Total Knee Systems
Medacta offers a comprehensive Total Knee System with multiple implant options designed to address the unique needs of patients and surgeons. The core of the system is an innovative Medially Stabilized Knee implant, designed to deliver maximum functional stability and improved knee kinematics with the goal of increasing TKA patient satisfaction during daily activities and potentially decreasing post-operative knee pain.
Based on the knee anatomy and kinematic studies performed by Prof. Michael Freeman and Prof. Vera Pinskerova[6], the GMK Sphere is an innovative total knee implant designed to deliver maximum functional stability with the goal of increasing TKA patient satisfaction during activities of daily living and decreasing post-operative knee pain.
GMK Sphere is also available with SensiTiN, a ceramic-like coating designed to reduce the release of metal ions from the implant. [12]
Patient Satisfaction
In a study in which patients had a conventional CR or PS in one knee and a medially stabilised device in the other, 76% preferred the knee with the “ball in socket” medial compartment[5]. Patients reported:
- It feels more normal
- It is stronger when ascending/descending stairs
- It has superior single-leg weight bearing
- It feels more stable during flexion and overall
- There are fewer clunks, pops and clicks
Despite the excellent longevity of total knee arthroplasty, many patients continue to experience functional deficits after surgery. Patient expectations are not as well fulfilled by TKA as by total hip replacement with fewer knee patients achieving a “forgotten joint” replacement. Studies show that around 20% of TKA patients are not satisfied[1, 2, 3]. Excessive A/P motion may result in anterior knee pain and continued swelling. In many P/S designs, the stabilising mechanism only engages after 70-80° of flexion leaving the knee vulnerable to A/P instability during the most commonly encountered functional activities[4].
Responsible Innovation
Medacta is committed to providing innovative and safe solutions for patients with an evidence-based approach. GMK Sphere was tested over 3 years prior to launch through an intensive evaluation program including in vitro and in vivo trials and Laboratory tests[8,10,11,14].
To potentially further improve KA results and ultimately patient satisfaction, Medacta has developed GMK SpheriKA, the first KA-optimized implant. GMK SpheriKA was developed starting from the strong heritage of GMK Sphere, with a particular focus on the anterior aspect of the femur.
KA-Optimized Anterior Aspect
- Funnel design of the trochlea groove to accommodate a wider range of Q-angles for a patient-specific PFJ tracking
- Optimized bone coverage for the KA technique
Medial Ball-in-Socket Stability
- Inherent stability with medial Ball-in-Socket [12,15,16]
- Unconstrained lateral compartment for patient-specific kinematics [12,16]
Kinematic Alignment
Kinematic Alignment (KA) aims at restoring the native pre-arthritic alignment through true anatomic resurfacing without ligament releases, allowing for more natural knee kinematics. In recent years Kinematic Alignment has been shown to provide better functional scores and patient outcomes in different comparative studies [1,3].
However, femoral implants currently on the market are mainly designed for the Mechanical Alignment (MA) technique. This could potentially represent a limitation to the KA technique [4,5].
GMK Sphere: a solid foundation
Medacta’s GMK Sphere has been proven to be a particularly suitable implant for KA [6-10], as it provides stability with its Ball-in-Socket design, while allowing patient-specific kinematic patterns with its unconstrained lateral compartment [11-14].
When combined with the KA technique, the GMK Sphere has been shown to provide better functional scores and improve patient outcomes compared to other designs [6-10].
Revision Knee Systems
Medacta’s Knee Revision portfolio consists of a wide range of implant solution combinations to address ligament instability and bone defects that allows the surgeon to find the best solution for each patient. Each revision option offers modular instrument and implant solutions to facilitate and deliver the flexibility to accommodate the interoperative demands even in the most challenging surgical scenarios.
The entire GMK Total Knee Replacement System has been designed to preserve the joint functionality without dramatically altering its anatomy and kinematics, even in cases of severe ligament instability or massive bone defects.
Thanks to the GMK Revision comprehensive range of options the surgeon can choose the most suitable solution for every patient within his care without any compromise.The established GMK REVISION implant, along with the easy to use instrumentation, help the surgeon to operate every day in total confidence, flawlessly addressing each surgical scenario, from primary augmentable cases to the most challenging knee revisions: with GMK REVISION any challenge is possible!
