ALMIS - MINIMAL INVASIVE HIP ARTHROPLASTY

The minimally invasive joint replacement surgery of the hip (ALMIS), is a modern concept for the treatment of osteoarthritis of the joint. This method enables the orthopedic surgeon to complete the surgery without cut muscle groups that surround the joint, but to distinguish between them and will reach the bones which will replace the hip.

The minimally invasive joint replacement surgery of the hip (ALMIS), is a modern concept for the treatment of osteoarthritis of the joint. This method enables the orthopedic surgeon to complete the surgery without cut muscle groups that surround the joint, but to distinguish between them and will reach the bones which will replace the hip.

There are no absolute age or weight restrictions for total hip replacements.

Recommendations for surgery are based on a patient's pain and disability, not age. Most patients who undergo total hip replacement are age 50 to 80, but orthopaedic surgeons evaluate patients individually. Total hip replacements have been performed successfully at all ages, from the young teenager with juvenile arthritis to the elderly patient with degenerative arthritis.
When Surgery Is RecommendedThere are several reasons why your doctor may recommend hip replacement surgery. People who benefit from hip replacement surgery often have:

  • Hip pain that limits everyday activities, such as walking or bending
  • Hip pain that continues while resting, either day or night
  • Stiffness in a hip that limits the ability to move or lift the leg
  • Inadequate pain relief from anti-inflammatory drugs, physical therapy, or walking supports

  The method is minimally invasive ALMIS has the following advantages for the patient:

• less postoperative pain
• smaller incision
• immediate mobilization of the patient
• usually does not require a blood transfusion
• shorter duration of hospitalization in clinical
• minimize the total postoperative day the patient needs the use of walking aids (walker, crutches)
• faster return to daily activities and professional
The surgical method applied in recent years to major hip surgery centers worldwide are increasingly replacing the hitherto conventional methods.

The surgical method applied in recent years to major hip surgery centers worldwide, replacing the conventional methods.

CASE REPORT 1

22-year-old patient with end-stage arthritis due to the LEG PERTHES CALVE disease which started when the patient was 12 years old. LEG PERTHES CALVE disease is one of the type of osteonecrosis of the hip that occurs in teens and its etiology has not been clearly elucidated to date.


Pre op X-ray of the hips reveals dysplasia and  severe arthritis of the right hip 


Limb length discrepancy. The right lower limb has lost height (shorter than the healthy left). The red line highlights the problem


Limb length discrepancy. The right lower limb is shorter than normal

Magnetic resonance imaging of hips before surgery. Emphasizing the deformation of the head of the femur due to LEG PERTHES CALVE osteonecrosis of the femoral head

Removal of the damaged femoral head which has lost the normal anatomical shape

Pre op walking, limping and pain

20 days post op.  The patient walk without pain and limping.


Post op X-ray, total hip arthroplasty - minimal invasive ALMIS procedure

The method of minimal invasive hip replacement ALMIS enables and in selected patients with dysplasia of the hips to be treated by taking all the advantages of this new method.

CASE REPORT 2

Woman 48 years old suffer from pain and stifness of the right hip joint due to arthritis (developmental acetabular dysplasia)


X-ray: Severe arthritis of the right hip due to developmental dysplasia of the acetabulum


X-ray of the right hip


Right lower limp shortening due to arthritis about 0,7 mm

Pre op walking


Anatomical points and skin incision drawing (about 7 cm)


Post op X-ray,  ALMIS right hip arthroplasty


X-ray imediatelly after surgery.  Right hip ALMIS arthroplasty


Nine weeks post op

One day after ALMIS hip artrhoplasty

17 days post-op walking without pain and assistive devices

CASE REPORT 3

Female patient 44 years old suffers from severe arthritis in both hips of those due to developmental hip dysplasia - DDH. The left hip is in subluxation (upward displacement of the femoral head) due to congenital dysplasia of the acetabulum, so that the left leg is shorter and the patient has limping during walking.


Leg length discrepancy (left lower limb is shorter 2.5 cm as compare to right)


Pre op X-ray: severe hip osteoarthritis bilaterally.  The left hip is subluxed due to developmental hip dysplasia DDH


CT Scan - 3D reconstruction.  Developmental hip dysplasia


Pre op skin incision drawing (straight line)


Post op X-ray.  ALMIS hip arthroplasty left


Post op. The leg length are equal

CASE REPORT 4

Αctive woman of 65 years, suffering from rheumatoid arthritis which among others has hip arthropathy bilaterally.


X-ray: hip arthropathy bilaterally due to rheumatoid arthritis


X-ray: profile position

The patient underwent left hip arthroplasty ALMIS

The woman 10 days after operation can walk comfortably without pain as well as running up and down stairs without problem

CASE REPORT 5

Female 70 years old and 97 kg weight, suffering from severe osteoarthritis in his right hip resulting in the last year to permanently use crutches to walk due to severe pain in the joint.
The patient underwent minimally invasive hip replacement by a new method ALMIS. Raising and walking the patient was the same day of surgery and its outcome was excellent.
The ALMIS method may be applied to patients with a large body weight, allowing for them an opportunity to regain their mobility without pain and difficulties.


Pre op X-ray.  Hip degenerative osteoarthritis, bilaterally.


ALMIS hip arthroplasty right. Eight weeks post op X-ray


Profile X-ray of the right hip arthroplasty ALMIS

CASE REPORT 6
Female 66 years old suffering from advanced osteoarthritis in her right hip which creates intense pain when walking and severe discomfort during sleeping at night. It is very typical rapid development of arthritis as reflected in chronological ranking in the patient X-rays of the hips.

X-Ray of patients hip in 2012 at age 62. Arthritis in the right hip is already a clinical problem for the patient


The same X-ray three years after - 2015. The progress of arthritis in the right hip is visible while deteriorating  of patients as regards to pain in the joint and limiting the functional capacity


Radiographic image of the patients hip in 2016 at the age of 66 years. It was decided to replace the joint of the right hip of the patient with the novel method of ALMIS hip arthroplasty


Magnetic resonance imaging of the patients hip shows the severity of arthritis by creating subchondral cysts in the femoral head and the creation of large osteophytes on the edge of the hip joint

The patient underwent minimally invasive ALMIS hip arthroplasty. The mobilization of the patient was rapid, the pain disappeared and the adaptation of its daily activities easier.


Post-op X-ray

Two months after ALMIS minimal invasive hip artrhoplasty, the patient walk without any problem

CASE REPORT 7

Female 39 years old with advanced arthritis in her right hip. Pain is the main symptom of the patient as well as the limitation of anatomical movements of the joint. Because the patient is relatively young, the problem in her right hip affects the quality of life significantly limiting the social and professional activities.

Advanced regenerative arthritis of the right hip joint

Hip MRI. Severe degenerative artrhitis of the right hip joint (red arrow)


Preoperative planning and selection of implant sizes


The patient is in the operating room. The sectional design has been done always according to the guide anatomical points (straight line)

Post op X-ray.  ALMIS right hip arthroplasty


The incision of ALMIS hip arthroplasty does not exceed 7-10 cm

CASE REPORT 8

The method ALMIS used to address femoral hip fractures to perform bipolar hemiarthroplasty, with all the advantages of the process, ensuring the immediate mobilization and full weight bearing of the affected limb. This helps the patient to get out quickly from the vicious circle that creates a hip fracture thus avoiding the complications of immobilization in bed.


Femoral hip fracture right


Bipolar semiarthroplasty of the right hip