The ultimate knee replacement experience

Joint replacement has come a long way – see what it can do for you.

OXINIUM◊ implants built to last

OXINIUM Oxidized Zirconium is an award-winning1 metal alloy available only from Smith+Nephew. OXINIUM implants are designed for strength and durability, and to give patients added confidence in their implant choice. Here’s how OXINIUM implants differ from the rest:

Implants designed to last

The surface of OXINIUM implants is more than twice as hard and twice as scratch resistant as the surface of standard implants (those made with cobalt-chrome). The hardness of a material is important to its ability to resist scratching. Implant scratching is a concern because it can cause implants to wear down sooner than expected.3,4 Tested to 9 times the minimum industry standard, OXINIUM implants remain strong and durable over time, giving your implant an excellent wear performance.3-10

Not made from Cobalt-Chrome alloy

Many patients have concerns about the metal alloys used in their implants. If you are one of these patients, you should know that OXINIUM implants are made from a zirconium alloy rather than the more common cobalt-chrome alloy. Talk to your surgeon about the impact different metals such as OXINIUM Technology may have on the long-term outcome of your joint replacement.

Real life results

OXINIUM implants have been used in more than a million joint replacement surgeries around the world. In fact, several studies have shown that OXINIUM implants in total hip replacements have a lower risk of revision (repair surgery) than implants made with cobalt-chrome or ceramic materials.11-14 In addition, another study showed that 10 years after surgery, 98% of OXINIUM knee implants were functioning without need of revision.15*

Robotics-assisted Surgery

Our handheld robotics-assisted technology for partial and total knee replacements enables your surgeon to plan and perform your surgery with a greater degree of accuracy than is possible with traditional methods.1,2

A unique plan

Your knee replacement surgery is as unique as you are. After all, it is the only one that’s based on the combination of your individual knee anatomy and the specific implant your surgeon has determined is right for you. To help ensure your implant is positioned and aligned correctly to your anatomy, the CORI◊ Surgical System creates a customized 3D digital model of your knee. This three-dimensional view helps your surgeon choose the right implant for you. In addition, 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

The CORI Surgical System is also designed to help your surgeon perform the surgery as he/she planned it – bringing together the enhanced accuracy of robotic-assistance and the skill and training of your surgeon.

More implant options

Unlike other robotics platforms, our system works with all of our partial and total knee implants – including those made from our exclusive OXINIUM Technology for added durability. This wide selection allows your surgeon to choose the right implant for you.

Higher patient satisfaction—Smoother recovery1,2*

The JOURNEY◊ II Knee System has been demonstrated to improve a patient’s range of motion more quickly after surgery. This faster recovery, along with the implant’s normal pattern of motion, have been shown to lead to high levels of patient satisfaction.

What Is JOURNEY◊ II Technology?

The JOURNEY II AKS Difference

One of the most remarkable breakthroughs in design of total knee replacements has been the creation of the JOURNEY II Active Knee Solutions. Using advanced human simulation software, and built using some of the most wear-resistant materials available3, this implant was designed to address two of the most common concerns associated with knee replacement implants: implant wear and implant feel.

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.

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Knee Assessment

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Yes – you can

It’s time to stop settling and start getting on with your life. You can – with the ultimate knee replacement experience.

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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.

◊ Trademark of Smith+Nephew. The information on this site is intended for US residents only © 2023 Smith+Nephew
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OXINIUM OXIDIZED ZIRCONIUM

