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• Your Company Name
  • Your Product Name
• Advanced Bio-Surfaces, Inc.
  • Knee interpositional arthroplasty device
  • Metallic medial hemiarthroplasty implant
  • Ortho-Glide medial knee implant system
• BioTechnology USA, Inc.
• Tibial knee
• Biomet Orthopedics, Inc.
  • Oxford Unicompartmental knee system (1)
  • Repicci II Unicondylar knee system
  • Vanguard Unicondylar knee system
• ConforMIS, Inc.

• Unicondylar knee repair
• uCR or unicompartmental resurfacing

• Smith & Nephew (1)
  • Accuris
• Stryker Orthopaedics AND

• Avon Patellofemoral Knee
• EIUS Unicondylar Knee (1)
• Peri Apatite Biological Coating for knees
• X3 - Advanced Bearing Technology
• Wright Medical Technology (1)
• Advance Unicompartmental Knee

• Zimmer Austin AND
  • Comprehensive Natural-Knee family
  • CSTi (OR Cancellous-Structured Titanium) porous coating
  • Unicompartmental interpositional spacer
  • Knee joint tibial (hemi-knee) metallic resurfacing uncemented
  • Unispacer Knee System
  • Unicompartmental High Flex Knee System (2)
• Knee Resurfacing AND
  • Arthrofibrosis
  • Biomaterials
    • Hydroxyapatite
    • Porous metal
  • Biocompatible polymers
  • Cement fixation
  • Coatings
    • Polyethylene (2)
    • Titanium porous coating
  • Growth factors
  • Implant loosening
  • Kinematics (1)
  • Medial OR lateral tibiofemoral
  • Osteoarthritis OR arthritis (3)
  • Osteolysis
  • Osteonecrosis
• Knee joint patellar (hemi-knee) metallic resurfacing uncemented

• Knee joint tibial (hemi-knee) metallic resurfacing uncemented

(A small sampling of results from a December 1, 2006 - March 15, 2007 MIB Abstract Alert search)

Simultaneous in vitro measurement of patellofemoral kinematics and forces following Oxford medial unicompartmental knee replacement

Journal of Bone and Joint Surgery. (British volume). London: Dec 2006.Vol.88, Iss. 12; pg. 1591, 5 pgs

A J Price, P T Oppold, D W Murray, A B Zavatsky

The Oxford medial unicompartmental knee replacement was designed to reproduce normal mobility and forces in the knee, but its detailed effect on the patellofemoral joint has not been studied previously. We have examined the effect on patellofemoral mechanics of the knee by simultaneously measuring patellofemoral kinematics and forces in 11 cadaver knee specimens in a supine leg-extension rig. Comparison was made between the intact normal knee and sequential unicompartmental and total knee replacement. Following medial mobile-bearing unicompartmental replacement in 11 knees, patellofemoral kinematics and forces did not change significantly from those in the intact knee across any measured parameter. In contrast, following posterior cruciate ligament retaining total knee replacement in eight knees, there were significant changes in patellofemoral movement and forces.
The Oxford device appears to produce near-normal patellofemoral mechanics, which may partly explain the low incidence of complications with the extensor mechanism associated with clinical use.

**Click Here to view the full text of this abstract**

Proquest Identifier: 1187679221
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Smith & Nephew could succumb to private equity HEATHCARE; [LONDON 1ST EDITION]

Financial Times. London (UK): Dec 27, 2006. pg. 16

SALAMANDER DAVOUDI

Smith & Nephew is vulnerable to a takeover bid from private equity groups, according to corporate brokers, after Europe's biggest medical devices company was knocked out of the auction for Biomet, its US rival.

Analysts believe S&N's failure to close the deal - its second attempt to bulk up in size in three years - makes it a target for private equity rather than industry buyers.

Financial sponsors are considered to be the most likely buyers because they would not face the same regulatory hurdles that rival trade companies would.

"We maintain the view that an industry bid is unlikely due to the anti-competitive marker share positions an acquiror of S&N would gain. Therefore the most likely source of a bid would be from private equity," the team at Dresdner Kleinwort said. It values S&N at 537p a share. The shares closed at 533p last Friday.

Some analysts believe that the private equity consortium that bought Biomet for Dollars 10.9bn (Pounds 5.6bn) could bid for S&N with the aim of putting both companies together and floating the enlarged group within a few years.

However, others believe S&N is well positioned to restructure itself. The healthcare team at UBS, for example, said it could"benefit from improving top-line growth from strong orthopaedic launches".

