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VERILAST Knee Technology


What is OXINIUM Oxidized Zirconium?

oxinium-full

What is OXINIUM Oxidized Zirconium?

If it is determined that an implant made with VERILAST technology is right for you, the femoral - or thighbone portion - of your implant will be made from OXINIUM Oxidized Zirconium - a patented and award winning ceramicised metal alloy that Smith+Nephew spent more than a decade developing.

During manufacture, OXINIUM implants undergo a process that transforms the implant's surface into a hard, ceramicised metal - while still retaining all of the durability of the underlying metal. In addition to being more durable than a true ceramic, this metal implant's ceramicised surface is more than twice as hard and therefore twice as resistant to the kind of scratching that can cause a cobalt chrome implant to wear out before its time.1

Important safety notes

Knee replacement surgery is intended to relieve knee pain and improve knee functions. However, implants may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your knee joint from overloading due to activity level, failure to control body weight or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


What is XLPE?

kneexlpe

What is XLPE or highly cross-linked plastic?

As remarkable as OXINIUM Oxidized Zirconium is, it is the combination of the OXINIUM material on XLPE that makes VERILAST Technology. XLPE is created by altering chemical bonds in the polyethylene we use to create our plastic inserts. By doing so, we are able to create a tighter weave at the molecular level, thus reducing the amount of wear experienced when the metal component rubs against it. Perhaps the easiest way to think of it is like a fabric with a higher thread count.

Important safety notes

Knee replacement surgery is intended to relieve knee pain and improve knee functions. However, implants may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your knee joint from overloading due to activity level, failure to control body weight or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


VERILAST knee technology

Our LEGION CR knee with VERILAST technology was lab-tested to simulate the number of steps the average person takes in 30 years1

OXINIUM + XLPE = VERILAST Technology Verilast Knee

If knee replacement is in your future, you've come to the right place to learn about one of the truly significant advancements in joint replacement materials in the past 20 years, VERILAST knee technology.

It's important to remember that not every knee implant is the same. VERILAST knee technology directly addresses one of the most commonly cited concerns associated with knee replacement implants:1

  • Implant wear

Whether or not to undergo knee replacement surgery is a very important decision. No matter how statistically safe and successful knee replacement surgery has proven to be, every surgery has risks. Before making any surgical decision, conversations should take place with your family, your primary care doctor and your orthopaedic surgeon to make sure that knee replacement with VERILAST Technology is the right course of action for your particular situation.

Important safety notes

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.

References

  1. Australian Orthopaedic Association National Joint Replacement Registry Annual report. Adelaide: AOA; 2012.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


30 year knee wear testing

LEGION CR Knee with VERILAST technology was lab-tested for 30 years of wear performance.1 (See Important Testing Note below)

30 Year Knee Wear We understand that "30 years of wear performance" is a pretty significant statement for any implant manufacturer to make. That's why we want you to see how we can back it up.

Initial testing

Using an internationally accepted testing protocol, our LEGION Knee with VERILAST Technology was placed alongside identical implants made from cobalt chrome and a standard plastic liner and cobalt chrome and an XLPE liner into a sophisticated machine that continually simulates the cycle of movement required by a normal walking motion. Each cycle is equivalent to the range of movement required for an average person to take a step.2

During the first phase of testing, all three implant types were placed under a load of 899 pounds, or 4.9 times the typical body weight of a knee replacement patient (185 pounds), while the machine completed 5 million cycles. The machine was then stopped and all of the implants were carefully measured to determine how much wear had occurred to the metal and plastic components. The results from this first phase of wear testing very encouraging.

Continued testing

Armed with the data from the first 5 million cycles, we decided to continue "walking" the LEGION CR Knee with VERILAST Technology Implant out to 45 million cycles - the equivalent of 30 years of an active adult's life under typical conditions.3-9

After a total of nearly three years of continuous laboratory wear testing, the results surpassed even our high expectations.

After 45 million cycles, the LEGION CR Knee with VERILAST Technology showed 81% less wear - even when compared to the cobalt chrome knee that was stopped after only 5 million cycles.

Knee wear chart

Why 45 million cycles?

Based on scientific literature reviews, a person who undergoes knee replacement surgery at the relatively young age of 45 years old would subject the implant to between 36 and 44 million cycles over a 30-year period, depending on how active the person's lifestyle is. Smith & Nephew chose the high end of this range - 45 million cycles - as the simulated 30-year mark.

Important testing note

VERILAST knee wear testing and results apply only to the VERILAST LEGION CR Primary Knee System only. Extended lab-testing for other VERILAST knee systems have not been performed. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.

