mk569-1010 evolution sales brochure 5 - surgical specialties...the evolution™ medial-pivot knee...

EVOLUTIONMedial-Pivot Knee System

Wright Medical Technology, Inc.5677 Airline RoadArlington, TN USA 38002901.867.9971 phone800.238.7188 toll-freewww.wmt.com

Wright Medical EMEAKrijgsman 11 1186 DM Amstelveen The Netherlands 011.31.20.545.0100 www.wmt-emea.com

Size A B C D E F (PS Only)

1 59 51 10 9 16 20

2 61 54 10 9 16 20

3 64 57 10 9 18 22

4 66 60 10 9 18 22

5 70 64 11 9 18 22

6 73 68 11 9 18 22

7 77 72 11 9 20 25

8 80 76 11 9 20 25

Dimensions listed are in mm

Size A B C

1 54 40 31

2 58 43 31

2+ 62 46 34

3 62 46 34

4 66 49 34

5 70 52 38

6 74 55 38

6+ 78 58 41

7 78 58 41

8 82 61 41

8+ 86 64 41

The EVOLUTION™ Medial-Pivot Knee System was designed based on the success of the ADVANCE® Medial-Pivot Total Knee, which was launched in 1998. The ADVANCE® Medial-Pivot Knee was one of the fi rst total knee implants designed based on modern studies which showed that the medial compartment of the knee moves less than the lateral compartment.1

All of Wright’s Medial-Pivot total knee implants feature ball-in-socket articulation which enhances stability and allows the prosthesis to move and feel more like a normal knee. Traditional knee implants slide anteriorly (commonly referred to as paradoxical motion), due to tibiofemoral incongruity and a loss of stabilizing structures after total knee replacement. In addition, paradoxical motion seen in traditional total knees may cause a patient’s knee to feel less stable and exhibitmore noise.2,3,4,5

Peer-reviewed literature has shown Medial-Pivot total knees to be more stable and patient-preferred, compared to traditional total knee implants.6

1. Pinskerova. Knee Imaging Study Sheds New Light on Flexion, Rollback. Orthopaedics Today. November/December. Vol 2 Number 6. 1999.2. Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 20033. Schmidt R, Komistek RD, Blaha JD, Penenberg BL, Maloney WJ. Fluoroscopic analyses of cruciate-retaining and medial pivot knee implants. Nov;(416):37-57. 4. Shakespeare, Murray, Gill, et al. How eff ective are added constraints in improving TKR kinematics? J Biomech. 2007;40 Suppl 1:S31-7. Epub 2007 Apr 12.5. Anderson, M. “Patellofemoral Complications After Posterior Stabilized Total Knee Arthroplasty” Journal of Arthroplasty, Vol. 17, No. 4, 2002.6. Pritchett, J. “Patient Preferences in Knee Prostheses” Journal of Bone & Joint Surgery [Br] Vol. 86-B, 2004.

Medial-Pivot Knee System

Instability is a leading cause of short-term total knee implant revisions.1 The EVOLUTION™ Medial-Pivot Knee System’s proprietary ball-in-socket mechanism provides stability.2,3

Traditional total knee implants do not feature a ball-in-socket mechanism. Without ball-in-socket articulation, traditional knees can be less stable and more likely to slide forward during a patient’s daily activities. This slide forward is commonly referred to as paradoxical motion.2,3 Paradoxical motion can even cause a patient’s knee to exhibit noises such as pops, clicks, and clunks.4 Ball-in-socket knees have also been shown to produce greater range of motion when compared to traditional PS knees and have a femoral rollback profi le similar to the natural knee. 5

The EVOLUTION™ Medial-Pivot Knee System allows both the surgeon and patient to experience stability through its proprietary ball-in-socket concept, which is off ered in all three of its primary knee options. The three options off ered are: Cruciate Substituting (CS), Cruciate Retaining (CR), and Posterior Stabilized (PS). Although each off ers unique benefi ts, all three incorporate spherical femoral condyles which match a conforming medial socket to create a ball-in-socket concept. Meanwhile, they also off er a lateral surface which allows for mixed rolling and spinning to occur in a 15° arcuate path.

