Issue link: https://beckershealthcare.uberflip.com/i/956253
31 Executive Briefing Medacta® International is a world leading manufacturer of orthopedic implants, neurosurgical systems, and instrumentation. Medacta's revolutionary approach and responsible innovation have resulted in standard of care breakthroughs in hip replacement with the AMIS® system and total knee replacement with MyKnee® patient matched technology. Over the last 10 years, Medacta has grown dramatically by taking a different approach and placing value on all aspects of the care experience from design to training to sustainability. Medacta is headquartered in Castel San Pietro, Switzerland, and operates in over 30 countries. To learn more about Medacta International, please visit www.medacta.com or follow @Medacta on Twitter. Ryan Molli, DO Anthony Robins, MD practical point of view, storing it. We have very limited storage space. This procedure, in many respects, is a soft tissue procedure with bone resurfacing. We all aim for knees that are stable and correctly aligned, which requires accurate assessment of the soft tissue balance. I am not sure that a robot can make this dynamic assessment. While a robot may help with bone resections I don't trust it to balance a knee. Q: How has Medacta supported education for MOTO? RM: Every surgeon gets the full support of the Medacta education "machine." There is one-on-one instruction, ability to visit surgeon reference centers to see several cases in one day, learning centers with didactics and cadaver labs and of course the presence of a proctor in the first cases. It doesn't stop there. Frequent tips and tricks, case presentations and education reminders are delivered via email periodically. These features continue with time. Q: The Oxford mobile bearing UKA was designed to minimize wear. 1 Do you see wear as a major cause of failure with UKA? MK: Interestingly, no. Aseptic loosing, infection and advancing OA into other compartments of the knee are the most common failure modes. We took great care with Medacta engineers to design MOTO components to optimize fixation and thus prevent aseptic loosening. I'm very respectful of the mobile bearing outcomes, yet we wanted a solution that applied to every knee. Q: Did you feel apprehension going into a case prior to MOTO? RM: I did have some apprehension with the Oxford, because it's difficult to change once you've started down the pathway. I take comfort in knowing that I can change gaps, implant size and positioning if I need to. AN: I did have apprehension with the ZUK in dealing with knees with significant flexion-extension gap mismatch. I was forced to do some interesting free-hand adjustments or resect more tibial bone, but now I know I have all the instruments needed to address any situation with this system. Q: The accurate implant sizing allows for full cortical rim contact on the tibial component to prevent subsidence. The femoral component has an extended posterior condyle to allow patients deep flexion without posterior impingement. What other features do you feel are important for you with the MOTO Partial Knee System? AN: The ability to make resections to the millimeter with independent flexion and extension balancing has been the greatest feature for me. I never have to worry about overcorrecting a knee. This allows me to obtain the perfect alignment and a well-balanced knee. RM: The fact that I have never burned any bridges with this technique [is an important factor]. By that I mean that I can revise any step through the surgery. If I want to go back and fine tune one of my first steps I can do that as easily as I can the step I just finished. I can even change the femoral component up or down a size after the lug holes have been drilled. It is the most flexible system I have ever used. MK: The goals to reduce failures have been well addressed with this system. I appreciate the safety features like cutting the distal femur in flexion and minimal pin fixation needed for the tibial cut guide. It is the most versatile and reliable system I have ever used. What my colleagues have said is very true and this all can be summarized in the surgical philosophy of the Moto system — balanced aligned resection. n References 1 Murray DW, Goodfellow JW, O'Connor JJ. The Oxford medial unicompartmental arthroplasty: a ten-year survival study. The Journal of Bone and Joint Surgery, British Volume. 1998 Nov.;80(6):983- 9. Q: Why would an ASC choose MOTO? AN: As an ASC owner, I'm interested in outcomes, costs, and because it is a business, profitability. MOTO is cost-effective, doesn't take up a lot of storage space, and allows for very efficient turnover times, and most importantly good outcomes with very low complication rates. Q: Do you feel a robot would give you an advantage? RM: No. I've done a high volume of arthroplasty, and am quite happy with my outcomes. I don't deny that a robot might be more accurate, but this has not been shown to yield better outcomes. The soft tissues tell me how much alignment correction I can gain. Knowing my alignment goals I believe I can better balance gaps with the MOTO instruments. AN: As an owner of an ASC, I am simply not interested in the capital expenditure of a robotic system, the longer turnover times, and from a All trademarks and registered trademarks are the property of their respective owners.