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Patient Specific Technologies

Patient Specific Technologies

Prophecy® Pre-Op Navigation Guides

Overview

Prophecy®
Pre-Operative Navigation Guides

To reduce patient dissatisfaction and minimize risk of implant failure, Prophecy® Pre-Operative Navigation Guides deliver more repeatedly accurate resections for optimal function and balanced loading to the prosthesis. This is essential because patient satisfaction and implant survivorship is directly linked to accurate alignment of the prosthetic components in total knee arthroplasty. Studies show the probability of revision surgery at fifteen years with accurate alignment is 4.7%.1-6 However, the rate drastically increases to 54% with malalignment.1-6 Prophecy® can make a measurable difference.

Not all products and options are available in all countries.
 
 

    How Does it Work?

    With normal knee kinematics and stability throughout the full range of motion, aMP™ and eMP™ Knee Systems better replace the natural stabilizing structures of the knee. They also prevent feelings of instability, which is the most common cause of TKA failures.1-6

    Combined with the Prophecy® Pre-Operative Navigation Guides, both knee systems are distinctly capable of delivering successful knee replacements.

     

      Simple Instrumentation

      Conforming Resection Guides

      Replacing much of the standard instruments typically involved in establishing resections, Prophecy® guides conform to each patient’s individual anatomy. Through natural contours and osteophytes, Prophecy® guides are designed to fit precisely to the patient for optimal alignment, implant function, and longevity.

      Competitive designs require resecting through nylon cutting slots, which can contaminate the joint with particulate debris. With built in housing for metal cutting guides, Prophecy® guides are fully compatible with standard instrumentation to provide precise, clean resections and even allow for recuts if necessary.

       

      Improved OR Time

      Reduced Surgical Steps

      Up to twenty or more surgical steps required with standard instrumentation can be eliminated by using Prophecy® guides.

      Reduced Operative and Turnover Time

      Operative and setup time can be greatly reduced by using more surgically efficient and reproducible Prophecy® guides instead of standard instrumentation.

      No IM Canal Penetration

      With alignment and rotation established virtually prior to surgery, Prophecy® cutting guides do not require intramedullary canal penetration. Standard instrumentation previously forced surgeons to drill into the intramedullary canal to establish correct alignment, which could potentially increase the risk of intraoperative complications.

       

      Accurate Results

      Improved Alignment

      By aligning the knee pre-operatively using unobscured anatomic landmarks, Prophecy® guides improve accuracy and eliminate intraoperative bony landmark identification previously required to determine ideal femoral alignment and rotation.

      Standard Checks

      To provide secondary checks for proper alignment and resections, Prophecy® guides are fully compatible with standard instrumentation unlike competitive designs.
      Advantages:
      • More consistent neutral mechanical axis alignment.
      • Fewer +/- 3° outliers of the hip-knee-ankle line.
      • No soft tissue impingement or issues with poor bone quality.

        References

        1. Mayor MB, McNamara JL, Surprenant VA, Jensen RE. Analysis of the failure of 122 polyethylene inserts from uncemented tibial components. Clin Orthop Relat Res. 1991;273:232-42.
        2. D’Lima DD, Chen PC, Colwell CW Jr. Polyethylene contact stresses, articular congruity and knee alignment. Clin Orthop Relat Res. 2001;392:232-8.
        3. D’Lima DD, Hermida JC, Chen PC, Colwell CW Jr. Polyethylene wear and variations in knee kinematics. Clin Orthop Relat Res. 2001;392:124-30.
        4. Jeffrey RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991;73:709-14.
        5. Rand JA, Coventry MB. Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop Relat Res. 1988;232:168-73.
        6. Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res. 1994; 299:153-6


        Prophecy® Gap Balancing System

        Overview

        Prophecy®
        Gap Balancing System

        To provide the surgeon with a more accurate simulation of optimum final implant placement and correction of joint imbalance before any femoral resections are performed, the Prophecy® Gap Balancing System offers balancing-oriented devices and tensioners that significantly overcome limitations of standard instrumentation. The value of this superior gap balancing is illustrated by literature that shows nearly half of all knee revisions can be attributed to a cause that can be prevented with correct gap balancing.1-3


        Not all products and options are available in all countries.

          One-Cut Simulation

          Now, prior to any femoral resections being performed, the Prophecy® Gap Balancing System can simulate the final prosthesis position and alignment, with ligament correction, via a single tibial resection.
           

            Flexion and Extension Gap Balancing

            With the patella reduced for anatomic tibiofemoral gap assessments, Prophecy® guides and instrumentation allow for full extension and 90 degrees of flexion balancing.

              Axial and Rotational Adjustments

              The femoral Prophecy® guide allows for the use of anterior and distal pin guides to account for joint gap corrections that may necessitate axial and rotational adjustments.

                References

                1. Babazadeh S et al. The relevance of ligament balancing in total knee arthroplasty: how important is it? A systematic review of the literature. Orthopedic Reviews 2009; 1:e26.
                2. AOA national joint replacement registry. AOA, 2009 [cited 2009 17/02/2009]
                3. Sheng PY, Konttinen L, Lehto M, et al. Revision total knee arthroplasty: 1990 through 2002. A review of the Finnish arthroplasty. J Bone Joint Surg Am 2006;88:1425-30.