The best, most reliable thing of its type in a product or business category is often referred to as the “gold standard.” In August 2003, IMP designed what was to become the company’s “gold standard” in patient positioning for knee surgeries – the De Mayo Knee Positioner®, a solution that allowed for precise control of flexion, extension, tilt and rotation of the knee during surgery.

The IMP positioner generated unprecedented sales and sparked the beginning of a steady evolution in providing the latest in patient positioning technology for knee surgery. This progression has so far produced a variety of products for surgeons and OR staff to choose from within IMP’s family of De Mayo Knee Positioners: the D2, V2™ and V2E™.

D2: The first step in the advancement of the original De Mayo Knee Positioner was mainly in response to personnel in hospital sterile processing departments. Staff members there wanted a positioner that would let them easily remove the carriage from the rail for disassembling and thorough cleaning. IMP designed the D2 to be used with the positioner’s existing clamping system, as many customers had requested, but with a completely different carriage engineered for easy removal. As an added benefit, the new carriage design provides a better gripping capability by holding the positioner’s boot in place more securely than the original version.corporate-1

(It should be noted that users are not able to install the new D2 carriage on the original De Mayo Knee Positioner [the D], as the D2 base plate has been largely redesigned and is not interchangeable with the D.)

V2: The second advancement in IMP’s knee positioner evolution is the V2. This solution was also designed in response to customer feedback. Some surgeons reported that when they pulled up on the patient’s knee during surgery to achieve the necessary distraction, the positioner sometimes had a tendency to lift up off the table, owing to the design of the clamp. To prevent this from happening, IMP redesigned a new clamp and the bar that swings down into a slot on the clamp where it can be firmly tightened and locked into place.

Also, at surgeons’ requests, IMP provides a Varus tilt control slide mechanism for the V2 that locks the positioner’s ball solidly into place, thus stopping a patient’s leg from drifting off to the side of the OR table. This solution is especially effective in dealing with large patients whose weight and size can put additional stress on the knee positioning system.

(The V2 is its own complete system and cannot be interchanged with the clamps on the original D or D2 knee positioners.)

V2E: The V2E is the latest step forward in IMP knee surgery technology. The solution is unique for its sterile extension arm that comes off the end of the OR table. Orthopedic surgeons, especially those performing unicompartmental surgeries, were requesting a positioning solution that would enable them to stand between the legs of the patient and easily see the inside of the patient’s knee. With such a solution, surgeons would no longer have to lean over the OR table when performing unicompartmental procedures. IMP is the first company in the marketplace to make and sell a sterile extension.

IMP’s patented sterile extension arm solution not only allows the surgeon easy access to the inside of the patient’s knee but, through the manufacturing process for connecting the extension arm to V2 base plate, the V2E plate and extension have been made significantly lighter, which is a big advantage for OR staff who often have to lift or move heavy surgical equipment. Although engineered lighter, the V2E positioning system has not been compromised in its strength capabilities.

IMP Distractor: IMP’s distractor is a device that has significantly improved the surgical technique in knee surgery. Before IMP developed this solution, OR staff typically had to use manual methods to distract the knee joint. One technique was to have an OR assistant pull up and hold a patient’s leg in the hamstring area during the surgical procedure. This is difficult for the assistant and not very effective. That’s when IMP came up with its solution: The De Mayo Universal Distractor®.

The distractor’s advantages are clear: Reducing procedure time for unicompartmental, arthroscopies, ACL and TKA surgeries, it eliminates the need for lamina spreaders, the use of a bone hook or manually pulling on the femur at the thigh throughout the surgical procedure. The IMP device also delivers precise, finite femoral distraction with a completely unobstructed view of the operative site.

Ideally used with any version of the De Mayo Knee Positioner, the IMP distractor is a sterile external device that allows the surgeon to independently control the distracting of the knee joint. The distractor applies finite pressure to separate the joint space by means of a handle on the device that incrementally pumps the required tension.

A Pacesetter in Trendelenburg Positioning

Not only has IMP striven to emulate its “gold standard” through its evolution of knee surgery positioning solutions, it has also broadened its portfolio in patient positioning for Trendelenburg surgeries.

Like its partnership with Dr. Edward De Mayo to create orthopedic positioning solutions, IMP has worked with the renowned gynecologist and oncologist, Ricardo Estape, M.D., in developing TrenMAX, a new, safer, more secure positioning system that provides OR staff a better alternative to all foam solutions when positioning patients for Trendelenburg surgical procedures.

corporate-2The key component of the TrenMAX system is IMP’s proprietary sticky pad. The Sticky Pad™ adheres directly to the patient’s torso and fastens securely to the OR table’s siderails to prevent patients from moving or sliding off the OR table. Foam pads, on the other hand, depend on the patient’s anatomy and weight to sink into the material to prevent slippage.

For maximum, secure fixation of the base pad to the OR table, TrenMAX employs patent-pending TrenMAX clamps that tightly secure the base pad hook-and-loop material straps affixed to the OR table’s siderails. IMP’s clamps are a sure-holding, back-up mechanism that other positioning systems lack.

“TrenMAX has the highest co-efficient of friction, or the minimalist amount of patient movement, compared to any other Trendelenburg positioning system in the market today,” remarked Dr. Estape.

Besides its unique holding power, TrenMAX provides additional benefits:

  • A system of arm straps that allow access to leads and IVs by anesthesiologists.
  • Designed to meet AORN recommendations, IMP’s arm strap system prevents potential neurological impairment caused by sheet tucking.
  • Does not require the use of a chest strap, therefore improving ventilation.
  • Prevents nerve damage by eliminating pressure on the brachial plexus caused by shoulder-holder devices.
  • Designed for single usage, The Sticky Pad™ is free from potential cross contamination.

Innovations Built on Partnership with Stakeholders

IMP’s ground-breaking solutions in knee surgery and in Trendelenburg patient positioning technology did not simply spring whole from IMP’s imagination. Rather, IMP developed its positioning solutions by listening to stakeholders whether they be surgeons, nurses, hospital staff members, or sales representatives – everyone who voiced a need to help make patient outcomes safer and more successful.

“We constantly listen to what the market is telling us,” notes Earl Cole, IMP vice president. “By responding to customer needs, we continue to produce innovations that aren’t just new for newness sake but are real, practical solutions based on customer feedback. In this way, we remain faithful to the ideals inherent in our original ‘gold standard’ solution produced more than a decade ago.”