Important safety notes

Knee replacement surgery is intended to relieve knee pain and improve knee functions. However, implants may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your knee joint from overloading due to activity level, failure to control body weight or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. ASTM F2384.19404-1 and ASTM F75.17485-1
  2. ISO 14243-3
  3. R. Papannagari, G. Hines, J. Sprague and M. Morrison, "Long-term wear performance of an advanced bearing knee technology," ISTA, Dubai, UAE, Oct 6-9, 2010.
  4. Goldsmith AA et al., "Comparative study of the activity of the total hip arthroplasty patients and normal subjects". J Arthrop, (16)5:613-619, 2001.
  5. Morbidity and mortality weekly report, 55(40):1089-1092, October 13, 2006.(//www.cdc.gov/mmwr/preview/mmwrhtml/mm5540a2.htm?s_cid=mm5540a2_e. Accessed on October 30, 2009).
  6. Gioe TJ et al., "Knee Arthroplasty in the young patient - Survival in a community registry". Clin Orthop Relat Res, 464:83-87, 2007.
  7. Wallbridge N and Dowson D. "The walking activity of patients with artificial hip joints". Eng Med 11:95, 1982
  8. Wimmer M A et al., "Joint motion and daily activity profile of total knee patients in comparison with the ISO knee wear simulator". Paper 0159, 48th ORS, 2002. - 8 Huddleston J I et al., "How often do patients with high-flex total knee arthroplasty use high flexion?",Clin Orthop Relat Res, 467:1898-1906, 2009.
  9. Naal F D et al., "How active are patients undergoing total joint arthroplasty? A systematic review", Clin Orthop Relat Res, DOI 10.1007/s11999-009-1135-9, published online: 28 October 2009.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.

JOURNEY II Knee Implant


JOURNEY II XR

Rediscover your active life with the high performance

A New Chapter in Knee Implants

Recent advances in biomedical engineering software have opened a new chapter in high performance knee implants.

One remarkable breakthrough has been the creation of the JOURNEY II XR Active Knee System, which combines an implant designed to restore the stability and natural motion of the human knee with low-friction materials that may help extend the longevity of the implant itself.

While the longevity of a knee implant is heavily influenced by the materials used to make it, the natural feeling of the implant during physical activity is dependent upon the way the patient's muscles, ligaments and tendons are addressed during surgery and by the implant's shape within the body after surgery.

Every knee implant design is faced with two important challenges; how to recreate the normal swing-and-rotate motion of your natural knee, and how to restore stability to your joint after surgery.

For the first challenge, conventional knee implant designs have attempted to recreate the natural, fluid motion of the knee with either a rotating platform (a simple pivot point) within the implant or by requiring an angled alignment of the implant during surgery. Both of these options force the muscles around your knew joint to work harder as they adjust to the joint's new and unnatural shapes and movement patterns.

For the second challenge, most implants rely on design aspects within the plastic insert to provide the stability that is sacrificed after the anterior and posterior cruciate ligaments (ACL/PCL) within your joint are removed to accommodate the new implant.

JOURNEY II XR is Different

Fortunately, the JOURNEY II XR Knee Implant is different from most knee implants.

First, the JOURNEY II XR implant features an anatomically shaped femoral component and two plastic inserts designed to work together to reproduce the original internal shapes and forces of your natural knee as it goes through its full range of motion. This attention to anatomic detail means that the muscles and other soft tissues around your joint don't have to adjust to unfamiliar stresses and you may be able to return to a natural pattern of motion after surgery.

Second, the JOURNEY II XR uses a U-shaped tibial base plate that fits around your healthy ACL and PCL, allowing them to remain in place and function normally after surgery. In short, the function of these important ligaments doesn't have to be re-engineered because they were never removed.

Added Durability

The JOURNEY II XR implant addresses durability with VERILAST Technology, a combination of two wear reducing materials - the proprietary OXINIUM metal alloy and a highly cross-linked plastic insert - that were designed to address wear on both surfaces of the implant.

Because it is twice as hard as cobalt chrome, the most commonly used metal in knee implants, implants made with OXINIUM material have been shown in lab testing to reduce joint wear by more than 80% when compared to cobalt chromium components.1

VERILAST Technology was designed to address "wear and tear," which is only one of several reasons why a knee implant may need to be replaced. Each patient should listen carefully when his or her orthopedic surgeon reviews other risks that can shorten the life of a new knee - such as infection, weight gain or high impact sports.

The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.

Not all patients are candidates for the JOURNEY II XR Knee Implant. Discuss your condition and implant options with your surgeon.

