Minimally invasive joint endoprosthetics: the essence of the new method.
AMIS (Anterior Minimal Invasive Surgery) is considered the safest and gentlest surgery for treatment in Germany.
In brief, the technique looks like this: a new joint is inserted into the thigh through an anterior access to replace the old joint. This operation does not damage the soft tissues involved in the functioning of the joint, hence the quick recovery.
With the help of an electro-mechanical table for fixing the leg, the joint replacement operation is completely safe and with minimal side effects. A very small incision (6-8 cm) is made, which heals quickly.
To date, more than 150,000 hips have been implanted worldwide using the AMIS procedure. In most countries, this method is a priority in joint surgery.
Minimally invasive joint replacement: why is anterior access important?
The surgery is performed under general or spinal anesthesia, which relaxes the muscles as much as possible and eliminates pain.
During endoprosthetics the orthopedic surgeon determines the optimal access to the joint requiring replacement. Traditional accesses are often accompanied by trauma to tissues (muscles, tendons, nerves), which leads to incomplete restoration of motor activity in the new joint.
In AMIS, the most direct and safe way is chosen — anterior, and a certain patient positioning is used on a special table for anterior access, which allows the operation to be performed without cutting the muscles. The table is equipped with special movable supports on which the patient’s legs are placed during the operation, which facilitates access to the joint. Traditional methods use the position of the patient on the side or behind, which increases the risk of traumatization of the musculo-ligamentous apparatus, nerves and vessels.
On the anterior surface of the thigh, the surgeon makes a 6-8 cm incision, introduces special equipment and, further, from the monitor screen directs the course of the operation, seeing only the patient’s leg, which seems to hang in the air and becomes accessible to the surgeon in all planes.
Minimally invasive joint endoprosthetics: advantages of the method.
The AMIS method is ahead of traditional therapies for many reasons:
- A small wound surface.
- Minimal blood loss, which reduces the risk of thrombosis, embolism and infections.
- Quick recovery after surgery (with the help of a special support you can stand up and walk on the first day after surgery).
- After AMIS, the patient returns to daily motor activity more quickly.
- By preserving large vessels, there is no risk of massive bleeding.
- A small wound in the skin leaves no scarring.
- Low risk of dislocation (dislocation) of the joint, as posterior access is known to have a higher incidence of dislocation.
- Absence of lameness after surgery.
- Significant cost savings due to less nursing effort and less physical therapy.
Minimally invasive joint endoprosthetics: recovery after surgery.
After the operation, the doctors will monitor the patient for some time in the post-operative ward, from where he or she will be transferred to the general ward. Bed rest is recommended on the day of surgery. The next day you can get up and try to walk. A special walking support has been developed for this purpose. Early getting up and physiotherapeutic procedures after surgery allow you to quickly and painlessly restore the correct gait.
After AMIS, early discharge from hospital is possible.
In which situations AMIS surgery is indicated?
The unique AMIS technique is indicated at:
- Complete endoprosthetics.
- Incomplete endoprosthetics (when part of an artificial joint is replaced).
- Operations on the acetabular lip of the hip joint, articular cartilage.
- Surgery after traumatization (dislocations, fractures).
Disadvantages and possible complications.
The method is technically more complex than the traditional method and therefore requires intensive training.
In many countries around the world, including Germany, where this method of prosthetics has been practiced for a long time, special training centers have been established to educate and train orthopaedic surgeons in the peculiarities of AMIS surgery.
The classic posterior or lateral approaches do not provide a sufficient view of the operative field. With AMIS access, the view is much better, but there may also be some complications:
- The common general complications that can occur in any prosthetic surgery are mainly related to technical problems such as bone lacerations or fractures, dislocations;
- implants used today are very well tolerated (mostly titanium), so what is known as «rejection», is almost never observed;
- Also, there may be bruising, which, as a rule, has no consequences with this procedure and disappears on its own.
A new method of hip arthroplastyа by minimally invasive access.
For many millennia, people have suffered from diseases of the musculoskeletal system. It is not easy to cure joint diseases (arthritis, arthrosis, hormonal or traumatic changes): conservative treatment can only provide pain relief for a while, because the cartilage and bone tissues that form a joint are not capable of regeneration and full recovery.
Therefore, the issue of surgical treatment is acute among patients with joint pathology. In this case, joint endoprosthetics, when part or all of a joint is replaced with a prosthesis, is sometimes the only chance to restore a person’s ability to move actively.
According to many renowned experts specializing in orthopaedic surgery and traumatology, such as Professor Andre Gechter, the method is considered the leading surgical technique. It is currently the safest and gentlest method of prosthetics, after which patients of various ages show a rapid recovery.
Where it all started?
Back in 1890 in Munich, Dr. Gluck pioneered the use of a prosthesis made of ivory, plaster, rosin and pumice in the treatment of the knee joint, thus ushering in the era of endoprosthetics. In the early 19th century, Dr. Smee-Peterson suggested covering the head of the femur with a cap made of vitalium. Later, a cementless method of retaining the prosthesis was used.
A total hip joint replacement was made in the 1950s. The new prosthesis was an alloy of chromium and cobalt, which was fixed to the pelvis with metal pins. In 1959, methyl methacrylate was first used as bone cement, which is still used today.
It was only in the 90s that France began to use a minimally invasive procedure for joint replacement. In 2003 in America, Prof. Berger proposed a method in which only two small incisions are made. Such incisions, even for larger interventions, are extremely successful, however, many orthopedists denied the possibility of using the method in hip replacement.
Frédéric Laud from Paris has proposed a special device that allows prosthetics to be performed through a small incision. He demonstrated the new surgical device to various companies, most of which dismissed the innovation. Only one Swiss company (Medacta) agreed to develop the so-called Legholder for mass production.
With this development, the success story of the minimally invasive technique began.
- NAME OF SERVICE ADDITIONALLYPRICE, €
- Minimally invasive prosthetics Orthopedics 25 000 €