Lehman Brothers said the group could also benefit from a turnround in the wound management business - a division S&N had planned to sell had it won the Biomet auction.

The bank believes that S&N's new management team led by Adrian Hennah, chief financial officer, is more "dynamic and better focused on cost control".

Investors will also be keen to hear the results of S&N's cost- saving program, which will be relayed to the market in the first quarter of 2007.

S&N generates half its revenue from its core orthopaedic business, which manufactures hip and knee implants. Half of all sales are generated in the US. The global hip and knee market is rising at an annual rate of 6 per cent because of an ageing and affluent baby-boomer generation.

Proquest Identifier: 1186294281
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ORIGINAL ARTICLE; ADAPTIVE BONE REMODELLING OF ALL POLYETHYLENE UNICOMPARTMENTAL TIBIAL BEARINGS

ANZ Journal of Surgery. Oxford: Jan 2007.Vol.77, Iss. 1-2; pg. 69

R. Mark Gillies, Michael C. Hogg, Lawrence Kohan, Rebecca L. Cordingley

Failure of unicompartmental knees is either by progressive osteoarthritis or by failure of the prosthesis. Prosthesis failure can be because of either the actual component itself or its fixation method. Specifically, the tibial component may wear, loosen or subside into the tibial metaphyseal bone. We modelled all polyethylene tibial components and investigated the periprosthetic adaptive remodelling of the bone.

Computed tomography scans were used to reconstruct the tibial geometry and a 3-D finite element mesh was created. The tibia loading was set at 45% of the gait cycle. The distal end of the tibia set as fixed. Implant orientations were in accordance with the manufacturer specifications. The bone mineral density changes at three regions of interest under the component were measured and plotted.

All regions of interest became stable at the 12-month time-point. Predictive bone mineral changes were minimal in both reineral density. The Eius (Stryker Orthopaedics, Mahwah, NJ, USA) showed increased loading asorption and deposition. Zones 1-3 for the St Georg Sled (Waldermar Link, Hamburg, Germany) presented evidence of stress shielding and a maximum loss of approximately 6% bone mnd caused an increase in bone mineral density for all regions of interests; the maximum being approximately 10%.

These findings are consistent with the clinical experience of unicompartmental knee replacements, where the changes are small and have little effect on the outcome of the prosthesis. From a mechanical perspective, the results are also consistent when a compliant material is used to distribute loads. They do, however, support the biomechanical theory that a change in geometry influences the loading environment and as a consequence the adaptive response of the bone is also influenced.

Proquest Identifier: 1199086531
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Tennessee Inventors Develop Distal Radius Bone Plating System

US Fed News Service, Including US State News. Washington, D.C.: Dec 26, 2006. pg. n/a

ALEXANDRIA, Va., Dec. 26 -- Chad J. Patterson of Bartlett, Tenn., F. Barry Bays of Collierville, Tenn., and Jeffrey G. Roberts of Germantown, Tenn., have developed a distal radius bone plating system with locking and non-locking screws.

According to the U.S. Patent & Trademark Office: "A bone plating system for fixating distal or proximal ends of long bones includes a bone plate having a head portion and a shaft portion, and a plurality of bone screws, at least one of which is a locking bone screw and at least one non-locking cancellous bone screw. The bone plate has a plurality of plate holes in the head portion and a plurality of plate holes in the shaft portion."

An abstract of the invention, released by the Patent Office, said: "The head portion or the shaft portion of the bone plate may have a plurality of threaded plate holes for engaging the at least one locking bone screw and at least one non-threaded plate hole for engaging the non-locking cancellous bone screw. The non-locking cancellous bone screw and the at least one non-threaded plate hole are configured and dimensioned to have a particularly useful dimensional relationship."

The inventors were issued U.S. Patent No. 7,137,987 on Nov. 21.

The patent has been assigned to Wright Medical Technology Inc., Arlington, Tenn.

The original application was filed on July 2, 2004, and is available at:

For more information about US Fed News federal patent awards please contact: Myron Struck, Managing Editor/US Bureau, US Fed News, Direct: 703/866-4708, Cell: 703/304-1897, Myron@targetednews.com.

Call 800/786-9199 (in the U.S. or Canada) or 703/308-4357 for assistance from a U.S. Patent & Trademark Office Customer Service Representatives and/or access to the automated information message system.

