Zimmer AAOS Daily Highlights - February 15, 2007
Revision THA
Feb 15, 2007 04:42 PM
| A large crowd of surgeons demonstrated the strong interest in revision hip arthroplasty as Wayne Paprosky, M.D., Allan Gross, M.D., and Daniel Estok, M.D. discussed some of the ways they approach the revision and reconstruction of hips. Dr. Paprosky provided tips on selecting an appropriate implant for each type of defect. He discussed the use of curved stems, modular tapered stems, and fully coated porous stems. Dr. Gross talked about acetabular revision and the various biological materials available. |
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He discussed the various uses for the components of theTrabecular Metal™ Acetabular Revision System, and highlighted his procedure for using a cup/cage construct in place of a traditional cage. Dr. Gross explained that the theory behind the cup/cage construct is that the cage might provide protection to the cup while ingrowth occurs. Dr. Estok then described his use of the ZMR® Hip System, explaining why he prefers a modular system for revision hip procedures. He then reviewed his personal clinical experience with the system, which he first implanted in 2000.
Zimmer Continues MIS Education Program in Zimmer Institute
Feb
15, 2007 04:41 PM
| Dr. Thomas Coon, gave an education presentation on the Zimmer® MIS™ Quad-Sparing™ Total Knee Procedure in the Zimmer Institute area of the Zimmer AAOS exhibit booth today. In the sawbones presentation Dr. Coon highlighted key areas of the surgical procedure, from instrument knowledge to final implant placement. The presentation was part of the ongoing specific surgeon education program Zimmer is conducting in its Zimmer Institute area throughout the AAOS meeting. |
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MIS/THA Panel Discussion
Feb 15, 2007 03:15 PM
Dr.
Mark Hartzband moderated a panel of prominent surgeons regarding the use
of MIS for THAs. This panel, including Dr.
Kenneth Gustke, Dr.
Dana Mears, Dr.
David Nazarian, Dr.
Steven Weeden and Dr.
Wayne Paprosky each practice different MIS techniques, from the cutting
edge to more traditional.
All panel members concurred that there is
no consensus on the definition of MIS. Some define MIS as a small incision
on the outside and the inside, another defines MIS as a procedure that
reduces tissue trauma, and another suggested that MIS is not a technique,
but rather a process and a philosophy in managing the THA patient.
The
panel discussed the improved outcomes that result from using MIS procedures
for THAs. Most importantly, it was said that the patients who benefit most
are those who are motivated to return to a desired quality of life more
rapidly and with less pain.
MIS-specific instrumentation also was
discussed and validated as important to the success for the procedure.
MIS-specific instruments are tissue-friendly, illuminated, and are shaped
specifically for use with smaller incisions.
Challenges to consider
when adopting an MIS practice include educating the nurses,
anesthesiologists, discharge planners and rehab personnel. Learning the
procedure isn't the toughest part.
Zimmer Sponsors Annual J. Robert Gladden Orthopaedic Society
Feb
15, 2007 03:13 PM
| Dr. Robert L. Satcher, M.D., an orthopaedic surgeon who also recently completed astronaut training and is now awaiting a flight assignment, provided a history of African American participants in the U.S. space program as the keynote speaker at the annual meeting of the J. Robert Gladden Orthopaedic Society today. Dr. Satcher noted there have been 19 African American astronauts in either the civilian or military space programs since their inception. |
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The Gladden Society annual meeting lunch was sponsored by Zimmer. As part of the program, Zimmer U.S. Sales Executive Jon Kramer provided an update on the Zimmer Back in the Groove™ program. The Zimmer program is designed to promote greater awareness of the benefits of orthopaedic treatment among minority and underserved populations. Mr. Kramer noted that more than eight million potential patients have been exposed to media messages under the program, and that the first two community programs conducted under the program last year resulted in the development of a 1,500-patient database. The program will continue this year, including adding another community program. During this year's AAOS meeting Zimmer is also sponsoring a mentoring program for more than 50 minority medical students to help promote interest in the orthopaedic specialty.
The Gladden Society is a pluralist multicultural organization designed to meet the needs of minority orthopaedic surgeons, and to advance the ideals of excellent musculoskeletal care for all patients with particular attention to underserved groups.
The Knee Everyone's Talking About - Part II
Feb 15, 2007 02:54
PM
Jean-Noel Argenson, M.D., Mohamed Mahfouz, Ph. D., and Kim
Bertin, M.D. discussed gender differences in total knee arthroplasty at
the Zimmer Theater. Dr. Argenson said that in addition to anatomical
differences, men and women are affected differently by arthritis, and are
also more likely to have complications after TKA. "Anatomically, the
differences are more related to shape than to size," he said. But he
stressed that the differences are significant. To those who might suggest
otherwise, he pointed out that the genetic difference between men and women
may be only about 1%, but the genetic difference between chimpanzees and
humans is only 1.5%.
Dr. Mahfouz explained how gender atlases were
used to quantify these gender differences. Doing so provided the motivation
for the Zimmer Gender Solutions™ Implants. Dr. Bertin then explained
the clinical significance of the gender differences. Using knee registries
involving more than 45,000 patients, he tied the gender differences to a
higher incidence of lateral retinacular releases, as well as certain
postoperative complications in female patients.