Disclaimer

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.

References

  1. jHunter, G., and Long, M., Abrasive Wear of Oxidized Zr-2.5Nb, CoCrMo, and Ti-6Al-4V Against Bone Cement. 6th World Biomaterials, Minneapolis, MN 2000, p. 835

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


JOURNEY II Active Knee Solutions

Aren't all total knee implants the same?

In theory, yes, all total knee implants are intended for the same purpose: the elimination of painful bone-on-bone contact, and the restoration of motion and function to the joint. In reality, however, the way each implant is designed, built and implanted not only makes them different, but can have an impact on how well they perform for each patient.

How your knees move

Commonly described as a hinge joint, your knees actually do much more than simply swing back and forth. In fact, every time your knee bends, forces in and around the joint work together to produce a subtle and complex rotational movement that you don't even realize is there. However, if this rotational movement is removed, the change can be felt in the muscles and ligaments through the entire leg.

The JOURNEY II AKS difference

montagebcs_journey

One of the most remarkable breakthroughs in design of total knee replacements has been the creation of the JOURNEY II Active Knee Solutions. Designed using the latest in human simulation software, and built using some of the most wear-resistant materials available, this unique implant was designed to address two of the most common concerns associated with knee replacement implants: implant wear and implant feel.

The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


JOURNEY II AKS PHYSIOLOGICAL MATCHING

sn_journey_concept_jointline

The rationale behind the concept of PHYSIOLOGICAL MATCHING is simple: any change you make to the knee joint will ultimately impact the entire leg. Of course, as is so often the case, simple rarely means easy.

The primary hurdle to overcome in a knee replacement is the knee itself. Described as a hinge joint, the knee actually does much more than bend back and forth. In fact, every time your knee bends, forces in and around the knee cause it to move with a complex rotational motion that most of us never realize. However, when that motion is removed after knee replacement, the result can be disappointing.

Traditionally, most knee implants have attempted to replace the natural swing-and-rotate of the knee by building a simple pivot point into the implant (known as a rotating platform) or by using a slightly angled alignment of the implant during surgery. Unfortunately, both of these options can force the muscles and ligaments around the new joint to work harder and move in unfamiliar, stressful ways; resulting in pain, muscle fatigue and an unnatural feeling while walking or bending the knee.

The JOURNEY II implant was designed using Smith & Nephew's proprietary LifeMOD human simulation software. This advanced software system allows engineers to examine in a virtual 3-D environment the exact internal shapes and angled forces that act on the knee throughout each phase of motion. As a result, the JOURNEY II implant has been designed to physiologically match how the hard structures of a normal knee joint move and rotate in an effort to maintain normal muscle activity and return the patient's stride to it's a natural rhythm.

Important safety note

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.

Talk to your doctor to determine what treatment may be best for you.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


JOURNEY II AKS implant feel

The right "feel" often starts with the right design

To most of us, total knee implants all look very similar. With the exception of color (the OXINIUM alloy used in JOURNEY II implants is black while the cobalt chrome used in other implants is silver), it can take an experienced eye to see the subtle differences in size and shape between two implants. However, as subtle as the differences may seem, they can often have a profound impact on how an implant feels to the patients after surgery.

Fortunately, JOURNEY II implants were designed using a concept called PHYSIOLOGICAL MATCHING. This unique process begins with proprietary human simulation software that virtually recreates the exact internal shapes and angled forces that act on the knee through each phase of motion. This detailed information helped Smith & Nephew engineers create an implant that replicates as closely as possible the complex, natural rotation of the knee.

Important safety note

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.

Talk to your doctor to determine what treatment may be best for you.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


JOURNEY II AKS Implant Wear

Implant materials can impact durability

Virtually all total knee replacement systems use a combination of metal and plastic components to replace the surfaces of a damaged knee. Metal is typically used to replace the surfaces of the bone, while plastic is most commonly used to replace the joint's cartilage.

Unfortunately, the metal and plastic surfaces of an implant can wear down over time. The primary cause of this "implant wear" is the friction created when the upper, metal, part of an implant - called the femoral component - rubs against the plastic insert. Even with pristine implants, over time, this friction can cause tiny particles of the insert to wear away. If the metal component becomes scratched for any reason, this destructive process can be increased dramatically. In fact, this type of implant wear is a leading cause of premature knee replacement failure.

Fortunately, implant wear can be offset by using advanced, wear-reducing materials during the creation of the implant.

