New knee replacement procedure available at Euxton Hall
One of Euxton Hall’s most experienced orthopaedic surgeons, Mr Aslam Mohammed, will be commencing with an innovative new Knee replacement procedure called Signature Personalised Patient Care.
Mr Mohammed’s philosophy is to use implants which match patient’s needs and function, therefore he uses a variety of implants for both hip and knee replacements which will serve to provide optimal function for each individual patient.
This Signature Personalised Patient Care utilises MRI (magnetic response imaging) technology to create personalised positioning guides for total knee replacement.
The Signature system utilises custom femoral and tibial positioning guides developed from your MRI. The MRI is used to create a three-dimensional joint model, which enables the surgeon to preoperatively plan your knee replacement. In the past, surgeon planning has typically been based off of two-dimensional X-rays.
When used in conjunction with the Signature system, the Vanguard
Complete Knee System allows orthopaedic surgeons to provide more of a custom fit specifically for you, regardless of race, size, or gender. The Vanguard knee offers twice the femoral size options of other knee systems, which allows for 90 different size combinations.
Mr Mohammed has been to the USA to the Biomet Head Quarters to see the MRI scans being assessed and the software which allows it to be utilised to make the jigs.
Once the computer generated implants and jigs have been approved the information is sent to Leuven in Belgium where the actual jigs and moulds are made using lasers to model the jig from a special material.
Mr Mohammed has visited this facility to see the manufacturing of the moulds and jigs. After assessing this technique in detail Mr Mohammed believes this is the most accurate way of aligning the knee replacement and placing the implants on the femoral and tibial. However the surgeon is still responsible for the soft tissue balancing of the knee.
Anterior approach to the Hip Joint for Hip Replacement Surgery (THR)
Mr Mohammed has been performing this in selected patients for over 3 years. He visited surgeons on Paris and Switzerland to learn the
anterior approach and now is teaching it to surgeons in the UK without the use of the distraction table.
Anterior incision Total Hip Replacement has a number of advantages.
The anterior approach technique causes less surgical trauma than other techniques because NO MUSCLES ARE CUT[1,2], which can aid in rapid recovery. Many namea are given to this approach: AMIS, DAA and some describe the use of a distraction table.
It can potentially provide you with the following benefits:
1. Less post operative pain [1,3]
In comparison with "conventional" surgical techniques, as muscles are not cut.
2. Shorter rehabilitation[3,4]
Rehabilitation can usually start the day of the operation or the day after, subject to your doctor's approval, based on your post-operative conditions. Standing up and walking with arm crutches can start immediately.
3. Reduced length of stay in hospital [2,5]
The antereiror incision technique usually significantly reduces the duration of hospital stay. Your surgeon may still recommend you a longer stay depending on your post-operative condition.
4. Smaller scar 
With the anterior incision is often shorter than with “conventional” surgery and therefore scar tissue is reduced.
5. More rapid return to daily activities and routine [5,6,7]
The anterior incision technique allows you to return to daily activities in a shorter time frame.
6. Less blood loss [2,3]
Preservation of muscles and vessels potentially reduces blood loss. Transfusions are rare, blood clots in the legs (deep venous thrombosis) are potentially less likely. as the leg is not held in an awkward position as in the other traditional approaches.
7. Lower risk of dislocation (separation of the hip ball and socket) [4,8]
As a result of the anterior incision technique the preservation of muscles significantly improves the stability of the hip. The risk of dislocation is minimal and the post-operative limitation of movements, usually prescribed in other techniques, is not necessary. The risk of dislocation is reduced because the anterior approach is performed from the front of your body and dislocation is mainly related to posterior hip structure damage.
8. Prevents limping due to muscle damage [9,10,11,12]
the anterior incision is characterised by a surgical technique that protects the various muscles, blood vessels and nerves encountered during exposure of the hip joint. Minimizing muscle and nerve damage reduces the chances of limping.
The primary goal of the anterior incision technique Total Hip Replacement is to minimize harm to muscles, blood vessels and nerves surrounding the joint and give a pain free functioning hip joint.
 Arthroplastie totale de hanche par voie antérieure et son évolution mini-invasive; F. Laude et al.; EMC; 2004, 44-667-B
 Single-incision anterior approach for total hip arthroplasty on an orthopaedic table; JM Matta et al; Clin Orthop Relat Res, 2005 Dec, (441): 115-24
 Minimally Invasive total hip arthroplasty: anterior approach; F. Rachbauer; Orthopäde, 2006 Jul;35(7):723-4, 726-9
 Mini-incision anterior approach does not increase dislocation rate: a study of 1037 total hip Replacement; T Siguier et al; Clin Orthop Relat Res, 2004 Sep, (426): 164-73
 What‘s new in hip arthroplasty; MH Huo et al; JBJS Am; 2005 Sep, 87(9):2133-46
 Rapid Rehabilitation and recovery with minimally invasive total hip arthroplasty; RA Berger et al; Clin Orthop Relat Res, 2004, (429): 239-247
 The minimally invasive anterior approach to hip arthroplasty; RE Kennon et al; Orthopäde, 2006 Jul, 35 (7): 731-7
 Dislocation after hip hemiarthroplasty: anterior versus posterior capsular approach.; JB Bush et al; Orthopedics. 2007 Feb;30(2):138-44
 Muscular damage after total hip arthroplasty: conventional versus minimally invasive anterior approach.; Dr Dora, Dr Kalberer; AOA 2008, Australia, Hobart
 Abductor Tendons and Muscles Assessed at MR Imaging after Total Hip Arthroplasty in Asymptomatic and Symptomatic Patients. C. Pfirmann et al., Radiology 2005, 235: 969-976.
 MR imaging of the abductor tendons and muscles after total hip replacement in asymptomatic and symptomatic patients. PD Dr. Dora, EFORT 2007
 Der anteriore Zugang für die minimal-invasive HTEP. C Dora; Leading Opinions Sept 2006, 1/2006
Mr Aslam Mohammed aswell as being a teacher and trainer of furture doctors and orthopaedic surgeons, he attends courses to to teach and to learn about the most up to date techniques and management of conditions so that he remains at the forefront in order to providede his patients with the best care possible.
APRIL 3-5 2017 Faculty Confirmation - Richard Villar Hip Arthroscopy Course
APRIL 24-25 2017 Delegate Direct Superior Approach Cadaveric Lab Meeting
West Midlands Surgical Training Centre, Coventry
July 6-7 2017 Cadaver work shop Multi Ligament Knee Instructional Course