*using OXINIUM GENESIS◊ II implants

  1. 2005 ASM International Engineering Materials Achievement Award.
  2. Hunter G, Dickinson J, Herb B, et al. Creation of oxidized zirconium orthopaedic implants. Journal of ASTM International. 2005;2:1-14.
  3. Sheth NP, Lementowski P, Hunter G, Garino JP. Clinical applications of oxidized zirconium. J Surg Orthop Adv. 2008;17(1):17-26.
  4. Long M, Riester L, Hunter G. Nano-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. 24th Annual Meeting of the Society for Biomaterials. April 22-26, 1998.
  5. Papannagari R, Hines G, Sprague J. Long-term Wear Performance of an Advanced Bearing Technology for TKA. Poster presented at: ORS 2011 Annual Meeting 2011.
  6. Parikh A, Hill P, Pawar V, Sprague J. Long-Term Simulator Wear Performance of an Advanced Bearing Technology for THA. Poster presented at: ORS 2013 Annual Meeting.
  7. ISO 14243-2 Implants for surgery — Wear of total knee-joint prostheses — Part 2: Methods of measurement. 2016.
  8. ISO 14243-1 Implants for surgery — Wear of total knee-joint prostheses — Part 1: Loading and displacement parameters for wear-testing machines with load control and corresponding environmental conditions for test. 2009.
  9. Davis ET, Pagkalos J, Kopjar B. Bearing surface and survival of cementless and hybrid total hip arthroplasty in the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man. Journal of Bone Joint Surgery. 2020;5(2):pe0075.
  10. Peters RM, Van Steenbergen LN, Stevens M, et al. The effect of bearing type on the outcome of total hip arthroplasty. Acta Orthopaedica. 2018; 89(2):163-169.
  11. Atrey A, Ancarani C, Fitch D, Bordini B. Impact of bearing couple on long-term component survivorship for primary cementless total hip replacement in a large arthroplasty registry. Poster presented at: Canadian Orthopedic Association; June 20–23, 2018; Victoria, British Columbia, Canada.
  12. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) Hip, Knee & Shoulder Arthroplasty: 2022 Annual Report.
  13. Innocenti M, Matassi F, Carulli C, Nistri L, Civinini C. Oxidized zirconium femoral component for TKA: A follow-up note of a previous report at a minimum of 10 years. The Knee. 2014;21:858–861.

ROBOTICS-ASSISTED SURGERY

  1. Gregori A, et al. 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.
  2. Bollars P, et al. 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):723-729

JOURNEY II Total Knee System

*Compared to non-JOURNEY II knees; Based on BCS evidence

  1. MaymanDJ, Patel AR, Carroll KM. Hospital Related Clinical and Economic Outcomes of a Bicruciate Knee System in Total Knee Arthroplasty Patients. Poster presented at: ISPOR Symposium;19-23 May, 2018; Baltimore, Maryland, USA
  2. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41

POLAR3

  1. National Joint Registry for England, Wales and Northern Ireland: PolarstemCementless implant summary report. 18 February 2021.

* We thank the patients and staff of all the hospitals in England, Wales and Northern Ireland who have contributed data to the National Joint Registry. We are grateful to the Healthcare Quality Improvement Partnership (HQIP), the NJR Steering Committee and staff at the NJR Centre for facilitating this work.   The views expressed represent those of the authors and donot necessarily reflect those of the National Joint Registry Steering Committee or the Health Quality Improvement Partnership (HQIP) who do not vouch for how the information is presented.

The data used for this analysis was obtained from the National Joint Registry (“NJR”), part of the Healthcare Quality Improvement Partnership (“HQIP”). HQIP, the NJR and/or its contractor, Northgate Public Services (UK) Limited (“NPS”) take no responsibility (except as prohibited by law) for the accuracy, currency, reliability and correctness of any data used or referred to in this report, nor for the accuracy, currency, reliability and correctness of links or references to other information sources and disclaims all warranties in relation to such data, links and references to the maximum extent permitted by legislation including any duty of care to third party readers of the data analysis.

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.

◊ Trademark of Smith+Nephew. The information on this site is intended for US residents only © 2022 Smith+Nephew
Smith+Nephew Facebook Page | Follow Smith+Nephew on Twitter | Privacy & Cookies | Terms of Use

CORI◊ Surgical System

  1. 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
  2. Smith+Nephew 2020. Comparison of the number of available implants for robotic-assisted knee arthroplasty systems. Internal Report. EO.REC.PCS015.001.v1

