At six months post-op, the patient continues to grow and move without limitations.
Deep Peroneal Neurectomy for Treatment of Midfoot Arthritis
Patient/Injury
The patient is a 64-year-old female with a four-year history of painful midfoot arthritis. Despite receiving corticosteroid injections over several years, her symptoms persisted. She was advised by a prior surgeon that arthrodesis was the only option, prompting her to seek a second opinion in pursuit of a less invasive alternative.
View Outcomes
Treatment
The patient underwent a deep peroneal neurectomy with implantation of the transected nerve into the adjacent extensor hallucis longus (EHL) muscle belly. VersaWrap was applied as a sheet directly over the nerve transfer site to help protect the repair and reduce the risk of neuroma formation.
Results
The patient was able to bear weight immediately following surgery, and the incision had fully healed by one week postoperatively. Her pain level dropped from 10 to 0 immediately after surgery, with no postoperative pain medication required. At one-year follow-up, the patient remains symptom-free with no recurrence of pain and no clinical evidence of neuroma at the neurectomy site.
Peroneal Tendon Dislocation Reconstruction
Patient/Injury
The patient is a 44-year-old active female who had a twisting injury while skiing 3 months prior to surgery. She experienced lateral ankle pain and snapping of the peroneal tendons during activity. The axial T2 MRI demonstrates a superior peroneal retinacular tear (SPR) with a split tear of the peroneus brevis.
View Outcomes
Treatment
Peroneal tendoscopy was performed followed by an open repair which revealed a denuded distal fibula. VersaWrap was placed around the peroneal tendons prior to the final repair of the SPR.
Results
The final repair allowed for gliding of the tendons with a restoration of a normal SPR. At 3 months post-op the patient was pain free and returned to sports activity with full excursion of her tendon unit.
Insertional Achilles Repair
Patient/Injury
The patient is a 55-year-old female with chronic insertional Achilles tendinopathy marked by recurrent pain from repetitive stress and overuse. Progressive inflammation limited her daily and recreational activities. Conservative treatment—including eccentric strengthening, physical therapy, heel lifts, NSAIDs, and corticosteroid injections—failed to provide lasting relief.
View Outcomes
Treatment
She subsequently underwent open insertional Achilles tendon repair with debridement of diseased tissue and re-anchoring of the tendon to the calcaneus. VersaWrap Hydrogel Sheet was placed over the posterior repair site before closure to create a gliding interface and minimize postoperative scarring and adhesion between the tendon and overlying skin.
Results
At three months postoperatively, the patient reported complete pain resolution, full return of ankle range of motion, and unrestricted activity. No tendon-skin adhesions or wound complications were observed.
Anterior Ankle Ganglion Cyst Excision
Patient/Injury
The patient is a 67-year-old male with 2 years of anterior ankle pain and swelling. He developed tibialis anterior synovitis and compression of his anterior neurovascular bundle (NV) at the level of the ankle causing pain and numbness.
Axial T2 MRI demonstrate a complex cyst encapsulating the tendon (TA) with abutment to the anterior tibial artery and nerve.
View Outcomes
Treatment
Operative findings included a multi-loculated cyst with invasion of the tendon sheath and nerve.
VersaWrap was placed around the tendon and next to the neurovascular bundle.
Results
At 6 months the patient had full tendon function and no nerve symptoms with all numbness resolved.
Tarsal Tunnel Release with Nerve Decompression
Patient/Injury
The patient is a 72-year-old farmer who is an avid skier with 5 years of medial ankle pain and plantar foot numbness.
An axial T2 MRI demonstrates an accessory flexor digitorum longus tendon in the tarsal tunnel compressing the neurovascular bundle.
View Outcomes
Treatment
Tarsal tunnel release is performed with a nerve decompression and the accessory muscle is removed.
VersaWrap is placed over the tarsal tunnel prior to closure to prevent scarring and nerve adhesions.
Results
After 3 months the patient was pain free with no medial ankle tenderness and a negative Tinel’s exam.
Acute Achilles Tendon Repair
Patient/Injury
The patient is a 29-year-old martial artist who suffered an acute Achilles rupture while kick boxing
A sagittal T2 MRI demonstrates an acute tear with tendon retraction.
Post-operative scarring of the tendon to the skin would potentially be career ending for this patient
View Outcomes
Treatment
VersaWrap is placed over the posterior aspect of the tendon to prevent adherence and accelerate healing.
Results
After 3 months, the patient is pain free and back to training.
No adherence of the skin to the tendon.
Full tendon excursion.
Always refer to the complete instructions for use for the complete clinical instructions.
This content is for informational purposes only and is not intended to constitute medical advice. As with any medical device, there are multiple factors affecting patient outcomes, including post-operative recovery time and activity level. Patient outcomes may vary based upon, among other factors, the nature and extent of loss or damage, the time between injury or damage and surgery, and the natural course of the patient’s recovery.
The availability of these products is in the United States only. Warning: Applicable laws restrict these products to sale by or on the order of a physician.