VERILAST Technology

Unlike other implants that only available with cobalt chrome for their metal femoral components, the JOURNEY II Active Knee implant can also be made with a proprietary metal alloy called OXINIUM Oxidized Zirconium. While cobalt chrome has been used successfully for years, laboratory tests have shown that the "ceramicized" OXINIUM metal alloy is twice as hard as cobalt chrome and can be twice as resistant to the type of scratching that can cause implant wear.1 First introduced in 1997, OXINIUM implants have been used in more than 1 million surgeries around the world.

And since each implant is a combination of metal and plastic, JOURNEY II implants also use a harder, highly cross-linked polyethylene known as XLPE for the plastic insert.

Working together, these materials form a bearing surface combination known as VERILAST Technology, which is unique to global medical device maker, Smith & Nephew.

Important testing note

VERILAST Technology has been designed to address "wear and tear," which is only one reason why a knee implant may need to be replaced. Listen carefully when your orthopedic surgeon reviews other risks that can shorten the life of your new knee - such as infection, excessive weight gain or high impact sports.

The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.

Important safety notes

Individual results of joint replacement vary. Implants are intended to relieve knee pain and improve function, but may not produce the same feel or function as your original knee. There are potential risks with knee replacement surgery such as loosening, wear and infection that may result in the need for additional surgery. Patients should not perform high impact activities such as running and jumping unless their surgeon tells them that the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if a surgeon's limitations on activity level are not followed.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.

VERILAST Hip Implant



All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


VERILAST Hip OXINIUM

What is OXINIUM Oxidized Zirconium?


If it is determined that an implant made with VERILAST technology is right for you, the femoral head or ball of your implant will be made from OXINIUM Oxidized Zirconium - a patented ceramicised metal alloy that Smith & Nephew spent more than a decade developing.

During manufacture, OXINIUM implants undergo a process that transforms the zirconium surface into a hard, ceramicised metal - while still retaining all of the durability of the underlying metal. This means that it won't fracture like a true ceramic, yet its ceramicised surface is more than twice as hard and therefore twice as resistant to the kind of scratching that can cause a cobalt chrome implant to wear out before its time.1

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


How long do you want your hip implant to last?

Just like the surfaces of your natural hip joint, friction created when the surfaces of a hip implant rub together can cause these surfaces to wear down over time. This type of implant wear is a leading cause of hip replacement failure.

Conventional wisdom indicates that most hip implants should be expected to last 10 to 15 years before implant wear becomes an issue.1 At Smith & Nephew, we've always thought we could do better. And since today's more active hip patients are having surgery at a younger age and living longer, we knew we had to do better.

Enter VERILAST Hip Technology - a remarkable combination of advanced, low-friction materials that was designed to address implant wear on both surfaces of the implant: the award-winning OXINIUM Oxidized Zirconium, a ceramicised metal alloy for the ball, and a highly "cross-linked" plastic for the socket. In fact, laboratory testing has shown that VERILAST Technology is capable of reducing hip implant wear by 67% when compared to traditional materials (cobalt chrome implants and highly cross-linked plastic) - even after 45 million cycles of laboratory wear simulation testing.2 That testing is 9 times longer than the industry standard for hip replacements! (See Important Testing Note below)

So while we cannot say we've eliminated implant failure due to wear, we believe our 20 years of dedicated research is paying off for patients who want to rediscover their active lives.

verilasthipwearchart

Important testing note

The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Elena Losina, Ph.D., co-director, Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Women's Hospital, Boston; William J. Robb III, M.D., chairman, Department of Orthopaedic Surgery, NorthShore University Health System, Evanston, Ill; Feb. 10, 2012, presentation, American Academy of Orthopaedic Surgeons, annual meeting, San Francisco.
  2. A. Parikh, P. Hill, V. Pawar and J. Sprague, "Long-term simulator wear performance of an advanced bearing technology for THA," Orthop Res Soc, San Antonio, TX, Jan 26-29, 2013, 1028.
  3. ASTM F2384.19404-1 and ASTM F75.17485-1

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


OXINIUM Oxidized Zirconium

What is OXINIUM Oxidized Zirconium?

oxiniumhip

If it is determined that an implant made with VERILAST technology is right for you, the femoral head or ball of your implant will be made from OXINIUM Oxidized Zirconium - a patented ceramicised metal alloy that Smith & Nephew spent more than a decade developing.

During manufacture, OXINIUM implants undergo a process that transforms the zirconium surface into a hard, ceramicised metal - while still retaining all of the durability of the underlying metal. This means that it won't fracture like a true ceramic, yet its ceramicised surface is more than twice as hard and therefore twice as resistant to the kind of scratching that can cause a cobalt chrome implant to wear out before its time.1

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


What is XLPE?

hipxlpe

What is XLPE or highly cross-linked plastic?