Proquest Identifier: 1185589311
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Women's Wellness

The Saturday Evening Post. Indianapolis: Nov/Dec 2006.Vol.278, Iss. 6; pg. 22, 1 pgs

New Option for Knee Replacement

The FDA recently approved a new implant designed to fit a woman's anatomy. The Gender Solutions High-Flex Knee was developed by surgeons, including Dr. Robert E. Booth, chief of orthopaedic surgery at Pennsylvania Hospital, and Zimmer, a leading orthopaedic company.

Narrower and less bulky than traditional artificial knees, the new implant option may provide greater flexibility when climbing stairs, sitting in a chair, gardening, and golfing.

"Mounting research indicates that a woman's knee is not simply a smaller version of a man's knee. The differences involve the bones, ligaments and tendons in the joints," explained Dr. Booth.

Proquest Identifier: 1183242001
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UNIVERSITY OF TEXAS, U.S.; University of Texas, U.S., describe recent developments

Pharma Investments, Ventures & Law Weekly, January 14, 2007

Orthopaedic surgeons at University of Texas Southwestern Medial Center are the first in North Texas to use knee implants specifically designed to fit a woman's anatomy.

The implant addresses three distinct and scientifically documented shape differences in women's and men's knees. Designed using three-dimensional computed tomography imaging, the Gender Solutions High-Flex Knee more closely mimics the joints and inner workings of women's knees.

"We'll be the first in Dallas to use the new design," said Dr. Robert Bucholz, chairman of orthopaedic surgery at UT Southwestern. "This is one in a series of technical improvements in the design of knee implants that is long overdue."

During total knee replacement surgery, or arthroplasty, surfaces of the thighbone (femur), the shinbone (tibia) and the kneecap (patella) are replaced with a metal-and-plastic implant.

Traditionally, the implants have been designed based on men's knees. For women, smaller implants were used, but size did not resolve the anatomical differences, which sometimes accounted for pain and discomfort and an "awkward" feeling.

Researchers have found numerous shape differences between the average male and female knee. The new replacement, created by Zimmer, Inc., of Warsaw, Ind., and approved in May by the Food and Drug Administration, addresses three gender-specific issues:

- Narrower shape: Knee implants are typically sized by measuring the end of the femur from front to back and from side to side. Most women's knees are shaped like a trapezoid and narrower from side to side; men's knees are more rectangular. Implant size is typically based on the front-to-back measurement to allow the knee to move and flex properly. In women, however, an implant that fits from front to back can be too wide from side to side, sometimes causing it to overhang the bone.

- Thinner density: Typically, the bone in the front of a woman's knee is less prominent than in a man's. After traditional implantations, some women describe a "bulky" feeling in the joint despite better function. The front of the new implant is thinner so the replacement more closely matches the female anatomy.

- Tracking: A woman's femur attaches to the tibia at a slightly different angle than a man's because most women have wider hips. The angle difference between the pelvis and the knee joint - taken into account with the new implant - affects how the kneecap tracks over the end of the femur as the knee moves through a range of motion.

Dr. Bucholz said about 80% of knees are replaced because patients suffer from osteoarthritis. The condition causes the cartilage that cushions the bones of the knee to soften and wear away. The bones then rub against one another, causing knee pain.

The number of joint and knee replacement procedures performed by orthopaedic surgeons is increasing due, in part, to aging baby boomers and an increasingly overweight population. In the 1950s, the first artificial knees were little more than crude hinges; now there are a variety of knee-replacement designs that take into account age, weight, activity level and overall health.

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Effects of patellar resurfacing on contact area and contact stress in total knee arthroplasty.

Knee. 2007 Mar 5; [Epub ahead of print]

Xu C, Chu X, Wu H.

Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai, 405 Feng Yang Road, Shanghai 200003, PR China; Department of Orthopaedics, Jiangsu Provincial Corps Hospital, Chinese Peoples' Armed Police Forces, 227 Yun He Xi Road, Yangzhou, Jiangsu 225003, PR China.

The objective of this study was to examine the effects of patellar resurfacing on patellofemoral joint contact pressure and contact area in total knee arthroplasty. We tested seven fresh-frozen cadaveric knees using a custom knee jig which permits the simulation of physiologic quadriceps loading. Before patellar resurfacing, the mean peak contact pressure of medial and lateral patellofemoral joints was less than 10 MPa at knee flexion angles of 30 degrees , 60 degrees and 90 degrees , that of medial and lateral patellofemoral joints were 11.63 MPa and 11.42 MPa at a knee flexion angle of 120 degrees respectively, and the mean contact area of patellofemoral joint ranged from 70 to 150 mm(2). After patellar resurfacing, the mean peak contact pressure of medial and lateral patellofemoral joints ranged from 50 to 100 Mpa (P<0.05), which exceeds the yield strength of ultrahigh molecular weight polyethylene, and the mean contact area of patellofemoral joint reduced to 10-15 mm(2) (P<0.05). The contact pressure of patellofemoral joint was lower than the yield strength of articular cartilage before patellar resurfacing. Our results indicate that the yield stress of UHMWPE is exceeded after patellar resurfacing.

