AAOS 2009 - RESTORIS® MCK MultiCompartmental Knee System
AAOS 2009 - RESTORIS® MCK MultiCompartmental Knee System
AAOS 2009 - RESTORIS® MCK MultiCompartmental Knee System
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RESTORIS ® <strong>MCK</strong><br />
<strong>MultiCompartmental</strong> <strong>Knee</strong> <strong>System</strong><br />
Thomas M. Coon, M.D.
Prevalence of Osteoarthritis (OA)<br />
Unicompartmental tibiofemoral OA is<br />
estimated at 10% 1<br />
Patellofemoral OA is estimated<br />
around 24% 1,2<br />
40-65% of OA patients present with<br />
tibiofemoral-patellofemoral disease 1,2,3<br />
RESTORIS ® <strong>MCK</strong>-bone-conserving<br />
treatment options for unicompartmental<br />
and bicompartmental disease<br />
1 Duncan R, Hay E, Saklatvala J, Croft P. Prevalence of radiographic osteoarthritis: it all depends on your point of view. Rheumatology 2006;45:757-60.<br />
2 Ledingham J, Regan M, Jones A, Doherty M. Rediographic patterns and associations of osteoarthritis of the knee in patients referred to hospital. Annals of the Reeumatic<br />
Diseases 1993;52:520-526.<br />
3 Rolston L, Sprague J, Tsai S, Salehi A. A novel bone/ligament sparing posthesis for the treatment of patellofemoral and medial compartment osteoarthristis. <strong>AAOS</strong> 2006 Annual<br />
Meeting, Poster #P181.
The Argument for Bicompartmental<br />
Arthroplasty<br />
Conserves ligaments and bone<br />
Less loss of proprioception<br />
May increase patient satisfaction<br />
Recovery between UKA and TKA
<strong>System</strong> Requirements of RIO<br />
Enabled Design<br />
Anatomically shaped<br />
Wide range of sizes<br />
Bi-cruciate retaining<br />
Fixed bearing<br />
Modular components for<br />
compartment disease<br />
Modular implants for size<br />
interchangeability<br />
Minimal incision<br />
Bone prep using TGS system<br />
Cemented<br />
Articular<br />
Surface Design<br />
Multicompartmental<br />
Modularity<br />
Fixation Surfaces
Articular Surface Design<br />
Implant geometry based on quantitative mapping of 121<br />
femurs & 115 tibias in 55 healthy, 50 OA and (balance)<br />
cadaver knees.
Articular Surface Design<br />
Implant geometry based on quantitative mapping of 121<br />
femurs & 115 tibias in 55 healthy, 50 OA and (balance)<br />
cadaver knees.<br />
Male Female<br />
C1 – 100-01-0011<br />
Size 1 Size 1<br />
C1 – 100-01-0031<br />
Size 3 Size 3<br />
C1 – 100-01-0048<br />
Size 1 Size 2<br />
C1 – 100-01-0037<br />
Size 3 Size 5<br />
C1 – 100-01-0030<br />
Size 3 Size 3<br />
C1 – 100-01-0035<br />
Size 4 Size 6
RESTORIS ® <strong>MCK</strong> <strong>MultiCompartmental</strong><br />
<strong>Knee</strong> <strong>System</strong>: Design Philosophy<br />
Sculpt the anatomy<br />
<br />
<br />
Preserving bone offers less traumatic<br />
interventions as OA progresses<br />
Implant should fit the anatomy<br />
Design for bicompartmental disease<br />
<br />
Nest components to enable optimal fit &<br />
smooth patella transition<br />
Target the patient-specific knee<br />
<br />
Specificity at just the gender level assumes<br />
all women are created equal
Customized Fit with Off-the Shelf<br />
Components
Fixation Surfaces<br />
Fully contoured anatomic surfaces to permit minimum<br />
bone removal.<br />
Peripheral edges, posts and keels permit entire bony<br />
resection with a single cutting tool.
Robotically Optimized Implants
Articular Surface Design<br />
Study of tibial<br />
plateaus across<br />
size range shows<br />
a lower aspect<br />
ratio would better<br />
fit the tibial plateau<br />
than many current<br />
UNI components,<br />
especially in larger<br />
sizes.<br />
ML (mm)<br />
Baseplate Aspect Ratio<br />
36<br />
34<br />
32<br />
30<br />
28<br />
26<br />
24<br />
22<br />
20<br />
35 40 45 50 55 60<br />
AP (mm)
Excellent bone fit and ligament<br />
balance
Anatomic Reconstruction
I Planned a UKA-Now What
<strong>MCK</strong> Bicompartmental <strong>Knee</strong>
<strong>MCK</strong> Bicompartmental <strong>Knee</strong>
Summary<br />
New tools enable novel approaches<br />
<strong>MultiCompartmental</strong> <strong>Knee</strong> system is:<br />
<br />
<br />
<br />
designed to address the early<br />
spectrum of DJD from single-<br />
to multi-compartmental resurfacing.<br />
based upon extensive anatomic<br />
data in healthy AND arthritic knees.<br />
based upon extensive use of FEA<br />
and dynamic mechanical modeling<br />
tools and cadaver laboratory experience.<br />
C1 – 100-01-0035<br />
Size 4 Size 6
The End