JOURNEY◊ II TKA

*Compared to non-JOURNEY II knees

+Based on JOURNEY II Bi-Cruciate Stabilized (BCS) evidence

  1. Mayman DJ, Patel AR, Carroll KM. Hospital Related Clinical and Economic Outcomes of a Bicruciate Knee System in Total Knee Arthroplasty Patients. Poster presented at: ISPOR Symposium;19-23 May, 2018; Baltimore, Maryland, USA.
  2. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41.
  3. Murakami K, Hamai S, Okazaki K, et al. In vivo kinematics of gait in posterior-stabilized and bicruciate-stabilized total knee arthroplasties using image-matching techniques. Int Orthop. 2018;42(11):2573-2581.
  4. Di Benedetto P, Vidi D, Colombo A, Buttrioni MM et al. Pre-operative and post-operative kinematic analysis in total knee arthoplasty. A pilot study. Acta Biomed 2019; Vol. 90, Supplement 12: 91-97.
  5. Kosse NM, Heesterbeek PJC, Defoort KC, Wymenga AB, Hellemondt GG. Minor adaptations in implant design bicruciate-substituted total knee system improve maximal flexion. Poster presented at: 2nd World Arthroplasty Congress;19-21 April, 2018; Rome, Italy.
  6. Takubo A, Ryu K, Iriuchishima T, Tokuhashi Y. Comparison of Muscle Recovery Following Bi-cruciate Substituting versus Posterior Stabilized Total Knee Arthroplasty in the Asian Population. J Knee Surg. 2017;30(7):725-729.
  7. Noble P.C, Scuderi G.R, Brekke A.C, et al. Development of a New Knee Society Scoring System. Clin Orthop Relat Res 2012;470(1):20-32.

JOURNEY◊ II XR

  1. Grieco TF, Sharma A, Dessinger GM, Cates HE, Komistek RD. In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy. J Arthroplasty. 2018;33(2):565-571.
  2. Smith LA, Nachtrab J, LaCour M, et al. In Vivo Knee Kinematics: How Important Are the Roles of Femoral Geometry and the Cruciate Ligaments? J Arthroplasty. 2021;36:1445-1454.
  3. Iriuchishima T, Ryu K. A Comparision of Rollback Ratio between Bicruciate Substituting Total Knee Arthroplasty and Oxford Unicompartmental Knee Arthroplasty. J Knee Surg. 2018;31(6):568-572.
  4. Murakami K, Hamai S, Okazaki K, et al. Knee kinematics in bi-cruciate stabilized total knee arthroplasty during squatting and stair-climbing activities. J Orthop. 2018;15(2):650-654.
  5. Carpenter RD, Brilhault J, Majumdar S, Ries MD. Magnetic resonance imaging of in vivo patellofemoral kinematics after total knee arthroplasty. Knee. 2009;16(5):332-336.

OXINIUM◊ Knee

  1. ASTM International Standard Specification for Wrought Zirconium-2.5Niobium Alloy for Surgical Implant Applications (UNS R60901) Designation: F 2384 – 10.
  2. Sheth NP, Lementowski P, Hunter G, Garino JP. Clinical applications of oxidized zirconium. J Surg Orthop Adv. 2008;17(1):17-26.
  3. Davidson JA, Mishra AK, Poggie RA. Friction and UHMWPE wear of cobalt alloy, zirconia, titanium nitride, and amorphous diamond-like carbon implant bearing surfaces. Poster presented at: 4th World Biomaterials Con1992; Berlin, FRG.
  4. Hobbs L, Rozen V, Mangin S, Treska M. Oxidation Microstructures and Interfaces in the Oxidized Zirconium Knee. Int J Appl Ceram Technol. 2005.
  5. Smith+Nephew 2010. Hip Simulator Wear Testing of XLPE Liners Against Oxidized Zr-2.5Nb and BIOLOX Delta Heads. Interal Report. OR-10-155.
  6. Long M, Riester L, Hunter G. Nano-Hardness Measurements of Oxidized Zr.2.5Nb and Various Orthopaedic Materials. 1998
  7. Vertullo CJ, Lewis PL, Peng Y, Graves SE, de Steiger RN. The Effect of Alternative Bearing Surfaces on the Risk of Revision Due to Infection in Minimally Stabilized Total Knee Replacement: An Analysis of 326,603 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am. 2018;100(2):115-123.
  8. Davis E, Pagkalos J, Kopjar B. Effect of Bearing Surface on Survival of Cementless and Hybrid Total Hip Arthroplasty: Study of Data in the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. JB JS Open Access. 2020;5(2):e0075.
  9. Peters RM, Van Steenbergen LN, Stevens M, Rijk PC, Bulstra SK, Zijlstra WP. The effect of bearing type on the outcome of total hip arthroplasty: Analysis of 209,912 primary total hip arthroplasties registered in the Dutch Arthroplasty Register. Acta Orthopaedica. 2018;89(2):163-169.
  10. Papannagari R, Hines G, Sprague J. Long-term Wear Performance of an Advanced Bearing Technology for TKA. Poster presented at: ORS 2011 Annual Meeting2011.
  11. Parikh A, Hill P, Pawar V, Sprague J. Long-Term Simulator Wear Performance of an Advanced Bearing Technology for THA. Poster presented at: ORS 2013 Annual Meeting2013.
  12. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2021. Hip, Knee & Shoulder Arthroplasty: 2021 Annual Report.
  13. Civinini R, Carulli C, Matassi F, et al. The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology. HSS Journal. 2017;13:28-31.

