Mirai means Future
The future of shoulder arthroplasty.
Mirai is a complete, modular and convertible system for anatomic and reverse shoulder arthroplasty.
Permedica Mirai®Shoulder System has been conceived and developed by maintaining the concept of modularity on both glenoid and humeral sides, providing solutions for a broad spectrum of typical indications in shoulder arthroplasty surgery.
Mirai® offers a solution for anatomical or reverse shoulder arthroplasty using the same humeral stemless core that does not need to be replaced in case of surgical revision if it is stable and osteointegrated.
- One system. Always 2 possibilities.
- 2 configurations: anatomic and reverse
- 2 humeral fixations: stemless and stemmed
- 2 glenoid fixations: press-fit central peg or compression central screw
- 2 fixation types: cementless or cemented
- 2 materials: Ti6Al4V and VITAL-E®
- 2 technologies: TRASER® and BIOLOY®
- Reproducing patient anatomy
The Mirai® Modular Shoulder System aims to reproduce patient’s anatomy due to the unique design of the anatomic glenoid insert and anatomic humeral head.
Both prosthetic components respect the double curvature of the natural glena and homerus, presenting two different curvature radii: one radius in the antero-posterior section and one radius in the infero-superior section.
- REDUCED WEAR [1]
The use of a non-spherical head with a more conformable glenoid component may reduce the risk of wear by allowing the gleno-humeral translation movement and increasing its contact area.
[1] Banci L., Meoli A., Hintner, M., Bloch H. R. (2019). Wear performance of inverted non-conforming
bearings in anatomic total shoulder arthroplasty. Shoulder & Elbow.
- IMPROVED ARTICULATION AND STABILITY
A non-spherical prosthetic head, imitating the anatomy of the original humeral head, accurately replicates the shape of the elliptical head of the humerus, the rotational movement and kinematic of the gleno-humeral joint and increases the stability of the original gleno-humeral joint.
- Bearing materials inversion
The Mirai® System proposes bearing materials inversion both in anatomic and reverse configuration:
- Anatomic humeral head and glenosphere in VITAL-E® - UHMWPE blended with 0.1% of Vitamin E, Eto sterilized
- Glenoid insert and humeral insert in Ti6Al4V alloy PVD coated with TiNbN - BIOLOY®
This offers several advantages:
- REDUCED RISK OF OVERSTUFFING
A metal glenoid liner can have a reduced thickness compared to a conventional polyethylene glenoid liner, thus minimizing overstuffing complication in the replaced shoulder.
- LIGHTWEIGHT PROSTHETIC COMPONENTS
More lightweight prosthetic components avoiding cobalt-chromium and stainless steel alloys from the prosthetic materials in favour of titanium alloy and UHMWPE.
- HYPOALLERGENIC PROSTHETIC COMPONENTS
Hypoallergenic prosthetic components without cobalt, nickel, chromium, avoiding cobalt-chromium and stainless steel alloys from prosthetic materials.
- A unique modular and convertible system
- from anatomic to reverse without replacing the osseointegrated components
- from stemless to stemmed
Humeral core with eccentric distal peg.
he methaphyseal humeral component is available with
7 different sizes (3 CCD angles, 3 offset).
- Solutions for revision cases
To address difficult primary glenoid defects as for example glenoid defects Walch classification B2/B3 or revision cases with important bone loss on the glenoid side there are available glenoid wedges correcting glenoid version.
Reconstructing humeral meta-diaphyseal fractures and/or addressing revision cases, long humeral stems, cemented and not cemented are available until 180mm length.
- Advanced material technologies
Mirai® Shoulder System is made using the most advanced manufacturing technologies and the most advanced materials available in prosthetic field.
- MIRAI® Trauma Core
A new solution for the reconstruction of the meta-epiphyseal region.
The Trauma Core is a new solution for the reconstruction procedure of the meta-epiphyseal humeral region with
a single component.
It is available in two CCD angles (140° and 150°) and two Core sizes
S and M).
In case a different CCD angle and/or Core size should be necessary to achieve an anatomic reconstruction of the shoulder, the modular solution (by assembling Metaphysis and Humeral Core) is indicated.
The Trauma Core can be used as an alternative to the modular solution with the same indication:
- Meta-epiphyseal fracture of the humerus
- Anatomic or Reverse Total Shoulder Arthroplasty in osteoarthritis
- MIRAI® CTA Humeral head
A further possibility for the prosthetic treatment in the presence of severe rotator cuff injuries.
The CTA Humeral Head (available in 4 sizes: 40, 44, 48, 52 mm) offers a further solution to treat shoulders with severe cuff tear lesions / cuff tear arthropathy.
Leaving the glenoid compartment unaltered, the use of the CTA Humeral Head is particularly indicated in all those cases where it is not possible to provide for its reconstruction.
The MIRAI® CTA Humeral Head is indicated in case of:
- cuff injuries in elderly patients with severe pain and limited functional needs;
- cuff injuries / cuff tear arthropathy in elderly patients with impossibility to reconstruct the glenoid and implantation of total reverse prosthesis;
- plurifragmental humeral head fracture in cuff tear arthropathy and/or non reconstructable cuff lesion in case of impossibility to implant a total reverse prosthesis;
- revision surgeries
Materials
Mirai is composed of the following materials: Titanium Aluminium Vanadium alloy ISO5832/3; VITAL-E® (UHMWPE + 0,1% wg Vitamin-E); BIOLOY® coating in TiNbN.
The CTA Humeral Head is made of PM734 highly nitrogenized Stainless Steel alloy (ISO5832/9).
Instruments Set
Only 4 trays for all the solutions: anatomic, reverse, stemless, stemmed.
A fifth tray is available on request in case of revision stems usage.