Amnion Case Study Series Compendium
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Amniotic Barrier Membrane Flowable Placental Tissue Matrix

Case Study | ACTISHIELD™ Amniotic Barrier Membrane Treatment of Retrocalcaneal Spur with ACTISHIELD™ Amniotic Barrier Membrane CASE STUDY HISTORY The patient is a 55-year-old female who works as a custodian at a theme park. The patient presented with severe posterior heel pain of the right side lasting several months in duration. Approximately two years prior, she had undergone excision of a retrocalcaneal exostosis and bursa with Achilles tendon debridement on the contralateral side. The patient now describes her pain as disabling, making it difficult for her to continue in her work or...

Case Study | ACTISHIELD™ Amniotic Barrier Membrane TREATMENT PLAN The patient had failed all available attempts at conservative care. She continued to walk with a marked antalgic gait and was unable to perform her job functions any longer due to this disability. Due to her increasingly marked clinical and radiographic presentation, surgical intervention was now discussed as a treatment option. The patient was familiar with the surgical procedure due to her prior surgery on the contralateral foot. The surgical treatment discussed was excision of the retrocalcaneal exostosis and bursa with...

Case Study | ACTISHIELD™ Amniotic Barrier Membrane SURGEON’S NOTES Final anchor and ACTISHIELD Membrane placement Wrapping ACTISHIELD Membrane around Achilles tendon after tendon sutured to bone Paratendon closure Post-op X-ray » Prior to placing the biocomposite anchor screws into the calcaneus, holes were created within the ACTISHIELD Membrane, corresponding to the screw placement, while it was held onto the bone. This facilitated ease of fixation. » ACTISHIELD Membrane was used because its thickness lent to better handling properties in this procedure. » A 6cm ACTISHIELD Membrane was...

Treatment of Surgical Wound after MPJ and Lapidus Fusion with the ACTISHIELD™ Amniotic Barrier Membrane CASE STUDY Patient History A 44 year-old female patient with no notable comorbidities presented with a hallux deformity on her left foot. The patient complained of persistent discomfort in this area, and after discussion and diagnostics surgical treatment was elected. To correct the deformity, an MPJ and lapidus fusion procedure was planned. Surgical Technique A large medial incision bisecting the dorsal and plantar margins and spanning from a point slightly distal to the metatarsal head...

Result At the four-day follow-up, the patient presented with a bloody but not swollen foot (FIGURES 1 and 2) and upon examination exhibited minimal pain. At the 17-day follow-up, the incision had healed well with no complication. At the 8 week follow up, the surgical wound showed very minimal scarring, atypical for an incision of this size at this time. (FIGURES 3, 4, and 5) 4 Days Post-Op FIGURE 1: 4 days post-op (medial view) FIGURE 2: 4 days post-op (anterior view) FIGURE 3: 8 weeks post-op (medial view) FIGURE 4: 8 weeks post-op (anterior view) FIGURE 5: 8 weeks post-op (oblique view) 7

ACTISHIELD™ Amniotic Barrier Membrane Use in Anterior Approach Total Ankle Arthroplasty CASE STUDY Patient History A 65-year-old male with a past history of left ankle arthrodesis presented to the office. He had undergone anterior approach tibiotalar joint fusion 10 months prior with placement of a plate. From the time he began postopertive weightbearing, he complained of continued pain and swelling in the ankle. In addition, he complained of walking on the inside of his ankle. Examination and Diagnosis Physical exam revealed a well-healed surgical incision at the anterior aspect of his...

Treatment Plan Treatment options were discussed with the patient, and he elected to undergo removal of the hardware, with total ankle replacement and a subtalar fusion to realign the hind foot into a slight valgus position. In addition, it was decided to use ACTISHIELD Amniotic Membrane (FIGURE 1) to cover and protect the anterior incision site. FIGURE 1. Chorion-based ACTISHIELD Amniotic Membrane Surgery The surgery was uneventful with hardware removal and total ankle arthroplasty. Closure was performed with minimal capsular closure; the extensor retinaculum was closed with a running...

Case Study | ACTISHIELD Amniotic Barrier Membrane Postoperative Care* and Follow-up The patient was placed in a compressive dressing and posterior splint and restricted from weightbearing until his first postoperative visit one week later. At that time, the incision was inspected and was observed to be well-coapted with no signs of infection or dehiscence (FIGURE 3). There was minimal edema noted around the incision site. The patient was placed in a below-the-knee cast, restricted from weightbearing, for 10 days. At 2.5 weeks postoperative, the incision continued to heal very well with less...

Case Study | ACTISHIELD™ Amniotic Barrier Membrane ACTISHIELD™ Amniotic Barrier Membrane Used in Wound Closure Following FHL Transfer Surgery to Repair Chronic Achilles Tendon Rupture CASE STUDY PATIENT HISTORY The patient presented as a 66-year-old male retired medical sales executive with a history of hypertension. He was playing pickle ball, and while planting his left foot, he experienced an acute onset of pain over the posterior aspect of his left ankle. Subsequently, the patient experienced pain, swelling, and weakness of the left foot when attempting push-off. He admitted to...

Case Study | ACTISHIELD™ Amniotic Barrier Membrane The treatment plan included dissection and debridement of the tendon fibers and reconstruction using a flexor hallucis longus (FHL) tendon transfer. This was elected based on the large amount of Achilles tendon gapping expected after debridement. The FHL is the second strongest plantar flexor (after the gastrocnemius/soleus complex) and is twice as strong as the FDL—its excursion is compatible with its function as a transfer tendon. This treatment plan would allow the patient to have better ankle balance due to the substitution of another...