As remarkable as OXINIUM Oxidized Zirconium is, it is the combination of the OXINIUM material on XLPE that makes VERILAST Technology.

XLPE is created by altering chemical bonds in the polyethylene we use to create our plastic inserts. By doing so, we are able to create a tighter weave at the molecular level, thus reducing the amount of wear experienced when the metal component rubs against it. Perhaps the easiest way to think of it is like a fabric with a higher thread count.

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


VERILAST Hip Technology

Lab-tested for wear 9-times longer than the industry standard.1

(See Important Testing Note below)

VERILAST Hip

OXINIUM + XLPE = VERILAST Technology

If hip replacement is in your future, you've come to the right place to learn about a truly significant advancement in joint replacement materials, VERILAST Hip Technology.

It's important to remember that not every hip implant is the same. VERILAST Hip Technology is the one technology that directly addresses two of the most commonly cited concerns associated with hip replacement implants:2

  • Implant wear
  • Implant fracture

Whether or not to undergo hip replacement surgery is a very important decision. No matter how statistically safe and successful hip replacement surgery has proven to be, every surgery has risks. Before making any surgical decision, conversations should take place with your family, your primary care doctor and your orthopaedic surgeon to make sure that hip replacement with VERILAST Technology is the right course of action for your particular situation.

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Testing concluded at 45 million cycles. ISO 14242-1 defines test completion at 5 million cycles.
  2. Australian Orthopaedic Association National Joint Replacement Registry Annual report. Adelaide: AOA; 2012.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.


VERILAST strength

What is the risk of hip implant fracture, chipping or squeaking?

Hip fracture

As one of the largest joints in the body, the hip is subjected to tremendous pressures even during simple, everyday activities. For example, the weight pressing against these joints during a simple walk can be 5 to 6 times your natural body weight.

Because the hip ball component of a VERILAST Hip implant uses a metal as its base, it can withstand forces far greater than those of a ceramic hip - another material often used in in hip implants.1

Unfortunately, while ceramic heads are biocompatible and may provide good resistance to implant wear, they can fracture under impact.2

As you will learn on the OXINIUM Oxidized Zirconium page of this site, the surface of the VERILAST Hip implant is transformed into a ceramicised metal, retaining all of the durability of the underlying metal and offering the smooth, wear-reducing surface of a ceramic.3

And because this ceramicised surface is not a coating, it cannot chip off or flake away. Finally, because the VERILAST Hip ball rotates against a highly cross-linked plastic liner, there is less concern of squeaking than there is in "hard-on-hard" implant couples like ceramic-on-ceramic or metal-on-metal implants.4

So whether it is fracture, chipping or squeaking that concerns you, VERILAST Hip technology addresses each of these concerns.

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.

References

  1. Data on file.
  2. G. Hadley Callaway, MD, William Flynn, MD, Chitranjan S. Ranawat, MD,and Thomas R Sculco, MD. Fracture of the Femoral Head After Ceramic-on-polyethylene Total Hip Arthroplasty. Journal of Arthroplasty; Vol. 10 No. 6: 1995.
  3. Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005.
  4. Claire L. Brockett, PhD, Sophie Williams, PhD, Zhongmin Jin, PhD, Graham H. Isaac, PhD, and John Fisher, D.Eng. Squeaking Hip Arthroplasties: A Tribological Phenomenon. Journal of Arthroplasty; Volume 28, Issue 1 , Pages 90-97, January 2013.

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.

Direct Anterior Approach Hip Replacement


Direct Anterior approach

Direct Anterior approach for hip replacement

Direct Anterior Approach

If you've been told you are a candidate for hip replacement surgery, you may benefit from a minimally invasive surgical technique called Direct Anterior hip replacement surgery. Put simply, this technique changes the direction from which a surgeon can access your hip joint.

With the Direct Anterior approach, your specially trained orthopedic surgeon is able to repair your painful hip through a natural space between the muscles of the anterior (front) portion of the hip, rather than making the incision on the posterior (back) side, which has the potential of damaging the muscles that make up the primary support system for the joint. These are the muscles you spend weeks and months rehabilitating after surgery.

During this procedure the hip joint is exposed between the anterior muscles, without the need to cut tissue or detach tendons. Once access is gained, the portion of the upper thigh bone (the femoral head and neck) and the hip socket (acetabulum) are prepared for the insertion of the hip replacement implant, just as in a traditional procedure.

