PRODUcT RAnGe HOW TO START WITH AMISAMIS ®. For this purpose, Medacta® has created the AMIS...
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Hip Knee Spine Navigation Surgical Technique Brochure HOW TO START WITH AMIS ® AMIS ® EDUCATION PROGRAM: A TESTED AND PROVEN METHOD Minimally Invasive Surgery is difficult to adapt to, and a steep learning curve is often introduced during the first cases. This learning curve has discouraged many surgeons and has left them to abandon MIS/LIS for other techniques. Medacta’s mission is to reduce such difficulties by providing unconditional support to surgeons who seek to adapt to AMIS ® . For this purpose, Medacta ® has created the AMIS ® Education Program, developed from the experience of hundreds of surgeons worldwide who have already performed thousands of AMIS ® cases. AMIS ® Leaflet ref: 99.98.11US rev.07 Last update: April 2014 Medacta International Strada Regina - 6874 Castel San Pietro - Switzerland Phone +41 91 696 60 60 - Fax + 41 91 696 60 66 [email protected] - www.medacta.com Medacta USA 1556 West Carroll Avenue - Chicago - Illinois 60607 Phone +1 312 878 2381 - Fax +1 312 546 6881 [email protected] [1] Huo MH, Gilbert NF. What‘s new in hip arthroplasty. JBJS Am; 2005 Sep, 87(9):2133-46. [2] Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res, 2005 Dec, (441): 115-24. [3] Rachbauer F. Minimally Invasive total hip arthroplasty via direct anterior approach. Orthopäde, 2005 Nov, 34 (11): 1103-4, 1106-8, 1110. [4] Siguier T, Siguier M, Brumpt B. Mini-incision anterior approach does not increase dislocation rate: a study of 1037 consecutive total hip replacements. Clin Orthop Relat Res 2004; 426: 164-73. [5] Jayankura M, Potaznik A, Roty M, Rooze M, Remy P, Biltiau N, Gillard B, Schuind F. Early recovery after total hip arthroplasty implanted by mini invasive direct anterior approach: isokinetic and isometric muscle strength analyse. Podium presentation at the 6 th Annual International Conference SICOT, Pattaya, Thailand, 29 October – November 1, 2009. [6] Lesur E, Laude F. The minimally invasive trend in total hip arthroplasty through the anterior approach. Encyclopédie Médico-Chirurgicale (2004) 44-667-B. [7] Pfirrmann CWA, Notzli HP, Dora C, Hodler J, Zanetti M. Abductor tendons and muscles assessed at MR Imaging after total hip arthroplasty in asymptomatic and symptomatic patient. Radiology 2005; 235:969–976. [8] Dora C, Pfirrmann C, Nötzli H, Hodler J, Zanetti M. MR imaging of the abductor tendons and muscles after total hip replacement in asymptomatic and symptomatic patients. EFORT 2007, Italy, Florence, 11-15 May 2007. [9] Dora C. Der anteriore Zugang für die minimal-invasive HTPE. Leading Opinions, Orthopädie 1, 2006. [10] Bremer AK, Kalberer F, Pfirrmann CWA, Dora C. Soft-tissue changes in hip abductor muscles and tendons after total hip replacement: Comparison between the direct anterior approach and the transgluteal approaches approaches. J Bone Joint Surg (Br) 2011–July; 93- B:886-9. [11] Mast NH, Laude F. Revision total hip arthroplasty performed through the Hueter interval. J Bone Joint Surf Am. 2011; 93:143-148. [12] Data on file: Medacta ® . [13] Heidelberg Lab-Report, Orthopädische Universitätsklinik Heidelberg, 2008. Data on file: Medacta ® . [14] Orthopaedic Research Laboratory Radboud University Nijmegen Medical Centre, Experimental assessment of the stability of the Cone stem relative to the AMIStem-C, April 2010. Data on File: Medacta ® . [15] Bernardoni M, Siccardi F, Quagliana I, Spadini E. Analysis of Versafitcup Double Mobility wear rates. M.O.R.E. Journal, May 2011; 1:3-7. [16] Leclercq S, El Blidi S, Aubriot JH. Treatment of recurrent dislocation of Total Hip Replacement using Bousquet type double mobility cup. Review of 13 cases. Revue de Chirurgie Orthopédique: 81; 389-394. Service de Chirurgie Orthopédique et Traumatologique, CHR Côte de Nacre, Caen, France. [17] Adam P, Farizon F, Fessy MH. Dual articulation retentive acetabular liners and wear: surface analysis of 40 retrieved polyethylene implants. Rev Chir Orthop 2005, 91 :627-636. [18] Farizon F, de Lavison R, Azoulai JJ, Bousquet G. Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop. 1998;22(4):219-24. REFERENCES PRODUCT RANGE ■ First stem specifically designed for AMIS ® . ■ Easy stem introduction through AMIS ® . [12] ■ Reduced bone removal. ■ Proven stability. [13,14] ■ Triple tapered design. ■ Wide range. ■ Reliable, compact and precise instrumentation. ■ AMIS ® friendly. ■ Low wear rate. [15] ■ Low dislocation rate. [16] ■ High range of motion. [17] ■ Long clinical history. [18] ■ Elliptical press-fit geometry for enhanced primary stability. ■ Equatorial macrostructures enhancing the contact surface area. ■ Wide range of liners for preoperative and intraoperative flexibility. ■ 36 mm head starting at 50 mm liner. ■ 5° upper raise provides additional coverage for increased stability and antiluxation. [email protected] ■ 1 ST STEP: AMIS ® REFERENCE CENTER VISIT In several countries, you will have the opportunity to visit a Reference Center and to assist during an AMIS ® surgery. ■ 2 ND STEP: AMIS ® LEARNING CENTER You will have the opportunity to operate on cadaver specimens with the assistance of teaching surgeons, to experience the advantages of the AMIS ® Mobile Leg Positioner, to analyse difficult cases, and have a thorough overview of the indications and contraindications of anterior approach. ■ 3 RD STEP: SUPPORT FOR THE FIRST AMIS ® SURGERIES You will receive the assistance of a Proctoring Surgeon for your first surgeries in your hospital. Participating in this time-tested program should help you to avoid early complications and to minimize your learning curve, but also give you some important “pearls” to help you during your first cases. Just contact Medacta ® and we will arrange the AMIS ® Education Program for you!
Transcript of PRODUcT RAnGe HOW TO START WITH AMISAMIS ®. For this purpose, Medacta® has created the AMIS...
Hip Knee Spine Navigation
Surgical TechniqueBrochure
HOW TO START WITH AMIS®
AMIS® EducAtIon ProgrAM: A tEStEd And ProvEn MEthodMinimally Invasive Surgery is difficult to adapt to, and a steep learning curve is often introduced during the first cases. This learning curve has discouraged many surgeons and has left them to abandon MIS/LIS for other techniques. Medacta’s mission is to reduce such difficulties by providing unconditional support to surgeons who seek to adapt to AMIS®. For this purpose, Medacta® has created the AMIS® Education Program, developed from the experience of hundreds of surgeons worldwide who have already performed thousands of AMIS® cases.
AMIS® Leafletref: 99.98.11US rev.07 Last update: April 2014
Medacta InternationalStrada Regina - 6874 Castel San Pietro - SwitzerlandPhone +41 91 696 60 60 - Fax + 41 91 696 60 [email protected] - www.medacta.com
Medacta USA1556 West Carroll Avenue - Chicago - Illinois 60607Phone +1 312 878 2381 - Fax +1 312 546 [email protected]
[1] Huo MH, Gilbert NF. What‘s new in hip arthroplasty. JBJS Am; 2005 Sep, 87(9):2133-46. [2] Matta JM, Shahrdar C, Ferguson T. Single-incision anterior approach for total hip arthroplasty on an orthopaedic table. Clin Orthop Relat Res, 2005 Dec, (441): 115-24. [3] Rachbauer F. Minimally Invasive total hip arthroplasty via direct anterior approach. Orthopäde, 2005 Nov, 34 (11): 1103-4, 1106-8, 1110. [4] Siguier T, Siguier M, Brumpt B. Mini-incision anterior approach does not increase dislocation rate: a study of 1037 consecutive total hip replacements. Clin Orthop Relat Res 2004; 426: 164-73. [5] Jayankura M, Potaznik A, Roty M, Rooze M, Remy P, Biltiau N, Gillard B, Schuind F. Early recovery after total hip arthroplasty implanted by mini invasive direct anterior approach: isokinetic and isometric muscle strength analyse. Podium presentation at the 6th Annual International Conference SICOT, Pattaya, Thailand, 29 October – November 1, 2009. [6] Lesur E, Laude F. The minimally invasive trend in total hip arthroplasty through the anterior approach. Encyclopédie Médico-Chirurgicale (2004) 44-667-B. [7] Pfirrmann CWA, Notzli HP, Dora C, Hodler J, Zanetti M. Abductor tendons and muscles assessed at MR Imaging