Why aBall-in-Socket?

The SecondGenerationMedial-Pivot.

Experience Stability.™

1. Theodore Firestone, MD, et al.”Surgical Management of Symptomatic Instability Following Primary Total Knee Replacement” JBJS Vol. 88 20062. Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 20033. Schmidt R, Komistek RD, Blaha JD, Penenberg BL, Maloney WJ. Fluoroscopic analyses of cruciate-retaining and medial pivot knee implants. Nov;(416):37-57.4. Shakespeare, Murray, Gill, et al. How eff ective are added constraints in improving TKR kinematics? J Biomech. 2007;40 Suppl 1:S31-7. Epub 2007 Apr 12.5. Hossain. et al.”Knee Arthroplasty with a Medially Conforming Ball-and-Socket Tibiofemoral Articulation Provides Better Function” Clin Orthop Relat Res. 2010 Aug 11. [Epub ahead of print]

Cruciate Substituting Cruciate Retaining Posterior Stabilized

1 59 51 10 9 16 20

2 61 54 10 9 16 20

3 64 57 10 9 18 22

4 66 60 10 9 18 22

5 70 64 11 9 18 22

6 73 68 11 9 18 22

7 77 72 11 9 20 25

8 80 76 11 9 20 25

Size A B C

1 54 40 31

2 58 43 31

2+ 62 46 34

3 62 46 34

4 66 49 34

5 70 52 38

6 74 55 38

6+ 78 58 41

7 78 58 41

8 82 61 41

8+ 86 64 41

1 59 51 10 9 16 20

2 61 54 10 9 16 20

3 64 57 10 9 18 22

4 66 60 10 9 18 22

5 70 64 11 9 18 22

6 73 68 11 9 18 22

7 77 72 11 9 20 25

8 80 76 11 9 20 25

Size A B C

1 54 40 31

2 58 43 31

2+ 62 46 34

3 62 46 34

4 66 49 34

5 70 52 38

6 74 55 38

6+ 78 58 41

7 78 58 41

8 82 61 41

8+ 86 64 41

CT-Based SizingThe rationale behind the development of the EVOLUTION™ Medial-Pivot Knee

System implant sizing was to leverage modern technology to create stature-specifi c total knee implants for the global patient demographic. CT-scans (computed tomography images) from hundreds of patients around the globe were compiled and analyzed to create the stature-based femoral sizes, as well as the anatomic tibial base profi les.

EVOLUTION™

Cruciate Substituting/Cruciate Retaining Knee Systems

EVOLUTION™

Posterior-Stabilized Knee System

Stability without a post.Cruciate Substituting without a housing resection

Lateral meniscal pathallows 15°of motion

Posterior lipreplaces ACL

Anterior lipreplaces PCL

Medial socketprovides stability

The EVOLUTION™ Medial-Pivot PS Knee is a ball-in-socket design, but with a bone conserving box for the cam. With this design, the femur does not engage the cam until approximately 80° of fl exion, meaning the cam is not enaged during gait. This allows the medial condyle to pivot and “soft engage” the cam, continuing the pivoting action without an impact on the post.

The EVOLUTION™ Medial-Pivot Knee System allows both the surgeon and patient to experience stability through its proprietary ball-in-socket concept, which is off ered in all three of its primary knee options.

From Cruciate-Retaining toCruciate-Substituting in a snap.

Coronal Pre-Operative LimbAlignment with LandmarksIdentifi ed

Pre-Operative Femur with TransEpicondylar Axis, Posterior CondylarLine, and Mechanical and AnatomicAxes Identifi ed

Femoral Implant Aligned andPlaced onto Resected Femur

Sagittal Pre-Operative LimbAlignment with LandmarksIdentifi ed

Implant Overlay onto Distal Femur with Trans-Epicondylar Axis Defi ning Rotation

Distal Femur with ResectionsHighlighted

Two femoral options

Three medial-pivoting insert options.