GMK Revision is also available with SensiTiN, a ceramic-like coating designed to reduce the release of metal ions from the implant.
- Cemented and mechanically attached tibial augmentation can selectively address asymmetric bone defects
- Tibial inlays are available both on fixed and mobile versions with different levels of constraint to provide the maximum intra-operative flexibility.
- Besides the traditional symmetric inset patella, GMK Revision also offers the asymmetric resurfacing patella, increasing the patella-femur contact surface, reducing stress on polyethylene and improving stability.
- GMK Revision femoral component is bone preserving: the reduced box fits both posterior-stabilised and semi-constrained inlays therefore eliminating large bone loss.
- Same internal and articular profiles as GMK Primary femur ensures the freedom to choose intra-operatively the most suitable solution for the patient.
- Distal and posterior femoral augmentation mechanically attached to the femoral component help to fill condylar bone defects, accurately managing the joint line position and the flexion/extension gaps.
- 360° adjustable tibial and femoral offsets maximise bone coverage without compromise, reducing the risk of overhang.
- All the modular connections are tested and dedicated instruments are available in the operating room to standardise the procedure, providing every patient with the maximum level of safety.
- A complete range of extension stems is available when intramedullary fixation is required. Stems are available in a wide range or sizes and in cementless or cemented and are interchangeable between femur and tibia to minimise the OR inventory.
The entire GMK Total Knee Replacement System has been designed to preserve the joint functionality without dramatically altering its anatomy and kinematics, even in cases of severe ligament instability or massive bone defects.
The comprehensive range of GMK Hinge options enable surgeons to fix very unstable knees restoring confidence of movement for patients. The stress-free modular mechanism of GMK Hinge implant, together with its bone preserving design, help the surgeon to address demanding joint salvage procedures as well as unstable primary surgeries where the clinical indications show evidence of a constrained implant. Intuitive instruments help the surgeon to minimise the number of intra-operative steps and be confident that a standardised procedure will make the entire surgery more efficient and time saving.
- The jump distance increases with the inlay thickness
- Modular hinge mechanism
- 6 Anatomic femoral Sizes
- 360° Femoral offset
- Bone preserving femoral and tibial design
- 6 Anatomic Tibial Sizes
- 360° Tibial offset
- Cementless and cemented extension stem
GMK Hinge is also available with SensiTiN, a ceramic-like coating designed to reduce the release of metal ions from the implant.
Partial Knee Systems
Medacta offers a comprehensive Partial Knee System with multiple implant options designed to address the unique needs of patients and surgeons. Implants and instruments are designed to be soft tissue friendly and provide patients with a joint preservation option.
MOTO Patello-Femoral Joint (PFJ) is a compartment-specific implant conceived to restore a painless patellar movement throughout the whole articular range of motion when the osteoarthritis is localised in the femoral trochlea region.
Together with MOTO Medial and MOTO Lateral, MOTO PFJ is part of Medacta’s MOTO Partial Knee System, which provides for surgeons a complete portfolio to manage any type of unicompartmental knee arthroplasty. MOTO PFJ features a completely guided surgical procedure that avoids the need for any free-hand step and preserves the femoral intramedullary canal. These unique features, together with an optimised implant design, would provide the surgeon a reliable and reproducible system for treating the patellofemoral joint osteoarthritis as well.
Design Philosophy
MOTO PFJ features an onlay anterior design that immediately captures the patella during the knee extension, preventing patellar subluxation and instability. Distally, the implant has an inlay design to provide the smoothest transition from mid-flexion to complete flexion, thereby decreasing the risk of overstuffing the patella and limiting the load on the PFJ component in complete flexion, where patellar load stress is usually the most elevated.
A dedicated resurfacing patella component, thin and fully congruent with the PFJ trochlea, completes the MOTO PFJ system to further reduce trochlear anterior pressure and compartment overstuffing.
Each component of the MOTO Partial Knee System was designed with the following clear goals:
- accommodate the individual anatomy in order to achieve optimal coverage and fit.
- provide correct and individualised balance and alignment at every step of the procedure, with the potential of decreasing the incidence of loosening and progression of the disease, which is the main reason for revision of unicompartmental knee replacement.
MOTO Lateral is a compartment-specific, fixed-bearing implant that further expands the MOTO Partial Knee System, offering the opportunity to treat osteoarthritis localised on the lateral femoral and tibial condyles.