VISIONAIRE◊ 

  1. Smith+Nephew 2020. Systematic literature review and meta-analysis of the accuracy, efficiency and satisfaction using VISIONAIRE. Internal Report. EA/RECON/VISIONAIRE/001/v6.
  2. Smith+Nephew 2021. Accuracy of total knee arthroplasty component sizing as determined preoperatively with the VISIONAIRE patient matched cutting guides. Internal Report. EO.REC.PCS025.001.v1.

ABLE◊ Anterior Approach 

  1. Bertin KC, Rottinger H. Anterolateral mini-incision hip replacement surgery: A modified Watson-Jones approach. Clin Orthop Relat Res. 2004;429:248-255
  2. Hansen BJ, Hallows RK, Kelley SS, The Rottinger approach for total hip arthroplasty: technique and review of the literature. Curr Rev Musculoskelet Med. 2011;4:132-138
  3. Smith+Nephew. The ABLE◊ (advanced anterior approach): a retrospective case series. Clinical and Medical Affairs Evidence Outcomes Report. Published internal document. 2021. EO.REC.PCSgen.001.v1. https://www.smith-nephew.com/professional/products/all-products/able/.

Anterior Surgical Approach 

  1. Bertin KC, Rottinger H. Anterolateral mini-incision hip replacement surgery: A modified Watson-Jones approach. Clin Orthop Relat Res. 2004;429:248-255
  2. Hansen BJ, Hallows RK, Kelley SS, The Rottinger approach for total hip arthroplasty: technique and review of the literature. Curr Rev Musculoskelet Med. 2011;4:132-138
  3. Smith+Nephew. The ABLE◊ (advanced anterior approach): a retrospective case series. Clinical and Medical Affairs Evidence Outcomes Report. Published internal document. 2021. EO.REC.PCSgen.001.v1. https://www.smith-nephew.com/professional/products/all-products/able/.

BIRMINGHAM HIP◊Resurfacing 

  1. Haughom BD, Plummer DR, Moric M, Della Valle CJ. Is there a benefit to head size greater than 36 mm in total hip arthroplasty? The Journal of arthroplasty. 2016;31(1):152-155.

OXINIUM◊ Hip

  1. ASTM International Standard Specification for Wrought Zirconium-2.5Niobium Alloy for Surgical Implant Applications (UNS R60901) Designation: F 2384 – 10.
  2. Smith+Nephew 2020. Systematic Literature Review of Evidence to Support POLAR3 Challenger Messaging. Internal Report. EA/RECON/POLAR3/007/v1.
  3. Sheth NP, Lementowski P, Hunter G, Garino JP. Clinical applications of oxidized zirconium. J Surg Orthop Adv. 2008;17(1):17-26.
  4. Davidson JA, Mishra AK, Poggie RA. Friction and UHMWPE wear of cobalt alloy, zirconia, titanium nitride, and amorphous diamond-like carbon implant bearing surfaces. Poster presented at: 4th World Biomaterials Con1992; Berlin, FRG.
  5. Hobbs L, Rozen V, Mangin S, Treska M. Oxidation Microstructures and Interfaces in the Oxidized Zirconium Knee. Int J Appl Ceram Technol. 2005.
  6. Smith+Nephew 2010. Hip Simulator Wear Testing of XLPE Liners Against Oxidized Zr-2.5Nb and BIOLOX Delta Heads. Interal Report. OR-10-155.
  7. Long M, Riester L, Hunter G. Nano-Hardness Measurements of Oxidized Zr.2.5Nb and Various Orthopaedic Materials. 1998
  8. Vertullo CJ, Lewis PL, Peng Y, Graves SE, de Steiger RN. The Effect of Alternative Bearing Surfaces on the Risk of Revision Due to Infection in Minimally Stabilized Total Knee Replacement: An Analysis of 326,603 Prostheses from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am. 2018;100(2):115-123.
  9. Davis E, Pagkalos J, Kopjar B. Effect of Bearing Surface on Survival of Cementless and Hybrid Total Hip Arthroplasty: Study of Data in the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. JB JS Open Access. 2020;5(2):e0075.
  10. Peters RM, Van Steenbergen LN, Stevens M, Rijk PC, Bulstra SK, Zijlstra WP. The effect of bearing type on the outcome of total hip arthroplasty: Analysis of 209,912 primary total hip arthroplasties registered in the Dutch Arthroplasty Register. Acta Orthopaedica. 2018;89(2):163-169.
  11. Papannagari R, Hines G, Sprague J. Long-term Wear Performance of an Advanced Bearing Technology for TKA. Poster presented at: ORS 2011 Annual Meeting2011.
  12. Parikh A, Hill P, Pawar V, Sprague J. Long-Term Simulator Wear Performance of an Advanced Bearing Technology for THA. Poster presented at: ORS 2013 Annual Meeting2013.
  13. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2021. Hip, Knee & Shoulder Arthroplasty: 2021 Annual Report.
  14. Civinini R, Carulli C, Matassi F, et al. The Survival of Total Knee Arthroplasty: Current Data from Registries on Tribology. HSS Journal. 2017;13:28-31.