The hip replacement is comprised of metal and plastic components that replace the ball-and-socket elements of the hip joint. They are secured within the femur (thighbone) and acetabulum (hip socket) either with bone cement or by "press-fit," meaning the implants are shaped to achieve stability without bone cement. Through the use of X-rays, physicians can ensure the implants have the proper fit and alignment to ensure comfort and a natural range-of-motion after surgery.

Smith & Nephew offers a wide range of hip replacement implants and your surgeon will choose the most appropriate one for you. One consideration used in selecting your implant may be its resistance to the scratching and abrasion that can cause an implant to wear out before its time.

Advantages to utilizing the Direct Anterior approach

This minimally invasive technique allows for preservation of the soft tissue surrounding the joint, allowing for immediate stability following surgery, as well as a possible lower risk of dislocation, as the primary support muscles are left intact.

Patients may have a shorter hospital stay, as there are typically fewer post-operative restrictions and the possibility of a faster healing time associated with this technique.

Important safety notes

Hip replacement surgery is intended to relieve hip pain and improve hip function. However, implants may not produce the same feel or function as your original hip. There are potential risks with hip replacement surgery such as loosening, fracture, dislocation, wear and infection that may result in the need for additional surgery. Longevity of implants depends on many factors, such as types of activities and weight. Do not perform high impact activities such as running and jumping unless your surgeon tells you the bone has healed and these activities are acceptable. Early device failure, breakage or loosening may occur if you do not follow your surgeon's limitations on activity level. Early failure can happen if you do not guard your hip joint from overloading due to activity level, failure to control body weight, or accidents such as falls. Talk to your doctor to determine what treatment may be best for you.


All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2020 Smith & Nephew, All Rights Reserved.

CORI Robotic Assisted Knee Replacement


Discover more. Fear less.

Robotics-assisted knee surgery with Smith+Nephew implants can deliver the ultimate knee replacement experience - a quicker, smoother recovery*1,2†using a naturally shaped knee made from materials designed to last.

Knee replacement has changed-for the better

The earliest knee replacement procedures were performed in 1968 and relied on manual guides and procedures to remove damaged bone and place the implant within the joint.

Over time, more advanced implant techniques were introduced that used long metal alignment rods inserted into the center of the thigh bone (femur). These rods, which help determine the correct anatomic alignment between the knee and hip, provide an attachment point for positioning the surgical cutting guides. Once the bone cuts are made, the surgeon must remove these rods before the new implant can be positioned. More recently, pre-surgery improvements like computerized tomography (CT) scans and magnetic resonance images (MRIs) are now used to help create computer-generated surgical plans for each patient.

However, even with these advances, drawbacks still remain. For example, the use of alignment rods may lead to a risk of surgical complications such as fat embolisms3, CT scans can result in potentially harmful radiation exposure, and pre-surgical MRIs may increase overall costs or add time from consultation to procedure.

The ultimate knee replacement experience

Enter robotics-assisted surgery: combining the advantages of traditional methods with innovations while minimizing the drawbacks to patients. This advanced technology is designed to help your surgeon plan and perform your knee replacement surgery with a greater degree of accuracy than is possible with traditional methods,4-8 and without the need for metal rods, CT scans or pre-surgical MRIs. Smith+Nephew, the only company offering handheld robotics assisted technology for partial and total knee replacements, believes this enhanced level of accuracy can give you a better long-term outcome.4-6,9

A unique plan

Your knee replacement surgery is as unique as you are because it's the only one that combines your knee's anatomy with the specific implant your surgeon chooses for you. As a result, your surgery requires an individualized surgical plan to help ensure your implant is positioned and aligned correctly for your anatomy. With robotics-assisted surgery, your surgeon uses the CORI Surgical System to create a customized 3D digital model of your knee. This three-dimensional view helps your surgeon finalize and verify the right size implant for you and create a detailed surgical plan for how your replacement will be placed in order to optimize movement and function. As an added benefit, the 3D digital model eliminates the need to get a CT scan of your knee before your surgery, which reduces your exposure to harmful radiation.