after total hip arthroplasty in asymptomatic and symptomatic patient. Radiology 2005; 235:969–976. [8] Dora C, Pfirrmann C, Nötzli H, Hodler J, Zanetti M. MR imaging of the abductor tendons and muscles after total hip replacement in asymptomatic and symptomatic patients. EFORT 2007, Italy, Florence, 11-15 May 2007. [9] Dora C. Der anteriore Zugang für die minimal-invasive HTPE. Leading Opinions, Orthopädie 1, 2006. [10] Bremer AK, Kalberer F, Pfirrmann CWA, Dora C. Soft-tissue changes in hip abductor muscles and tendons after total hip replacement: Comparison between the direct anterior approach and the transgluteal approaches approaches. J Bone Joint Surg (Br) 2011–July; 93-B:886-9. [11] Mast NH, Laude F. Revision total hip arthroplasty performed through the Hueter interval. J Bone Joint Surf Am. 2011; 93:143-148. [12] Data on file: Medacta®. [13] Heidelberg Lab-Report, Orthopädische Universitätsklinik Heidelberg, 2008. Data on file: Medacta®. [14] Orthopaedic Research Laboratory Radboud University Nijmegen Medical Centre, Experimental assessment of the stability of the Cone stem relative to the AMIStem-C, April 2010. Data on File: Medacta®. [15] Bernardoni M, Siccardi F, Quagliana I, Spadini E. Analysis of Versafitcup Double Mobility wear rates. M.O.R.E. Journal, May 2011; 1:3-7. [16] Leclercq S, El Blidi S, Aubriot JH. Treatment of recurrent dislocation of Total Hip Replacement using Bousquet type double mobility cup. Review of 13 cases. Revue de Chirurgie Orthopédique: 81; 389-394. Service de Chirurgie Orthopédique et Traumatologique, CHR Côte de Nacre, Caen, France. [17] Adam P, Farizon F, Fessy MH. Dual articulation retentive acetabular liners and wear: surface analysis of 40 retrieved polyethylene implants. Rev Chir Orthop 2005, 91 :627-636. [18] Farizon F, de Lavison R, Azoulai JJ, Bousquet G. Results with a cementless alumina-coated cup with dual mobility. A twelve-year follow-up study. Int Orthop. 1998;22(4):219-24.
RefeRenceS
PRODUcT RAnGe
■ First stem specifically designed for AMIS®.■ Easy stem introduction through AMIS®.[12]
■ Reduced bone removal.■ Proven stability.[13,14]
■ Triple tapered design.■ Wide range.■ Reliable, compact and precise instrumentation.■ AMIS® friendly.
■ Low wear rate.[15]
■ Low dislocation rate.[16]
■ High range of motion.[17]
■ Long clinical history.[18]
■ Elliptical press-fit geometry for enhanced primary stability.■ Equatorial macrostructures enhancing the contact surface area.■ Wide range of liners for preoperative and intraoperative flexibility.■ 36 mm head starting at 50 mm liner.■ 5° upper raise provides additional coverage for increased stability and antiluxation.
■ 1ST STeP: AMIS® RefeRence cenTeR VISIT In several countries, you will have the opportunity to visit a Reference
Center and to assist during an AMIS® surgery.
■ 2nD STeP: AMIS® LeARnInG cenTeR You will have the opportunity to operate on cadaver specimens with
the assistance of teaching surgeons, to experience the advantages of the AMIS® Mobile Leg Positioner, to analyse difficult cases, and have a thorough overview of the indications and contraindications of anterior approach.
■ 3RD STeP: SUPPORT fOR THe fIRST AMIS® SURGeRIeS You will receive the assistance of a Proctoring Surgeon for your first
surgeries in your hospital.
Participating in this time-tested program should help you to avoid early complications and to minimize your learning curve, but also give you some important “pearls” to help you during your first cases.Just contact Medacta® and we will arrange the AMIS® education Program for you!
Specific instrumentation and a leg positioner should be used to facilitate the AMIS® procedure. Medacta®, in collaboration with orthopaedic surgeons, developed a set of instruments and the AMIS® Mobile Leg Positioner with the objectives of:■ Reducing errors.■ Reducing the learning curve.■ Simplifying the implementation of this technique.
AMIS® MobIlE lEg PoSItIonErA Medacta® patented design complying with ISO standards, the AMIS® Mobile Leg Positioner is not a complete table but an extension which easily adapts to any operating table.
