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VISIONAIRE*Patient Matched Instrumentation*smith&nephewVisionaire technology*Trademark of Smith & Nephew. - Christophe Maes Product Manager Knees-Shoulders

VISIONAIRE*Patient Matched Instrumentation*smith&nephew• What is Visionaire? The product• Benefits• The process• Pre-operative planning• Surgical technique*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched InstrumentationThe product*smith&nephewPatient matched cutting blocks built fromthe patient’s own preoperative images;- Full leg X-ray- MRI knee jointDisposable, single patient use distalfemoral and proximal tibial cutting blocks;based off the mechanical axisCan be used with GENESIS II andJOURNEY BCS Knee Systems*Trademark of Smith & Nephew.Trademark of Smith & Nephew. Certain marks Reg. Us Pat. & TM Off.

Design features*smith&nephew• Alignment, rotation and sizing are built intothe design• Osteophytes included in block design• Compatible with standard instrumentation forintraoperative adjustments• Incorporates pre-operative, surgeon specificdesign parameters• Made out of Nylon grade 12• Biocompatible material, delivered sterile• Ability to flash-sterilizeTrademark of Smith & Nephew.

Design features*smith&nephewAP AxisCutting SlotEpicondylar AxisPatient InformationMatch Standard MIS Cutting BlockSet Alignment and RotationMatch pins from AP blockTrademark of Smith & Nephew.

Design featuresOblique fixation pin*smith&nephewMedial 1/3 of tibia tuberclePatient informationCutting slotMatch standard MIS cutting blockMatch standard cutting blockSet alignment and rotationMatch pins holes on tibial trialTrademark of Smith & Nephew.

Block fit3 point fixation• Cutting block paddle should beflush distally on the medialcondyle• Cutting block paddle should beflush distally on the lateralcondyle• Anterior flange of cutting blockshould be flush over trochlearnotch• Ensures correct flex/ext position• Soft tissue must be pushed back1 2*smith&nephew3Note: The sulcus is another reference point to ensure the cutting blockhas found its homeTrademark of Smith & Nephew.

Block fit*smith&nephew3 point fixation• Cutting block paddle should beflush distally on the medial plateau• Cutting block paddle should beflush distally on the lateral plateau• Anterior face of cutting blockshould be flush on the anteriorbone medial to the tibial tubercle12Note: Meniscus must be removed and soft tissue pushed back anteriorly3Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched InstrumentationBenefits*smith&nephewMore efficient surgeryLess number of instruments and trays neededSurgical steps that can be eliminatedLess invasive procedureNo violation of the intramedullary canalGreater accuracypreop determination of alignment and sizingIncrease in patient satisfactionless traumatic surgeryQuicker return to life’s activities – faster and more productive recovery*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched InstrumentationThe process*smith&nephewStep 1: Doctor’s office enters patient specific information andschedules patient MRI and full leg X-ray*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewStep 2: Patient completes full leg X-Ray and MRI scan(of knee-joint) and patient images are uploaded to secure website*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewStep 3: Smith & Nephew engineer receives images via securewebsite and design work begins on patient matched instrumentationMRI ScanFull Leg X-Ray*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewStep 4: Patient specific 3D bone models are created*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewStep 5: Instrumentation designed to patient specific anatomical featuresFemurTibia*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewStep 6: Final design manufacturedStep 7: Sterile blocks sent for patient’s surgery*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched InstrumentationPre-opplanning*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewAfter approval of pre operative planning with thesurgeons preferences, blocks are made anddelivered sterile*Trademark of Smith & Nephew.

Surgical technique–femurNote: do not remove osteophytes*smith&nephewPlace cuttingblock on femurDrill distal holesPlace headed pinsin distal holesDrill anterior holesPlace smooth pinsin anterior holesMake Distal cutPlace Std A/P cuttingblock and makefinishing cutsTrademark of Smith & Nephew.

Surgical technique–Tibia*smith&nephewNote: do not remove osteophytesRemoveMeniscusPlace cuttingblock on TibiaDrill proximalholesPlace headed pinsproximal and Drillanterior holesPlace smooth pinsin anterior holesMake Distal cutBegin TrialingTrademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephewTimeline for setupVisit to surgeons / RadiologyValidation MRI (phantom device)MRI / X-ray upload to MemphisValidation pre-op planningSurgery date1 month 4 à 5 weeks*Trademark of Smith & Nephew.

VISIONAIRE*Patient Matched Instrumentation*smith&nephew*Trademark of Smith & Nephew.