A natural fit

Of course, robotics-assisted surgery is about more than a detailed 3D view of your knee. The CORI Surgical System also helps your surgeon perform the procedure as he/she planned it, giving you the combined benefits of the accuracy of robotics assistance and the skill and training of your experienced surgeon.5,6,10,11

When it comes to knee replacement surgery, accuracy is important because if an implant is positioned incorrectly, it may not function as well as it should nor last as long as possible. In addition to its added accuracy, when robotics-assisted surgical procedures are combined with the wide variety of Smith+Nephew implants available, your surgeon is able to choose the implant which best meets your needs, including options that allow you to keep more of your natural bone and ligaments, including the ACL.12 That means your body can maintain more of its natural rhythm and step.12,13 You may also regain function faster and get discharged from the hospital sooner as compared to conventional technique surgeries.* 13

A wide selection

Knee replacement shouldn't be a one-size-fits-all. With the CORI robotics-assisted surgical system, your surgeon is able to choose your implant from the widest selection available.14 Moving beyond the variety of options available, only Smith+Nephew knee implants can be made with a highly durable material called OXINIUM Oxidized Zirconium. This unique, innovative material has been lab tested to last significantly longer than conventional knee implant materials.14,15

Why does my knee hurt?

One of the most common reasons for knee pain is osteoarthritis, also known as "wear and tear" arthritis. This disease often requires treatment using either full or partial knee replacement surgery. Generally speaking, as osteoarthritis progresses it causes the smooth cushion between bones (cartilage) to break down. This loss of cartilage can cause your joints to become swollen, hard to move and painful.17 While there,s no cure for osteoarthritis, there are lots of treatment options, including both surgical and nonsurgical options you should discuss with your surgeon. These include:

  • Lifestyle changes that can include weight loss and reducing activities that are stressful on your knee
  • Physician-prescribed low-impact exercises and physical therapy
  • Medications to decrease swelling and provide temporary pain relief
  • Surgical options, such as arthroscopic surgery, and partial and total knee replacement

Which type of replacement is right for me?

Don't limit your options - the CORI Surgical System works with both partial and total knee replacements.

Partial knee replacement

Most often, this procedure is an option for early to mid-stage knee pain and damage. With this type of knee implant your surgeon replaces the area of your knee that is damaged while keeping the supporting tissue and ligaments that help stabilize your knee.

Accurate implant placement is especially important with a partial knee replacement since it requires that your new implant be correctly balanced with your remaining bone and cartilage in your joint. Smith+Nephew offers the only hand-held robotics-assisted system that helps design a surgical plan that allows you to keep as much of your healthy bone and cartilage as possible.

Traditional surgical techniques use mechanical cutting guides, instead of tailoring a surgical plan that's unique to you.

Total knee replacement

Most often, this procedure is an option for advanced knee pain and damage. With this type of knee implant your surgeon replaces the entire knee joint. It's one of the most common procedures performed in all of medicine.

Since no two knee joints are the same, aligning your new knee implant requires your surgeon to match the position with your knee's existing range of motion. The CORI System uses a robotics-assisted, handheld device - adding an additional layer of planning and accuracy directly in the skilled hands of the trained surgeon you trust.

Traditional surgical techniques still use rods and older methodology.

CORI Surgical System

When a highly skilled surgeon is equipped with the latest in robotics-assisted and knee implant technology, you can rest easy knowing you're getting the ultimate knee replacement experience.

The CORI Surgical System uses handheld robotics-assisted technology that helps your surgeon plan and perform your unique procedure. This robotics-assisted approach is efficient and more accurate than traditional knee surgery.5,6,8

At the beginning of your surgery, your surgeon uses the CORI system to create a customized 3D digital model of your knee. This three-dimensional view helps your surgeon finalize and verify the selection of your knee implant and create a plan for your surgery without the need for either a CT scan or MRI.

During the procedure, the CORI system works in conjunction with your surgeon's skilled hands to achieve accurate positioning of the knee implant based on your unique anatomy. 7,10,11,18,20,21 The system sends precise information about your knee to the robotics-assisted handpiece more than 300 times per second, allowing your surgeon to remove damaged surfaces, balance your joint and position the implant with accuracy. 7,10,11,18,20,21

The result is a naturally shaped knee, made from materials designed to last longer, that is positioned with an added level of accuracy to allow for a quicker, smoother recovery*1,2†

Important Safety Notes

Not all patients are candidates for the Smith+Nephew knee products. Knee replacement surgery is intended to relieve knee pain and improve knee functions. Implants may not produce the same feel or function as your original knee, and individual results will vary. Potential risks include loosening, wear and infection that may result in the need for additional surgery. There are risks associated with any surgical procedure including CORI-enabled Knee Replacement. The CORI Surgical System is not for everyone. Discuss your condition and implant options with your surgeon to determine if the CORI Surgical System is right for you. Children, pregnant women, patients who have mental or neuromuscular disorders that do not allow control of the knee joint, and morbidly obese patients should not undergo a CORI-enabled procedure. The information listed in this brochure is for informational purposes and is not meant as medical advice. For more information, please talk to your surgeon.