All options connect to a single anatomic tibial base.

The EVOLUTION™ tibial base now has an 8° medially oriented lock detail and a shortened dovetail for easier poly insertion. The keel has been shortened for easier and less invasive insertion.

EVOLUTION™ features an extended patellar groove on the femoral implant whilethe anterior portion of the insert has been rounded and recessed to providepatellar tendon relief. Designed for increased contact area as the patella ridesdeeper on the femur.

The constant radius on ADVANCE® (0° to 90°) has been extended from -45° to 100° degrees, allowing for higher contact area throughout range of motion.

EVOLUTION™ sizing options have been expanded to 8 sizes, compared to the 6 that are off ered with ADVANCE®. Nearly 300 scans from the United States, Japan, and Korea were used to assess various aspects of femoral sizing. There are 3 to 4mm between EVOLUTION™ sizes and the femoral pegs maintain a common distance across sizes, allowing for easy downsizing.

EVOLUTION™ Sizing ADVANCE® Sizing

The tibial base was changed from a symmetric profi le to an anatomically shaped design for better bone coverage. Sizing was confi rmed through CT scan evaluations and hundreds of cases of intra-operative templating.

EVOLUTION™ Tibial Base ADVANCE® Tibial BaseEVOLUTION™ Tibial Base ADVANCE® Tibial Base

EVOLUTION™ Tibial Base

ADVANCE® Tibial Base

ASYMMETRICPOSTERIOR CAMProvides greater posteriortranslation

The True ComparisonSide-by-side comparison between the ADVANCE® Medial-Pivot total knee and the EVOLUTION™ Medial-Pivot knee Systems

POSTERIOR CAM MECHANISMEngages post approximately 80° of fl exion

ANTERIOR CAMPermits up to 10° of constructhyperextension.

DESIGNED TO ELIMINATEPATELLAR CLUNKAnterior portion of housingmoved posteriorly

EVOLUTION™ Femur

- 45°

ADVANCE® Femur

EVOLUTION™ Knee

ADVANCE® Knee

EVOLUTION™ Femur ADVANCE® Femur

EVOLUTION™ Cruciate-Substituting Knee EVOLUTION™ Cruciate-Retaining Knee

allows up to 143° of fl exion allows up to 152° of fl exion

HIGH FLEXIONDesigned to allow up to162° of fl exion

Virtual Surgerywas completed to assess the sizing for Wright’s

EVOLUTION™ Medial-Pivot Knee.

EVOLUTION™

Two femoral options

EVOLUTION™ Femur

- 45°

ADVANCE® Femur

EVOLUTION™ Knee

ADVANCE® Knee

EVOLUTION™

Two femoral options

EVOLUTION™ Femur

- 45°

ADVANCE® Femur

EVOLUTION™ Knee

ADVANCE® Knee

EVOLUTION™

Two femoral options

EVOLUTION™ Femur

- 45°

ADVANCE® Femur

EVOLUTION™ Knee

ADVANCE® Knee

1 59 51 10 9 16 20

2 61 54 10 9 16 20

3 64 57 10 9 18 22

4 66 60 10 9 18 22

5 70 64 11 9 18 22

6 73 68 11 9 18 22

7 77 72 11 9 20 25

8 80 76 11 9 20 25

Size A B C

1 54 40 31

2 58 43 31

2+ 62 46 34

3 62 46 34

4 66 49 34

5 70 52 38

6 74 55 38

6+ 78 58 41

7 78 58 41

8 82 61 41

8+ 86 64 41

mk569-1010 evolution sales brochure 5 - surgical specialties...the evolution™ medial-pivot knee...

Documents