Why consider the AMIS® Mobile Leg Positioner?■ no capital expence - The AMIS® Mobile Leg Positioner is provided at no cost to the hospital.■ Easy extraction of the femoral head, and optimum exposure of the femur.■ Reduction aid and possibility of testing without removing the shoe.■ Multiple movements (traction, flexion, hyper-extension, rotation, adduction). ■ easy handling by one person.■ Reduced surgical team.
The AMIS® Mobile Leg Positioner - A unique and cost-effective option to facilitate the anterior approach!
AMIS® InStruMEntS
AMIS® ADVAnTAGeS DeDIcATeD InSTRUMenTATIOn THe AnTeRIOR APPROAcH: A LOGIcAL APPROAcH fOR MIS SURGeRy
sartoriusiliopsoasrectus femoris
tensor fasciae lataegluteus minimus
gluteus medius
gluteus maximus
femoral nerve
superior gluteal nerve
no MuSclES cutThe preservation of all muscles potentially assists with:
■ Shorter stays in the hospital.[1,2]
■ Shorter rehabilitation.[3,4]
■ Reduced risk of dislocation.[4]
■ Immediate post-operative muscle tone preservation.[5]
■ Decreased post-operative pain.[3,6]
■ Less blood loss.[2,3]
■ faster return to daily activities.[1]
■ Reduction of scar tissue.[3]
not only Short tErM bEttEr rESultSThanks to the AMIS® technique risks are decreased when compared to a standard technique both in the short and in the medium term. In fact, it has been demonstrated that:
■ After Total Hip Replacement, trochanteric soft tissue abnormalities may be associated with residual trochanteric pain and limping in symtomatic patients. Defects of the abductor tendons and fatty atrophy of the gluteus medius and the posterior part of the gluteus minimus muscle are rare in asymptomatic patients [7,8].
■ The use of the anterior approach for primary Total Hip Replacement shows, at one year after surgery, better functional results and a smaller extent of injury in the muscle and tendon units compared to other approaches [9,10].
This means the AMIS® approach shows that, at one year after surgery, there is less symptomatic muscle degeneration compared to other approaches. Therefore the AMIS® technique may provide better results in the short and medium term and an improved long term quality of life for the patient.
In addition, the preservation of muscle and soft tissue should prove advantageous in revision surgery [11].
■ No muscles cut aNd iNterNervous path followed
■ significantly shortened rehabilitation
■ many years of clinical experience
■ possible long-term benefits
More than110,000 *
AMIS®
*data as at December 2013
no muscle degeneration
Muscle degeneration
A N T E R I O R M I N I M A L L y I N V A S I V E S U R G E R y I N H I P R E P L A C E M E N T
AMIS® charnley: a modified Charnley retractor with hooks designed to enhance exposure of the operative site, especially the acetabulum.
AMIS® Hohmann: the “femur lifter” with an atraumatic tip ideally exposes and raises the femur.
AMIS® Starter: the curved starter rasp is used to open the femoral medullary canal, facilitating rasp positioning for femoral preparation.
AMIS® cup Impactor: an offset impaction handle is used for implanting the cup in an atraumatic manner.
AMIS® Broach Handle: a straight rasp handle gives a firm hold during femoral preparation, decreasing the risk of malpositioning of the stem.
chana Reamer: the offset reamer handle provides high-quality reaming in a reduced incision operative site.
Total Hip Replacement is a safe and clinically proven surgical procedure.
Implant manufacturers and orthopaedic surgeons have been working in partnership on Total Hip Replacement for many years, the former improving and mastering the materials used, and the latter refining the implantation techniques.
Medacta® International is committed to becoming a preferred partner for new technologies such as in total hip arthroplasty through the minimally invasive anterior approach (the AMIS® approach = Anterior Minimally Invasive Surgery).
A true Minimally Invasive Surgery (MIS) is characterized by a reduced skin incision and the preservation of muscles and tendons.The anterior approach follows the principles of MIS. Other approaches advertised as minimally invasive (posterior, lateral, or double incision approach) are associated with muscle and/or tendon injury and thus are only reduced skin incision techniques.
The anterior approach, strengthened by several years of clinical experience, is the only technique which follows a path both intermuscular and internervous and therefore reduces considerably the risk of damage to periarticular structures such as muscles, tendons, vessels and nerves.for this reason the AMIS® approach is the ideal approach for atraumatic surgery which is fundamental for a fast recovery.