MOTO Lateral and MOTO Medial provide the surgeon with a comprehensive range of options to resurface only the affected portion of the patient’s knee. MOTO Lateral was designed with the aim of optimising the anatomical fit and compartment-specific coverage for the broadest range of patient anatomies. It features a patient-specific gap balance and alignment technique with minimal and precise bone resections, without ligament releases. The implant design and instrumentation work together so that intraoperative decision-making and flexibility are optimised for each patient.
Design Philosophy
The fixed-bearing, round-on-flat design in partial knee replacement has demonstrated the potential to provide excellent midterm and long-term results, as reported in clinical studies and registry data [1-5]; however, there is still potential for improvement in terms of anatomic fit, size range, intraoperative feel and technique. Both MOTO Medial and MOTO Lateral Partial Knees have been developed in alignment with this proven philosophy, but feature an improved implant and instrument design, as well as flexibility of the system, taking the potential of partial knee arthroplasty to the next level.
The MOTO System was designed with clear goals:
- accommodate the individual anatomy in order to achieve optimal coverage and fit.
- provide correct and individualised balance and alignment at every step of the procedure with the potential of decreasing the incidence of loosening and progression of disease, the main reasons for revision of unicompartmental knee replacement [6-10].
Enhanced Implant Design
Extensive anthropometric research was performed on selected cases from our internal database containing more than 45.000 CT and MRI scans of knees[11] from all countries to validate the MOTO implant design.
Anatomic and Compartment-Specific Shape
Replicates the morphology of native lateral femur and tibia for an optimal shape matching and coverage.
Improved and Optimised Range of Size Options
- 7 femoral and 8 tibial sizes with fine increments that best fit the full spectrum of anatomic profiles. Range of inserts with 1mm increments (8, 9,10, 11,12, 14).
Uncompromised fit, coverage and positioning
MOTO Medial was designed with the aim to optimise the anatomical fit and compartment-specific coverage for the broadest range of patient anatomies.
MOTO Medial features a patient specific gap balance and alignment technique with minimised and precise bone resections, without ligament releases. The implant design and instrumentation work together so that intraoperative decision making and flexibility are optimised for each patient.
Design Philosophy
Fixed-bearing, round-on-flat design in partial knee replacement has shown the potential to provide excellent midterm and long-term results, as reported in clinical studies and registry data [1-5], however there is still potential for improvement in terms of anatomic fit, size range, intraoperative feel and technique. MOTO Medial Partial Knee follows this proven philosophy but improves upon implant and instrument design, as well as flexibility of the system, taking the potential of partial knee arthroplasty to the next level.
Enhanced Implant Design
Extensive anthropometric research was performed on cases selected from our internal database containing more than 45.000 CT and MRI scans of knees[11] from all countries to validate the MOTO implant design.
Anatomic and Compartment-Specific Shape
Replicate the morphology of native medial femur and tibia for an optimal shape matching and coverage.
Improved and Optimised Range of Size Options
- 10 femoral and 8 tibial sizes with fine increments that best fit the full spectrum of anatomic profiles.
- Range of inserts with 1mm increments (8, 9,10, 11,12, 14).
Uncompromised fit, coverage and positioning
Designed with clear goals:
- accommodate individual anatomy to achieve optimal coverage and fit
- provide correct and individualized balance and alignment at every step of the procedure with the potential to decrease the incidence of loosening and progression of disease – main reasons for revision of unicompartmental knee replacement [6-10].
Materials commonly used in orthopaedics consist of metal alloys which can release metal ions [1,2]. Metal ions might elicit hypersensitivity reactions and expose the patient to inflammatory states which might lead to implant removal and revision surgery [1,3,4]. Metal hypersensitivity affects about 10% to 15% of the general population, but recent studies report an even more frequent incidence due to the increasing exposure to metals [3]. It is important to consider alternative solutions in orthopaedics to reduce the release of metal ions and potentially reduce the occurrence of related reactions [5].
Enhanced coating to reduce metal ion release SensiTiN is a ceramic-like coating of titanium nitride, designed to reduce the release of metal ions from Medacta’s implants for knee replacement. This property makes SensiTiN the preferred choice of most orthopaedic surgeons for treating patients with metal hypersensitivity, and it is also considered a valid means of reducing the likelihood of hypersensitivity onset [6,7,8].
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