Physicians

Knees

ADVANCE® Medial-Pivot Knee

Medial-Pivot Kinematics. Sound Clinical History. Superior Instrumentation.

Due to the high stability and rotation provided by the partial ball-in-socket articulation, the ADVANCE® Medial-Pivot Knee functions like a normal knee. In fact, studies have shown it is preferred by 8 out of 10 patients with an ADVANCE® Medial-Pivot Knee in one leg and a competitive design in the other.^7,8 In the normal knee, the medial femoral condyle exhibits less roll than the lateral condyle during motion. The ADVANCE® Medial-Pivot Knee was the first major system to address and replicate these kinematics. Medial-pivoting kinematics is a critical design rationale, which has grown through the acceptance of modern kinematic studies and clinical success.^1,2,3,7,8,9

• Constant radius from 0° - 90° (1)
  • High contact area throughout ROM
  • Maintains constant ligamentous tension throughout range of motion
• Patella track at anatomic angle and depth
• Does not require a large intercondylar resection
• Raised anterior lip
  • (2) Replaces the spine of a traditional posterior stabilized knee
  • Allows PCL-substitution
• Lateral trough
  • Allows 15° of natural rotation for deep flexion
  • Allows freedom of rotational alignment
• Ball-in-socket articulation
  • Provides patient stability through range of motion^7,8
  • Highest contact area through range of motion

References

1. Komistek, R.; Walker, SA: An in vivo kinematic determination of the F/S 1000 medial pivot knee. Wright Medical Technology, Inc., Test Request TR97-0046, 1997.
2. S.G. Elias, MD, MAR; Freeman, MD, FRCS; and E.I. Gokcay, MD: A Correlative Study of the Geometry and Anatomy of the Distal Femur. Clinical Orthopedics Related Research: 260, 1990.
3. Blaha JD, et al. In vivo determination of kinematics for subjects having either an anterior cruciate ligament retaining or medial pivot total knee arthroplasty. Scientific Exhibit AAOS, 2002.
4. Stuchin S, Intermediate term follow-up of a new medial-pivot total knee. Poster presentation. AAOS 2005.
5. Komistek RD, et al. In vivo fluoroscopic analyses of the normal human knee. Clin Orthop 410:69-81. 2003.
6. Minoda M, et al. Polyethylene Wear Particles in Synovial Fluid After Total Knee Arthroplasty. Clin Orthop. 410:165-172,2003.
7. Kurosaka M, et al. Maximizing flexion after total knee arthroplasty. The needs and the pitfalls. J Arthroplasty 17(4) suppl 1. 2002.
8. Lotke PA. The posterior cruciate ligament in total knee arthroplasty: a commentary. University of Pennsylvania Orthopaedic Journal. Vol 12: 109. 1999.
9. Wright Medical Technology Report. Clinical survey of patient satisfaction – A study of bilateral knee recipients. MK475-701.
10. 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.
11. 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.
12. Laskin R, O’Flynn H. Total knee replacement with posterior cruciate ligament retention in rheumatoid arthritis. Clin Orthop 345:24-28. 1997.
13. Nelson CL. Total knee arthroplasty with preservation of the posterior cruciate ligament. University of Pennsylvania Orthopaedic Journal. Vol 12:96- 99. 1999.
14. Pritchett JW, Patient preferences in knee prostheses. JBJS (BR): 979-982, 2004.
15. Schmidt R, Komistek R, et al., Fluoroscopic Analyses of Cruciate-Retaining and Medial-Pivot Knee Implants. Clin Orthop Relat Res. 410:139-147. 2003.
16. Font-Rodriguez DE, G. Scuderi, J. Insall, R. Windsor and M. Moran: Survivorship of Cemented total knee arthroplasty., Clin Orthop Relat Res. Dec;(345):79-86. 1997.
17. Wright Engineering Report, ER010034.