Raised Anterior Lip - High Flexion. High Stability.

• Reduces anterior sliding (paradoxical motion) by maintaining the femur within the posterior 1/3rd of the tibial insert ^1,2,3
• Increases range of motion by avoiding impingement in flexion and lengthening the quadriceps lever arm^4,5
• Enhances anterior stability
• May share anterior stresses placed upon the posterior cruciate ligament (PCL)
• Theoretically allows longer, more effective PCL function
• May inhibit PCL loosening (a common complication among cruciate retaining knees)^6,7,8
• May substitute for the PCL in the event of rupture

  The ADVANCEŽ Double-High Knee features a low profile posterior rim (2A) and lateral relief (2B) to prevent interference as the PCL guides the femur in flexion.

1. Lotke PA. The posterior cruciate ligament in total knee arthoplasty:
   a commentary. University of Pennsylvania Orthopaedic Journal. 
   Vol 12: 109, 1999.
2. Blaha, JD, et al. In vivo determination of kinematics for subjects having either an anterior cruciate ligretaining or medial pivot total knee arthoplasty. Scientific Exhibit AAOS, 2002.
3. Schmidt R, Blaha JD, Penenberg BL, Maloney WJ, Komistek RD. Fluoroscopic analyses of cruciate retaining and medial pivot knee implants. Clin Orthop 410: 139-147, 2003.
4. Belleman J, et al. Fluorocopic analysis of the kinematics of deep flexion in total knee arthroplasty. JBJS (Br); 84-B: 50-3, 2002.
5. Mahoney OM, et al. The effect of total knee arthroplasty design on extensor mechanism function. J Arthroplasty 17(4): 416-21, 2002.
6. Mahoney OM, Noble PC, Rhoads DD, Alexander JW and Tullos HS. Posterior cruciate function following total knee arthroplasty: A biomechanical
   study. J Arthroplasty 9:569-78, 1994.
7. Laskin R, O'Flynn H. Total knee replacement with posterior cruciate ligament retention in rheumatoid arthritis. Clin Orthop 345: 24-28, 1997.
8. Nelson CL. Total knee arthroplasty with preservation of the posterior cruciate ligament. University of Pennsylvania Orthopaedic Journal. 
   Vol 12:96-99, 1999.