POLAR3◊ Total Hip

  1. Long M, Riester L, Hunter G. Nano-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. Abstract presented at: 24th Annual Meeting of the Society for Biomaterials. April 22-26, 1998, San Diego, California.
  2. Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing technology for TKA. Poster presented at: ORS 2011 Annual Meeting 2011
  3. Davidson JA, Mishra AK, Poggie RA. Friction and UHMWPE wear of cobalt alloy, zirconia, titanium nitride, and amorphous diamond-like carbon implant bearing surfaces. Poster presented at: 4th World Biomaterials Con1992; Berlin, FRG.

WILL DELETE

References

  1. Hall, et al. Unicompartmental knee arthroplasty (alias uni-knee): an overview with nursing implications. Orthopaedic Nursing. 2004;23(3):163-171. Accessed April 25, 2019.
    • Based on pre-surgical pain levels in UKA patients.
  2. Mayman DJ, Patel AR, Carroll KM. Hospital related clinical and economic outcomes of a bicruciate knee system in total knee arthroplasty patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  3. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41
    • Compared to non-JOURNEY II knees; Based on BCS evidence
  4. 1Short-term Range of Motion is Increased after TKA with an asymmetric bicruciatestabilized implant.AcceptedPoster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,RichardL. Murphy, Seth A, Jerabek, David J. Mayman
  5. 2J Orthop. 2017 Jan 7;14(1):201- 206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range
  6.  In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017
  7. Testing concluded at 45 million cycles, ISO 14242-1 and 14243-3 define test completion at 5 million cycles. 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.
  8. Iriuchishima T, Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. doi:10.4103/ortho.IJOrtho_392_18.
  9. Smith JR, Picard F, Lonner J, et al. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. August 4-9, 2013. Natal, Brazil.
  10. 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

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.

◊ Trademark of Smith+Nephew. The information on this site is intended for US residents only © 2020 Smith+Nephew

References

*Journey II BCS.

  1. Hall, et al. Unicompartmental knee arthroplasty (alias uni-knee): an overview with nursing implications. Orthopaedic Nursing. 2004;23(3):163-171. Accessed April 25, 2019.
    • Based on pre-surgical pain levels in UKA patients.
  2. Mayman DJ, Patel AR, Carroll KM. Hospital related clinical and economic outcomes of a bicruciate knee system in total knee arthroplasty patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  3. Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41
    • Compared to non-JOURNEY II knees; Based on BCS evidence
  4. 1Short-term Range of Motion is Increased after TKA with an asymmetric bicruciatestabilized implant.AcceptedPoster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,RichardL. Murphy, Seth A, Jerabek, David J. Mayman
  5. 2J Orthop. 2017 Jan 7;14(1):201- 206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range
  6.  In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017
  7. Testing concluded at 45 million cycles, ISO 14242-1 and 14243-3 define test completion at 5 million cycles. 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.
  8. Iriuchishima T, Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. doi:10.4103/ortho.IJOrtho_392_18.
  9. Smith JR, Picard F, Lonner J, et al. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. August 4-9, 2013. Natal, Brazil.
  10. 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

