Heritage
meets
progress
The Quadra-P System offers a complete set of stems developed preserving the characteristics important to the clinical success of Quadra-H
while incorporating proven innovative key features to address the modern challenges in THA.
QUADRA-H’s solid clinical history laid the grounds for the development of QUADRA-P.
The MectaGrip coating on the Quadra-P and Quadra-P Collared aims to provide an
enhanced proximal fill at metaphyseal level, and a mechanically stronger bone-implant interface, resulting in potentially improved load transfer[4].
Literature shows that young and active patients can be considered the challenge of
modern arthroplasty[17]. To address the high demands coming from very active and younger patients, QUADRA-P & QUADRA-P Collared feature proximal MectaGrip coating providing:
Neck lengths throughout the Quadra-P System increase size by size, based on AMIStem’s experience. This allows for progressive head center growth and to more efficiently restore the
hip joint biomechanics in a growing patient population.
QUADRA-P System is a complete range of products implantable with a single instrument platform allowing for intra-op flexibility.
Vertical offset does not change when adding lateral offset for each size implant, thus leg length is not affected when changing
from standard (135° neck-shaft angle) to lateralized (127° neck-shaft angle).
REGULAR NECK:
SHORT NECK:
12 STANDARD sizes (from 00 to 10)
11 LATERALIZED sizes (from 0 to 10)
9 STANDARD sizes (from 0 to 8)
9 LATERALIZED sizes (from 0 to 8)
QUADRA-P & QUADRA-P Collared are made of Titanium Niobium Alloy (ISO 5832-11) and sandblasted along their length.
Successively 300μm of MectaGrip, pure Titanium deposited through Plasma Spray technology, are applied on the proximal 50% of the stem.
Finally, 80μm of Hydroxyapatite (HA) are applied to the entire length of the stem.
MECTAGRIP
Professor William Walsh’s animal study[4] demonstrates how a surface treated with MectaGrip coating can achieve a stronger bone-implant interface compared to a surface treated with Hydroxyapatite alone.
QUADRA-P Cemented is made of High Nitrogen Sainless Steel (ISO 5832-9) and mirror polished along its length.
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SHAPE
The triple tapered design provides axial and rotational stability[11,12] and the trapezoidal shaped
cross-section is designed to facilitate preservation of bone vascularization, since the diaphysis is not completely filled[13,14,15].
NECK
The mirror polished surface helps minimize soft tissue damage and liner wear.
TIP
Double tapered distal tip reduces the risk of stress peak in the diaphysis.
MACROSTRUCTURES
QUADRA-P & QUADRA-P Collared: horizontal and vertical macrostructures increase contact surface area by 10-15%[13] increasing axial and rotational stability.
COLLARED OPTION
Additional help to stabilize the stem.
CEMENTED OPTION
Mirror polished surface helps to prevent the formation of cracks or gaps in the cement mantle[6].
The anterior approach, supported by years of clinical experience[16], is the only technique that follows an intermuscular and internervous path, potentially reducing the risk of damage to periarticular structures such as muscles, tendons, vessels and nerves. Convinced of the value of the anterior approach for improving patient well-being, but at the same time acknowledging the potential challenges in its adoption, an international group of expert surgeons, in collaboration with Medacta, set out to optimize and standardize the anterior approach, to make it more straightforward and enhance its reproducibility.
The result of this collaboration was the AMIS (Anterior Minimally Invasive Surgery) technique, created in 2004, along with the development of dedicated instrumentation to facilitate the procedure. Today, the AMIS technique has evolved into the AMIS Experience and is now more than just a surgical technique. The AMIS Experience is a complete set of services that delivers healthcare efficiencies, including economic and commercial advantages,
to the hospital and surgeon. Quadra-P will enter you into Medacta International’s world of the AMIS Experience.
[1] Everett S, Afzal I, Dora C, Crawfurd E, Field R. Medacta AMIStem: International, Multicentre, Prospective, Observational Study - ODEP Study 5 Year Results. EFORT 2017 Vienna.
[2] Viè P. AMIStem-H Radiological Assessment 5 Years Outcomes. Data on file: Medacta.
[3] Retrospective and prospective study to evaluate the AMISTEM H performance”, study approved by Swiss Ethic (Zurich canton) on 24 of March 2016 (BASEC-Nr 2015-00132).
[4] W. R. Walsh, M. H. Pelletier, N. Bertollo, V. Lovric, T. Wang, P. Morberg, W. C. Harington Parr, D. Bergadano, Bone ongrowth and mechanical fixation of implants in cortical and cancellous bone, Journal of Orthopaedic Surgery and Research (2020) 15:177.
[5] Bonnomet F, Delaunay C, Simon P, Lefebvre Y, Clavert P, Kapandji AI, Kempf JF. Comportement d’un tige fémoral droite en arthroplastie totale primaire non cimentée de la hance chez les patients de moins de 65 ans. Rev de Chir Orthop 2001; 87:802-814.
[6] Hardy DC, Frayssinet P, Guilhem A, Lafontaine MA, Delince PE. Bonding of Hydroxyapatite Coated Femoral Prostheses. J Bone Joint Surg Br. 1991 Sep; 73(5):732-40.
[7] Hardy DCR, Delince PE. Aspects Radiologiques de l’Arthroplastie Fémorale Revetue d’Hydroxyapatite et correspondence Histologiques Acta Orthop Belg. 1993; 59(1):229-334.
[8] Hardy DCR, Frayssinet P, Delince PE. Projection d’Hydroxyapatite sur Prothèses Articulaires : Progrès ou Illusion ? Acta Orthop Belg. 1993; 59(1):98-103.
[9] Fraissinet P, Hardy D, Conte P, Delince P, Guilhem A, Bonel G. Histological analysis of the bone-prosthesis interface after implantation in humans of prostheses coated with hydroxyapatite. The journal of Orthop Surg. 1993; 7(3):246-53.
[10] Piriou P, Bugyan H, Casalonga D, Lizée E, Trojani C, Versier G. Can hip anatomy be reconstructed with femoral components having only one neck morphology? A study on 466 hips. J Arthroplasty. 2013 Aug;28(7):1185- 91.
[11] Heidelberg Lab-Report. Orthopädische Universitätsklinik Heidelberg, 2008. Data on file:Medacta.
[12] Löhr JF, Schütz U, Drobny T, Munzinger U. Revision Arthroplasty with the SLR-Revision Shaft. 20 years of Zweymüller hip endoprosthesis, 4th Vienna Symposium. Zweymüller K (ed) – Bern; Göttingen; Toronto; Seattle: Huber, 2002.
[13] Moreau P. Cementless HA coated Quadra stem - 7 Years Clinical Outcomes. M.O.R.E. Journal, 2012 Jan; 2:3-6.
[14] Zweymüller K. 20 years of Zweymüller cement free hip endoprosthesis. Jatros Orthopädie 1999 Dez; 5:2-7.
[15] Dorn U, Kiss H, Engelhardt C, Dohnalek C, Steindl M, Zweymüller K. Results of Femoral Revision THR using the SLR stem: Minimum 2 years follow-up. 20 years of Zweymüller hip endoprosthesis, 4th Vienna Symposium. Zweymüller K (ed) – Bern; Göttingen; Toronto; Seattle: Huber, 2002.
[16] AMIS Publication Review – M.O.R.E. Journal Supplement, April 2016. 99.98.publ rev.01
[17] Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Hip, Knee & Shoulder Arthroplasty Annual Report 2019, AOA, Adelaide. Table HT17 and Figure HT7
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