e Hüfte - AMIS

HIP PROSTHESIS WITH AMIS METHOD

The insertion of an artificial hip joint, a so-called total hip endoprosthesis (also known as a hip TEP), is one of the most common surgical procedures. A hip prosthesis is necessary in cases of joint wear and tear and hip arthrosis (coxarthrosis) if conservative therapies do not lead to any improvement.

The AMIS method is the gentlest way to insert a hip prosthesis, as no muscles, tendons or nerves are cut or nicked on the way to the hip joint. The result is a significantly faster recovery time and return to everyday life and unchanged muscle function for occupational and sporting activities.

WHAT IS THE AMIS METHOD?

The great advantage of the AMIS method is that muscles, nerves and tendons are preserved on the way to the hip joint, as they are not severed but only pushed to the side.

The surgeon has various routes to the hip joint available for implanting a hip prosthesis. We also refer to these as surgical approaches. Many of these surgical approaches for hip TEP are advertised as minimally invasive. This is because small incisions are made in the skin to reach the deeper muscles and tendons and the joint.

With most conventional surgical techniques, however, the surgeon has to pass directly by the short lateral or posterior hip muscles in order to reach the hip joint. These muscles and tendons, which are incredibly important for hip function and can also be called the motor of the hip, are torn or deliberately severed during the operation.

The AMIS method is characterised by a reduced skin incision and the preservation of all muscles, tendons and nerves on the way to the hip joint. It is therefore the technique that best protects and preserves soft tissue.

WHAT HAPPENS DURING A HIP OPERATION?

When an artificial hip joint is implanted, the damaged femoral head, the damaged acetabular cartilage and bony attachments caused by osteoarthritis are removed. The joint is then reconstructed with an artificial hip joint. This usually consists of a hip stem, which is inserted into the thigh, and an acetabulum, which is fixed in the pelvic bone. The sliding surfaces, consisting of a cup insert made of high-quality plastic or ceramic and a ceramic or metal femoral head, are fixed between these implants anchored in the bone.

There are many surgical methods for inserting a hip prosthesis. Anyone who has previously had an artificial hip joint has generally had to expect a longer recovery period. The conventional approach to hip prosthesis surgery is from the back via the gluteal muscles or from the side through the hip muscles or just past them.

In order to reach the hip joint via the surgical approach from behind, numerous muscles (the so-called external rotators) must be severed, which must first be sutured at the end of the operation and then heal.

In the lateral approaches, too, the notched or torn muscles (so-called abductors) must first heal again, which in many cases does not happen completely. The result was a prolonged healing process with sometimes permanent pain and limping. This is a thing of the past with the AMIS method.

HOW DOES THE AMIS METHOD WORK?

AMIS stands for „Anterior Minimally Invasive Surgery“ and describes the muscle- and tissue-sparing approach to the hip joint from the front: an anatomically logical and very gentle approach. The patient lies in the supine position. The hip prosthesis is inserted via a small incision on the front of the thigh. Muscle cords are not severed or detached, but merely displaced.

The AMIS method is successful because the neighbouring muscles are all long muscles that extend from the pelvis to the knee joint and can therefore be easily held to the side like the long sides of a harp. Also, no important motor nerves cross the surgical field, as the access route lies exactly between the supply areas of the gluteal nerves and the large femoral nerve.

Once the hip prosthesis has been inserted, the hip capsule – the connective tissue envelope of the hip joint – is closed again. This creates a very stable hip joint. With the AMIS method, the muscles do not need to be sutured, but lie back in their anatomical position, closing the surgical access like a theatre backdrop. Only the fascia and skin need to be sutured with the AMIS method.

The advantages of the AMIS method for patients are enormous: they lose less blood, experience less pain after the operation and therefore need fewer painkillers. As the hip and thigh muscles are not damaged, you are fit again more quickly and can return to everyday life with a shorter rehabilitation phase. By preserving the muscles and capsule, the dislocation rate is reduced to an absolute minimum. At the same time, however, all implants can be used, i.e. the most suitable and highest quality implant is selected for the individual patient.