PreMedline Identifier: 17344046

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Fixation strength comparison of onlay and inset patellar implants.

Knee. 2007 Feb 19; [Epub ahead of print]

Rosenstein AD, Postak PD, Greenwald AS, Oxon DP.

Texas Tech Medical Center, Department of Orthopaedic Surgery, Lubbock, Texas, United States.

Patellar implant fixation continues to be one of the most troublesome areas in total knee arthroplasty (TKA). It has been reported that patellofemoral complications in TKA are responsible for almost half of all re-operations. The literature review revealed the rate of primary all-polyethylene patellar implant loosening ranging 1%-4.2% [Berend ME, Ritter MA, Keating EM, Faris PM, Crites BM. The failure of all-polyethylene patellar components in total knee replacement. Clin Orthop 2001;388:105-11, Chew JT, Stewart NJ, Hanssen AD, Luo ZP, Rand JA, An KN. Differences in patellar tracking and knee kinematics among three different total knee designs. Clin Orthop 1997;345:87-98, Barrack RL, Wolfe MW, Waldman DA, et al. Patellar resurfacing in total knee arthroplasty: a five to seven year follow-up of prospective, randomized, double-blind study. Proceedings of Sixty-Seventh Annual Meeting of the American Academy of Orthopaedic Surgeons 2000. p. 547]. The loosening rates for metal-backed or following patellar component revisions were considerably higher [Chew JT, Stewart NJ, Hanssen AD, Luo ZP, Rand JA, An KN. Differences in patellar tracking and knee kinematics among three different total knee designs. Clin Orthop 1997;345:87-98, Jordan LR, Sorrells RB, Jordan LC, Olivo JL. The long-term results of a metal-backed mobile bearing patella. Clin Orthop 2005;436:111-8, Berger RA, Lyon, JH, Jacobs JJ, Barden RM, Berkson EM, Sheinkop MB, et al. Problems with cementless total knee arthroplasty at 11 years followup. Clin Orthop 2001;392:196-207, Ritter MA, Pierce MJ, Zhou H, Meding JB, Faris PM, Keating EM. Patellar complications (total knee arthroplasty). Effect of lateral release and thickness. Clin Orthop 1999;367:149-57] Onlay and inset patellar components with variable fixation surface geometry are currently available for clinical use. The purpose of this study was to quantify the shear disassociation strength for both onlay and inset patellar fixation techniques. The variation in host material was minimized by the use of synthetic patellae, which has been previously validated in implant fixation studies. The testing revealed that inset patellar fixation resistance to shear disassociation was 25% higher than onlay patellae (p=0.0002).

PreMedline Identifier: 17317188

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Asymmetrical total knee arthroplasty does not improve patella tracking: a study without patella resurfacing.

Knee Surg Sports Traumatol Arthrosc. 2007 Feb;15(2):184-91. Epub 2006 Aug 15.

Barink M, Meijerink H, Verdonschot N, van Kampen A, de Waal Malefijt M.

Orthopaedic Research Laboratory, Radboud University Nijmegen Medical Center, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands, n.verdonschot@orthop.umcn.nl.

It is often suggested that patella tracking after total knee arthroplasty (TKA) with an asymmetrical patella groove is more physiological than with a symmetrical patella groove. Therefore, this study tried to address two questions: what is the effect of TKA on patella tracking, and is patella tracking after asymmetrical TKA more physiological than patella tracking after symmetrical TKA? The patellar and tibial kinematics of five cadaveric knee specimens were measured in the intact situation, after the incision and suturing of a zipper, and after placement of a symmetrical TKA and an asymmetrical TKA, respectively. The patellae were not resurfaced. The flexion-extension kinematics were measured with an internal and external tibial moment to determine the envelope of motion (laxity bandwidth) of the tibio-femoral and patello-femoral articulation. The kinematics after TKA showed statistically significant changes in comparison to the intact situation: patellar medio-lateral translation, patellar tilt and tibial rotation were significantly affected. No statistically significant differences in knee kinematics were found between the symmetrical and the asymmetrical TKAs. We conclude that conventional TKA significantly changes physiological patello-femoral kinematics, and TKA with an asymmetrical patella groove does not improve the non-physiological tracking of the patella.

