Hips, Shoulders, and Knees: New Orthopedic Products From DePuy

DePuy had some exciting announcements for new additions to many of their product lines at the annual meeting of the American Academy of Orthopaedic Surgery (AAOS). The new launches includes the new AOX Polyethylene, an anti-oxidant polyethylene liner for knee replacements; RECLAIM and GRIPTION TF, new systems for revision hip replacements; TRUMATCH, a personalized knee replacement system; and GLOBAL UNITE and GLOBAL STEPTECH, new solutions for shoulder replacement and fractures.

The AOX antioxidant polyethylene system, which we have covered in the past, is designed to resist free radical degradation and wear. Polyethylene in knee replacements undergoes cross-linking in gamma radiation to make it more wear resistant. This very process, however, can produce a high number of free radicals, which rarely can cause early failure if the implant is exposed to oxygen. The AOX implant has been designed to neutralize these free radicals, and some early studies have shown decreased wear and failure with these types of implants.

Hip replacement is a relatively straight-forward procedure, but cases where hip replacements need to be revised are extremely difficult. The bony anatomy is often distorted and there is often missing bone in critical areas. In regards to the femur component, the RECLAIM system is designed to provide modularity allowing for a very customized implant. There are 16 different diameter sizes for their stems as well as four different lengths to choose from. The proximal body also is customizable with three diameters, four lengths and 360-degree positioning.

The set is also designed with OR staff in bind with a comparatively more compact instrumentation set when compared with the standard. Addressing the acetabulum in revision surgery can also be quite challenging for which DePuy is announcing their GRIPTION TF system, a bony augment system designed for use with their PINNACLE acetabular cup system. This system is designed for cases where there are areas of missing bone in the acetabulum. The implant is made from a porous titanium designed to have a modulus of elasticity similar to bone. It utilizes locking screw technology for more rigid fixation along with a divergent screw configuration.

We have covered DePuy's TRUMATCH personalized knee replacement technology in the past. Using CT scans from the knees of patients DePuy will actually create customized cutting blocks to be used during their surgery, which they claim improves outcomes and decreases operating room time. At AAOS DePuy announced the next generation of this line, TRUMATCH Personalized Solutions 2.5i, which provides enhanced capabilities and efficiency.

The last two product announcements, GLOBAL UNITE and GLOBAL STEPTECH,  address shoulder replacement. GLOBAL UNITE is a system designed for fractures of the proximal humerus, with a unique feature being that it can later be converted to a reverse shoulder arthroplasty down the road. The GLOBAL STEPTECH system is designed for shoulders which have excessive bone loss in the posterior aspect of the glenoid (socket). It uses a proprietary step design which corrects the abnormal anatomy and counteracts posterior loading.

Here's more about the newly launched DePuy products from the press release:

AOX Polyethylene

Approved for use with the SIGMA Rotating Platform Knee System and LCS COMPLETE Mobile Bearing Knee System, the new AOX Polyethylene delivers an advanced blend of polyethylene resin and a unique antioxidant, COVERNOX, to create a new polyethylene material that is highly efficient in trapping free radicals and scavenging oxygen. By eliminating the annealing or remelting process, AOX Polyethylene delivers oxidative stability and optimum wear resistance without compromising the mechanical properties or strength of the polyethylene. By introducing COVERNOX Antioxidant into the base resin before the polyethylene is consolidated, the process enables the antioxidant to be uniformly dispersed and remain blended, eliminating the risk of outward migration.

Hip Revision Solutions

The RECLAIM Modular Revision Hip System is engineered to deliver a high level of implant strength. This system has been studied extensively through analytic techniques and rigorous laboratory testing and has demonstrated promising capabilities, particularly with respect to construct fatigue strength and torsional stability. The modular design of the RECLAIM Revision Hip System features novel instrument technology that may improve intraoperative handling, flexibility, and efficiency. The modularity of the system offers surgeons numerous options to treat a patient's unique pathology while simplifying the instrumentation required in surgery.

DePuy's GRIPTION TF Acetabular Augment System addresses bone defects in moderate to complex acetabular revision surgery using a highly porous structure made from commercially pure titanium; a strong, corrosion-resistant metal that has high surface roughness and a similar elasticity to bone. The GRIPTION TF System offers a wide range of options and configurations for the patient at the time of surgery and is designed to work in conjunction with the full range of PINNACLE Acetabular Cup options.

Procedural Efficiency in Knee Replacement

TRUMATCH Personalized Solutions 2.5i provides enhanced capabilities that aid implant positioning and procedural efficiency. TRUMATCH, which reduces procedure time by up to 35 minutes, is the first system to utilize CT scans and computer software to guide the development and production of femoral and tibial cutting blocks that are individually prepared to match the actual bone surfaces of each patient. The use of CT scans, rather than MRIs, results in improved bone imaging, less scanning time, and lower costs.

Advanced Shoulder Solutions

DePuy is launching two new shoulder solutions. The GLOBAL UNITE Platform System, which treats fractures of the proximal humerus, helps improve tuberosity healing and is the only system that can later be easily converted to a reverse shoulder arthroplasty for treatment of arthritis with a torn rotator cuff. The GLOBAL STEPTECH APG System has been designed to correct excessive retroversion caused by posterior glenoid bone loss, closely recreate the original glenohumeral joint line, and minimize the removal of healthy bone. The prosthesis incorporates a proprietary step design with an anterior backside surface that is spherical and a posterior backside surface that is conical. This unique dual surface design effectively counteracts posterior loading.

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