ADVANTAGES OF THE AMIS METHOD

Die AMIS Methode ist im Vergleich zu herkömmlichen Operationstechniken weniger traumatisch, da Muskeln und Nerven nicht durchtrennt, sondern zur Seite geschoben werden. Die Vorteile für Patienten sind vielfältig:

Reduzierter Blutverlust:

Der Schutz der Muskeln und Sehnen reduziert den Blutverlust.

Weniger Schmerzen nach Operationen:

Mit der AMIS Methode entstehen weniger Schmerzen nach der Operation, da keine Muskeln durchtrennt werden.

Kürzerer Aufenthalt im Krankenhaus:

Dank der AMIS Methode kann der Aufenthalt im Krankenhaus deutlich verkürzt werden.

Schnellere Rehabilitation:

Die Rehabilitation verläuft deutlich schneller, häufig ist keine stationäre Reha notwendig.

Kleinere Narben:

Mit der AMIS Methode ist der Hautschnitt kürzer als bei herkömmlichen Operationstechniken.

Schnellere Rückkehr in den Alltag:

Durch eine verkürzte Regenerationszeit wird eine schnelle Rückkehr in den Alltag ermöglicht.

Geringeres Luxationsrisiko:

Die Ablösung und Einkerbung von Sehnen und Muskeln erhöht das Risiko, dass eine Hüftprothese ausrenken kann. Klinische Studien zeigen, dass bei der AMIS Methode das Luxationsrisiko deutlich reduziert ist, da die stabilisierende Muskelfunktion voll erhalten bleibt. Zudem kann die stabilisierende Kapsel erhalten werden, die bei alternativen OP-Techniken entfernt werden muss.

Vermindertes Hinken:

Verringerte Muskel-und Sehnenschäden reduzieren das Risiko von Hinken.

Weniger langfristige Schmerzen:

Die AMIS Methode vermindert das Risiko chronischer Sehnenschäden mit schmerzhaften seitlichen Sehnen- und Schleimbeutelentzündungen.

WHEN IS AN AMIS HIP IMPLANTED?

Pain in the hip severely restricts everyday life. If hip osteoarthritis does not improve despite conservative treatment or the pain even worsens, the use of an artificial hip joint using the AMIS method is a sensible alternative. It relieves continuous pain and restores lost mobility.

The most common causes of hip pain are signs of wear and tear of the hip joint. This is also known as hip arthrosis.

In hip osteoarthritis, the joint cartilage – the sliding layer between the pelvic and femur bones – wears away. The damaged cartilage tissue causes the femur and acetabulum to rub against each other without protection. This friction causes inflammation, which results in pain.

Hip osteoarthritis can be caused by accidents, misalignment of the legs and hip joint, overloading and incorrect loading as well as age-related and genetic wear and tear.

PROF. DR. MED. GOLLWITZER AND PROF. DR. MED. WEBER

As renowned specialists in orthopaedics and trauma surgery, our hip specialists Prof Hans Gollwitzer and Prof Patrick Weber are international contacts for all questions relating to hip disorders.

They have extensive knowledge and experience in hip and knee endoprosthetics and joint-preserving hip surgery. Having performed several thousand hip operations, Prof Dr Gollwitzer and Prof Dr Weber are some of the few hip specialists with sufficient experience in joint-preserving hip surgery as well as hip joint replacement and prosthesis replacement.

Prof Dr Hans Gollwitzer was one of the first surgeons to use the AMIS method in Germany. Due to its advantages, our hip specialists Prof Dr Gollwitzer and Prof Dr Weber now use the AMIS method for all initial implantations of hip prostheses and also for replacement operations. Prof Gollwitzer is also a member of the international AMIS Educational Board.

WEITERE INFORMATIONEN ZUM DOWNLOAD

FOR QUESTIONS ABOUT THE AMIS METHOD

Do you have questions about the hip prosthesis with the AMIS method or other hip conditions? Prof. Dr Gollwitzer and Prof. Dr Weber, our hip experts at ECOM® Excellent Center of Medicine, will be happy to provide you with detailed information and advice in a personal consultation. Simply make an appointment. We look forward to hearing from you.

YOUR SPECIALISTS IN ROBOTIC ARM-ASSISTED SURGICAL PROCEDURES

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