PreMedline Identifier: 16909300

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Cartilaginous deposits in subchondral bone in regions of exposed bone in osteoarthritis of the human knee: Histomorphometric study of PRG4 distribution in osteoarthritic cartilage.

J Orthop Res. 2007 Mar 7; [Epub ahead of print]

Zhang D, Johnson LJ, Hsu HP, Spector M.

Tissue Engineering, VA Boston Healthcare System, 150 South Huntington Avenue, Boston, Massachusetts 02130.

The objective of this study was to identify and characterize cartilaginous deposits aggregates in the subchondral bone in areas of the human osteoarthritic knee with exposed bone. A specific aim was to determine the distribution of the joint lubrication molecule, lubricin/superficial zone protein [referred to by its gene, proteoglycan4 (PRG4)], in these cartilaginous deposits and in osteoarthritic cartilage. This work was carried out in the context of assessing the potential contribution of these chondrocyte aggregates for joint resurfacing in certain cartilage repair procedures. The discarded bone cuts of femoral condyles and tibial plateaus were collected from 11 patients with advanced osteoarthritis (OA) of the knee during total knee arthroplasty; 9 women and 2 men with a mean age of 68 years. Sections of paraffin-embedded tissue were stained with Safranin-O, and with antibodies to type II collagen, alpha-smooth muscle actin (SMA), and PRG4. Chondrocyte aggregates were found in the subchondral bone of regions of exposed bone in sections from five individuals. The average diameter of cartilaginous aggregates was 152 microm, and the average depth of the aggregates below the surface was about 475 microm. Most aggregates were fibrocartilaginous and stained positive for type II collagen. Of interest was the finding that the cartilaginous deposits and osteoarthritic cartilage contained PRG4. Only a small percentage of chondrocytes stained positive for SMA. Cartilaginous deposits containing chondrocyte aggregates exist in subchondral bone in regions of exposed bone in some patients with advanced OA of the knee. These cells may be able to contribute to the resurfacing of the joint in certain cartilage repair procedures. (c) 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

PreMedline Identifier: 17343281

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Osteotomy for the early varus arthritic knee.

Sports Med Arthrosc. 2007 Mar;15(1):3-14.

Parker DA, Viskontas DG.

Royal North Shore Hospital, Sydney, Australia. dparker@sydneyortho.com.au

High tibial osteotomy is a well-established procedure for the management of medial compartment arthritis that is currently experiencing a resurgence in popularity. A number of techniques have been described, with the ultimate goal of obtaining appropriate alignment to provide pain relief and functional improvement over a long-term period. Appropriate patient selection and careful surgical technique is necessary to achieve these goals with a minimal risk of complication. Newer technology such as computer navigation promises to improve the overall accuracy of the procedure. The need for alignment correction in combination with ligament reconstruction and chondral resurfacing surgery will increase the indications for this procedure. This article discusses the techniques available for high tibial osteotomy, the results and relative advantages of each, and the appropriate surgical technique to achieve optimal results while minimizing complications.

PreMedline Identifier: 17301697

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Effect of retaining a patellar prosthesis on pain, functional, and satisfaction outcomes after revision total knee arthroplasty.

J Arthroplasty. 2006 Dec;21(8):1169-74.

Masri BA, Meek RM, Greidanus NV, Garbuz DS.

Division of Lower Limb Reconstruction and Oncology, Department of Orthopaedics, University of British Columbia, Vancouver, British Columbia, Canada.

It remains controversial whether patients' pain, function, and satisfaction are affected in revision total knee arthroplasty by patellar prosthetic resurfacing. This is a retrospective, comparative cohort study to evaluate this. One hundred twenty-six patients who underwent total knee arthroplasty revision were identified. After revision, the presence or absence of a patellar prosthesis was ascertained. At a minimum of 2 years' follow-up, pain and function were assessed by Western Ontario and McMaster Universities Osteoarthritis Index, Oxford-12, Short-Form 12, and patient satisfaction questionnaires in 110 patients (58 with patellar component, 52 bony shell). Univariate and multivariate analyses demonstrated no significant difference between the 2 cohorts for Western Ontario and McMaster Universities Osteoarthritis Index pain, function, Oxford-12, and satisfaction outcomes. The absence of a patellar prosthesis does not appear to significantly affect pain, function, or satisfaction outcomes after revision total knee arthroplasty.

PreMedline Identifier: 17162177

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