Additional claim statements and support regarding Smith+Nephew implants and Robotics-assisted surgery

  • Implants that are built to last
  • LEGION◊CR Knee with VERILAST◊ technology was lab-tested for 45 million cycles (estimating 30 years of wear performance) and showed 81% less wear than similar 5-million cycle cobalt chrome implant.
    • Learn More
      • ISO 14243-3
      • 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.
  • Smith+Nephew implants may offer a more normal feeling knee
    • Based on JOURNEY◊ II BCS knee implant
    • Learn More
      • Verstaete MA, Van Onsem S, Zambianchi F, et al. Multi-centre evaluation of knee kinematics during different activities for anatomic total knee design. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
      • Sharma A, Dessinger G, Cates H, Komistesk R. In vivo kinematic comparison for subjects having a bi-cruciate substituting TKA vs the normal knee. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
      • Kosse NM, Heesterbeek PJC, Defoort KC, Wymenga AB, van Hellemondt GG. Improved maximal flexion after minor adaptations in implant design bicruciate-substituted total knee arthroplasty. Poster presented at 19th Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT); May 30 – June 1 2018; Barcelona, Spain.
  • 89% of patients were able to take the stairs again after surgery.
    • Based on JOURNEY◊ II BCS knee implant patients
      • Iriuchishima T and Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. DOI:10.4103/ortho.IJOrtho_392_18
  • A robotics-assisted knee replacement with Smith+Nephew implants may get you back in the game six months sooner than traditional knee replacement surgery
    • Based on UKA patients
      • 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
  • Over 90% of patients who had a Smith+Nephew knee replacement surgery returned to work within 6 months.
      • Harris AI, Luo TD, Lang JE, Kopjar B. Short-term safety and effectiveness of a second-generation motion-guided total knee system. Arthroplast Today. 2018;4:240–243. 1
  • Robotics-assisted surgery with Smith+Nephew implants may lead to a faster rehabilitation and shorter recovery time than traditional knee surgery when following your doctor’s recovery plan and physical therapy recommendations.
    • Claim 19 & 20 (PCS REC.015)
  • Due to its improved accuracy, Smith+Nephew robotics-assisted UKA has lower revision rates* compared to conventional techniques
    • Shown in clinical studies with follow-up of up to 5.5 years
      • Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1232-1240.
      • Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship. J Robot Surg. 2019;14(1):55-60.
      • Gregori A. 5 Yr Experience Semi Active Robotic Partial Knee Replacement: The Financial Impact. Poster presented at: SICOT;October, 2018; Montreal, Canada.
  • A study has shown Smith+Nephew robotic technology has demonstrated faster return to sport (4.2 vs 10.5 months) when compared to conventional techniques*
        • *n= 28 (n=11 robotic procedures), p<0.01
          • 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
  • Robotics-assisted surgery with Smith+Nephew implants may help patient get discharged sooner
    • Study of UKA patients
      • Sephton BM, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
      • Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
  • Robotics-assisted surgery with Smith+Nephew implants may provide patients with a smoother recovery
    • Based on JOURNEY II family of implants
      • Mayman DJ, Patel AR, Carroll KM. Hospital Related Clinical and Economic Outcomes of a Bicruciate Knee System in Total Knee Arthroplasty Patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
  • Robotics-assisted surgery with Smith+Nephew implants may help patients regain function faster
      • Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.

Additional statements and support regarding Knee Replacement

  • More than 90% of people who have knee replacement surgery experience dramatic relief in knee pain and are better able to perform common activities.
    • Based on pre-surgical pain levels
      • American Academy of Orthopaedic Surgeon website, http://orthoinfo.aaos.org/topic.cfm
  • The majority of patients experience profound improvements in their physical activity after having knee replacement surgery.
    • Based on pre-surgical activity levels
      • Brandes M, et. al., “Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty.” Clin Orthop Relat Res. 1991 Dec;(273):151-6. https://www.ncbi.nlm.nih.gov/pubmed/20981812 Accessed Wednesday, April 17, 2019