Gender Solutions in THA
Feb 15, 2007 02:23 PM
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"Gender differences in hips are even more significant than the knee
side," according to Wayne
Paprosky, M.D. who, along with Dr.
Mark Hartzband. and Andrew
Glassman, M.D., presented his findings at the Zimmer Theater.
According to studies, women tend to have less offset, greater
differences in leg length, a higher rate of dislocations, and a higher
incidence of osteoporosis. Dr. Paprosky pointed out that the proximal
femurs of male patients generally fall into one of two categories,
whereas, female patients require six classifications. "Women are not
just little men," he said, "We believe a different set of implants is
necessary to address every woman." |
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| Dr. Hartzband continued by pointing out four specific anatomical differences between men and women that affect THA. These include head height, offset, anteversion, canal shape, and canal size. Dr. Glassman said that, because of osteoporosis, female anatomy is more likely to change with age. Women are more likely to have thinner cortices and wider canals than men, requiring a larger, stiffer stem. He suggested using implants that are less stiff, such as the Epoch® Hip Prosthesis, to help avoid stress shielding. Dr. Glassman reviewed clinical results that showed no revisions at an average follow-up of eight years. |
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Metal-on-Metal THA Articulations
Feb 15, 2007 12:34 PM
- Proven: used of over 70 years in THA
- Results: excellent long-term results
- Success: new generation of metal-on-metal has over 20 years of clinical success with over 300,000 implants placed.
BRIGIT: More Than Just A Pretty Face
Feb 15, 2007 11:29 AM
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Another standing-room only crowd gathered at the Zimmer Theater to see
what Dr. Giles Scuderi referred to as the "beginning of the future in
orthopaedics." According to Dr.
Scuderi, the BRIGIT™
Bone Resection Instrument Guide is designed to address the need to
treat an increasing number of patients without sacrificing quality, and
while improving OR efficiencies. |
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Dr. Scuderi opened the presentation by explaining that BRIGIT is
not a robot, and not a navigation systems because it is completely
controlled by the surgeon. BRIGIT creates a three-dimensional
model that the surgeon uses to help make all adjustments. Although
landmarks are established in a similar manner to navigation, the surgeon
controls planning, intraoperative decision making, and resection. |
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The large crowd was treated to a live demonstration of BRIGIT by Tom
McCoy, M.D. He referred to BRIGIT as a passive assistant, and
showed how a single resection guide can be used for all cuts. The
surgeon has the flexibility to move the resection guide anywhere within
the selected plane of resection. |
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MIS TKA Implant Solutions
Feb 15, 2007 10:27 AM
The Zimmer Theater opened Thursday with a presentation about the latest
technology applied to MIS TKA. Jess
Lonner, M.D. and Thomas
Coon, M.D. reviewed a number of key elements for successful MIS
procedures, including instruments and components designed for MIS
procedures. The presenters suggested that all the potentially complicating
factors in MIS surgery can now be addressed, and that MIS procedures can now
be used in more complex primary and revision cases.
Dr. Coon asked
the question: How do you get a large implant through a small incision? One
answer, according to Dr. Coon, is to insert the implant in pieces by using
modular implants. Dr. Lonner reviewed the mini-keel tibial component that is
part of the NexGen® Complete Knee Solution. The implant has broader,
but shorter fins, and a modular drop-down stem, although Dr. Lonner does not
use a stem in about 90% of his patients. He pointed out that the implant
provides an excellent means to address issues with rotational alignment and
compromised cement mantle. Dr. Lonner has used the tibial implant in 350
patients with no loosenings after an average follow-up of 13 months.
Similarly, after one year, no loosenings have been reported in a
prospective, multi-center study.
Zimmer Focuses on Health Economics
Feb 15, 2007 09:21 AM
| Health Economics is a major focus of Zimmer at this year's AAOS meeting. In a special Health Economics area of the Zimmer exhibit booth, Zimmer is providing surgeons with a customized reimbursement coding book from Ingenix to help U.S. surgeon practices better understand common open orthopaedic and spine procedure codes.During this year's AAOS meeting Zimmer is also launching a special web site with reimbursement-related information that surgeons can access online,www.reimbursement.zimmer.com. |
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The Zimmer® Reimbursement Hotline also launched at AAOS, 866-946-0444, is available now from 9 a.m. to 8 p.m. Eastern for hospitals and surgeons. Zimmer also is highlighting economic research and reimbursement advocacy efforts for emerging technologies throughout the Zimmer booth.
Zimmer Communications Promotions
Feb 15, 2007 09:05 AM
| For the first time Zimmer is offering Bluecasting communications from its exhibit. Bluecasting provides announcements and brief informational text messages to surgeons in and around the Zimmer exhibit who have their Bluetooth personal device turned "on" to accept messages. Two kiosks in the Zimmer exhibit displays instructions on how surgeons may enable their cell phone to accept the messages. Zimmer this year also is sponsoring the online communications centers around the AAOS exhibit floor in order to help surgeons keep up with their Email and other online communications. Surgeons can also check their Email and the online news through connections as shown here in the Zimmer exhibit's Cyber Café. |
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