Trademark of Smith+Nephew.
© 2020 Smith+Nephew

References

* Partial knee replacement vs conventional techniques

  1. Sephton BM, Bakhshayesh P, Edwards TC, Ali A, Kumar Singh V, Nathwani D. Predictors of extended length of stay after unicompartmental knee arthroplasty. J Clin Orthop Trauma. 2019. 11(Suppl 2):S239-45
  2. Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771
    † n=28 (n=11 robotic procedures)
  3. Al-Shaer DS, Ayoub O, Ahamed NA, Al-Hibshi AM, Baeesa SS. Cerebral fat embolism syndrome following total knee replacement causing a devastating neurocognitive sequelae 2016 Jul; 21(3): 271-274
  4. Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship.J Robot Surg.
  5. Batailler C, White N, Ranaldi FP, et al. Improved implant position and lower revision rate with robotic assisted unicompartmental knee arthroplasty.Knee Surg Sports Traumatol Arthrosc.2019;27:1232.
  6. Herry Y BC, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique.Int Orthop.2017;41:2265-2271.
  7. Gregori A, Smith JR, Picard F, Lonner JH, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery (CAOS) 15th Annual Meeting; 2015; Vancover, Canada.
  8. Bollars P, Boeckxstaens A, Mievis J, Kalaai S, Schotanus MGM, Janssen D. Preliminary experience with an image?free handheld robot for total knee arthroplasty: 77 cases compared with a matched control group. Eur. J. Orthop Surg Traumatol. 2020;30(4):723-9
  9. Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM. Why Are Total knee Arthroplasties Failing Today?Clinical Orthopaedics and Related Research.2002;404:7-13
  10. Bollars P, Boeckxstaens A, Mievis J, Janssen D. The Learning Curve and Alignment Assessment of an Image-Free Handheld Robot in TKA: The First Patient Series in Europe. Poster presented at: 19th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery. 2019; New York, USA.
  11. Kopjar B, Schwarzkopf R, Chow J, et al. NAVIO Robotic Assisted Surgical System for Total Knee Arthroplasty Using JOURNEY II Guided-Motion Total Knee System. Poster presented at: ISTA 2-5 October, 2019; Toronto, Canada.
  12. 00225 V3 JOURNEY II Design Rationale 11.17.
  13. Shearman AD, et al. Robotic-assisted unicondylar knee arthroplasty is associated with earlier discharge from physiotherapy and reduced length of stay compared to conventional navigated techniques. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain
    ‡ n=62 (31 robotics)
  14. Smith+Nephew 2020. Comparison of the number of available implants for robotic-assisted knee arthroplasty systems. Internal Report. EO.REC.PCS015.001.v1
  15. Heyse TJ, Chen DX, Kelly N, et al. Matched-pair total knee arthroplasty retrieval analysis:Oxidized zirconium vs. CoCrMo. The Knee. 2011;18:448-452.
  16. Papannagari R, Hines G, Sprague J and Morrison M. Long-term wear performance of an advanced bearing knee technology. ISTA, Dubai, UAE, Oct 6-9, 2010
  17. https://www.arthritis.org/diseases/osteoarthritis. Accessed 22 Oct 2020
  18. Gregori A, Picard F, Bellemans J, Smith JR, Simone A. Handheld Precision Sculpting Tool for Unicondylar Knee Arthroplasty. A Clinical Review. Poster presented at: 15th EFORT Congress;4-6 June, 2014; London, UK
  19. Geller JA, Rossington A, Mitra R, Jaramaz B, Khare R, Netravali NA. Rate of learning curve and alignment accuracy of an image-free handheld robot for total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain.
  20. Mitra R, Jaramaz B, Nikou C, Kung C. Accuracy Assessment of a Novel Image-Free Handheld Robot for Knee Arthroplasty in Bi-Cruciate retaining knee and total knee replacement - A Cadaveric Study. World Arthroplasty Congress;2018; Rome, Italy.
  21. Kaper BP, Villa A. Accuracy and Precision of a Handheld Robotic-guided Distal Femoral Osteotomy in Robotic-assisted Total Knee Arthroplasty. European Knee Society Arthroplasty Conference;2019; Valencia, Spain

All information provided on this website is for information purposes only. Every patient's case is unique and each patient should follow his or her doctor's specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation. If you are seeking this information in an emergency situation, please call 911 and seek emergency help.

All materials copyright © 2021 Smith & Nephew, All Rights Reserved.