Zimmer MIS 2-Incision Hip Procedure

A Muscle Sparing Approach to Total Hip Replacement

Your patient’s goal is to live according to his or her own terms.  The Zimmer® Minimally Invasive Solutions™ (MIS™) 2-Incision ™ Hip Procedure, combined with many of the clinically proven Zimmer Hip components, is designed with a focus on better outcomes and returning patients to their desired quality of life.

Zimmer MIS THA solutions are at the forefront of minimally invasive instruments and product design.  The Zimmer MIS  2-Incision Hip Procedure is designed to facilitate implantation through two smaller incisions while sparing the muscles and tendons around the hip:

  • Minimizing tissue trauma
  • Reducing hospital stays
  • Facilitating less painful rehabilitation 

Philosophy-based Product Choice

The two incision, muscle-sparing approach accommodates supine patient positioning and is compatible with the VerSys® Porous line of product, as well as the Zimmer M/L Taper, Epoch®, and Trabecular Metal™ Primary stems.  Initially, until the surgeon feels comfortable with the surgical technique, it is recommended that the surgeon use only the VerSys Beaded FullCoat Stem. This is the stem of choice for the following reasons:

  • It is porous and does not require bone cement.
  • It comes in a wide variety of sizes and offsets that can meet the needs of most patients.
  • It has a collar providing a “stop” for the stem
  • It has the greatest porous surface area of all the VerSys stems. This offers the surgeon the best opportunity for immediate stability as well as long term fixation.

Clinical Goals and Experience

The Zimmer MIS 2-IncisionHip Procedure, conceptualized by Dana Mears, M.D. and further developed in collaboration with leading surgeons from around the world, courses between the sartorius, tensor fascia, and after retracting the rectus femorus, to the hip capsule. This intermuscular interval provides good exposure for preparing the acetabulum.  With the assistance of fluoroscopy, the glutius maximus is bluntly disected for preparing the femur.  This Zimmer MIS 2-Incision Hip Procedure preserves muscle integrity so the rehabilitation can be faster.  Among the goals of this minimally invasive technique are less trauma, faster and less painful rehabilitation, smaller scars, shorter hospital stay, and quicker return to work and daily activities.   

Since the introduction of the MIS 2-Incision Hip Procedure to the orthopaedic community in 2001, hundreds of surgeons around the world have participated in the training program at The Zimmer Institute.  Over 3,000 primary total hip replacement procedures have been performed using this innovative surgical technique.2

Some key features of the MIS 2-Incision Hip Procedure are:

  • A two incision approach with incisions ranging from 1 ½ to 2 inches
  • An approach with the patient in the supine position
  • A muscle-sparing approach intended not to cut muscles or tendons
  • Reduced blood loss and less of a need for pre-surgery donation
  • Potential for quicker return to work and daily activities
  • 30% less overall cost and 30% greater improvement in physical function compared to a conventional hip replacement, based on a three-month improvement of SF-36 Physical Function.1

Zimmer MIS 2-Incision THA Improves Short Term Outcomes and Cuts Costs

The results of a comparative analysis suggest that the MIS 2-Incision Hip Procedure provides superior short-term post-operative clinical outcomes at lower cost than the conventional THA technique.  Clinically demonstrated benefits of the MIS 2-Incision Hip Procedure compared to the conventional technique include shorter hospital stay, of one to two days versus three to five days, with many patients able to go home in less than 24 hours; faster, less painful rehabilitation; and the possiblity of a quicker return to work and daily activities.  Minimizing hospitalization and rehabilitation may reduce the cost of total hip arthroplasty by as much as 30%.  MIS 2-Incision Hip Procedure patients often experience better quality of life in the critical first weeks and months after surgery.

Innovative Instrumentation

Innovative easy-to-use instruments are designed specifically for the Zimmer MIS  2-Incision Hip Procedure to help provide accurate bone preparation and implant placement.  Zimmer has designed instrumentation to improve visualization, reduce the learning curve, and minimize soft-tissue trauma throughout the procedure in the following ways:

  • Retractors designed specifically to help protect muscle fibers as well as the option for retractor extenders to keep hands clear from fluoroscopy.
  • Backlit retractors improve visualization without encroaching on the incision site.
  • Offset shell inserter to facilitate cup implantation in supine patient positioning.

Advancing Skills and Knowledge

The Zimmer Institute, in true teamwork with the surgeon, provides hands-on training and transfer of knowledge to bring the benefits of minimally invasive surgery to joint replacement partners. The Zimmer Institute has numerous opportunities worldwide for surgeons to advance their minimally invasive surgical skills with the Zimmer MIS 2-Incision Hip Procedure or one of Zimmer’s other Minimally Invasive Solutions Procedures. Please contact your Zimmer Sales Representative regarding these opportunities and The Zimmer Institute schedule for details.

References:

  1. Schenck RA, PhD., Reyner DP, Dr.Ph., Brenner JS, MBA, George JC, MS, Blanchard C, PhD.  Cost Effectiveness of the Zimmer® MIS™ 2-Incision™ Hip Procedure. Zimmer release 2005.
  2. Zimmer press release.  Zimmer Holdings Announces Milestones in Minimally Invasive Joint Replacement.  http://biz.yahoo.com/prnews/051209/def005.html?.v=33.  December 9, 2005.