Medacta International: Founded by a Patient, Exceptional Through Training

There is training…and there is Medacta training.

You might even say that, ‘spare the muscle, spoil the surgeon’ is their motto.

Born out of a less-than-stellar total hip replacement (THR), Medacta International was created by Alberto Siccardi after he was dissatisfied with his surgical experience. Medacta, the only orthopedic company founded by a patient, is laser-focused on improving patient outcomes via superb surgeon training. Now, the company is celebrating its 200th Learning Center, a course where surgeons learn the company’s proprietary approach.

Francesco Siccardi, executive vice president of Medacta International—and son of the founder, tells OTW, “Years ago I watched my father suffer after undergoing a total hip replacement. He and I both knew that there had to be a better way.”

Enter the anterior approach.

“We could see the advantages of the anterior hip approach, and we were personally motivated to find a way to give patients a superior surgical experience. To that end, we partnered with esteemed French surgeon Frédéric Laude, M.D., one of the original innovators of the anterior approach. Together, we created the AMIS (anterior minimally invasive surgery) Technique, a muscle-sparing approach that has resulted in shorter hospital stays, faster rehabilitation time, and a quicker return to daily activities.”

Working alongside Dr. Laude, Medacta poured its resources into developing a training program with an unprecedented level of support and resources for surgeons.

“Medacta has an educational program that allowed me to learn this technique comprehensively and implement it in a safe manner. The anterior approach does have a steep learning curve and it can be frustrating. With the Medacta program, the surgeon first goes to a Reference Center to observe a surgeon who is proficient in the technique. After the Reference Center visit, the trainee can then participate in an introductory course with didactic classroom sessions and cadaver lab sessions. If he or she decides to adopt the technique, Medacta arranges for a proctoring surgeon to be on hand in the OR for their first cases and as many times after this as the trainee feels is necessary, ” says training participant-turned-AMIS educator, Peter Thadani, M.D., who is with the Illinois Bone and Joint Institute.

He tells OTW, “Typically, the way a surgeon learns how to implement the anterior techniques is through reading, video, or a weekend course where the surgeon listens to lectures and does a little cadaver practice. In my opinion, that is insufficient.”

200 AMIS Learning Centers, 3, 500 Surgeons

Medacta, headquartered in Castel San Pietro, Switzerland, recently hosted a series of events across five U.S. cities that included a live international webcast panel, and the commencement of Medacta’s 200th AMIS Learning Center.

To enhance and solidify the learning experience, surgeons can access the M.O.R.E. (Medacta Orthopedic Research and Education) Institute programs, an important resource for surgeons as they learn and adopt the AMIS technique. “The M.O.R.E. Institute was created to provide continuous support to professionals in the field of research and education and to improve patient outcomes. This is supported through effective training programs, surgeon to surgeon education, and a forum to share experiences.”

To date, more than 3, 500 surgeons in over 30 countries have been trained in the AMIS Education Program, which is only a small portion of the programs provided by the M.O.R.E. Institute.

Francesco Siccardi tells OTW, “We feel that the most important thing in orthopedics and joint replacement is not only to improve implant design, but how to elevate design standards. Given this, we focus substantial attention to hip and knee surgical techniques. These, along with additional methodology and improvements in pain management will move the field forward. The anterior approach plays a key role because it involves a faster recovery and is highly reproducible.”

“Surgeons want to know how to learn the new technique without putting their patients at risk. To ensure safety, we focus on minimizing complications during the learning curve; that is why we take a step-by-step approach. The key aspect to supporting the surgeon during the learning curve is our proctoring service…we promise the surgeons that they will never be left alone.”

“We estimate that it takes performing a minimum of 25-30 of these surgeries in order to go through the learning curve. At 100 surgeries the surgeon has fully mastered the technique and can operate on all comers.”

Eric Fontenot, product director for Medacta, tells OTW, “At present we have ongoing learning centers in the U.S., Australia, Singapore, France, and Switzerland. In April 2016, we will also conduct our 8th M.O.R.E. Symposium, a semi annual event, focusing on techniques in hip and knee arthroplasty. In addition to the symposium and the ongoing learning centers, our educational activities have to grow with our growing user base. The more surgeons become proficient in our technique, it is even more important that we add masters and revision level courses. The revision market is a burgeoning area and there is a lot to develop in terms of new instruments and techniques to preserve muscle in this setting. In revisions the dislocation rate is disproportionally high. If we can address this issue by improving the surgical approach and leaving the hip more stable, then we will have gone a long way toward serving our mission.”

The Product Is Education

Tyler Goldberg, M.D., U.S. medical director for Medacta, helped bring the technique to the United States in the 2008. “My message about Medacta is this: It is an educational company that just so happens to sell implants. They are in the business of educating surgeons on the safe way to pursue this innovative technique. The main difference in the way most surgeons are trained compared to the way Medacta surgeons are trained is that the latter is anatomically based. Medacta makes hip replacement about surgical dissection and appreciation of the anatomy. With other training, it’s often about retractor placements and moving the tissue forcefully out of the way to get to the fun of reaming and broaching. After Medacta training, several surgeons have told me things to the effect of, ‘I have been doing the anterior approach for years and it is nothing like this operation.’”

“While the learning curve can be intimidating, it can be shortened by teaching the surgeons through it and letting them know what to expect and how to handle different situations. By sending in surgeons like myself who have a vast amount of experience, the company ensures that the surgeon is never abandoned on their own ‘island.’”

“The company’s definition of success is, ‘What is the rate of conversion to the anterior approach after a surgeon undergoes Medacta training?’ We have evidence showing that 85% of surgeons who receive the AMIS training continue to do this approach after the training.”

Just what Medacta’s original patient, Alberto Siccardi, would call a success indeed.