Knee Replacement Questions?

Discover new, game-changing technologies that can help you start living your full life again—a more normal feeling knee,¹ a smoother recovery^2,3 and implants built to last.

Official joint replacement
technology of the
Pro Football Hall of Fame

The Ultimate Knee Replacement Experience

See how knee replacement has changed—and what it can do for you.

Robotics

Designed for you

With 3D digital modeling from the CORI^◊ Surgical System you get a surgical plan that’s customized to your unique anatomy. That means your surgeon can perform your procedure more efficiently and accurately than traditional knee replacement surgery.

Robotics-assisted Surgery

The latest innovation from Smith+Nephew is our handheld robotics-assisted technology for partial and total knee replacements. This advanced technology enables your surgeon to plan and perform your surgery with a greater degree of accuracy than is possible with traditional methods.⁹

A unique plan

Your knee replacement surgery is as unique as you are. After all, it is the only one that’s based on the combination of your individual knee anatomy and the specific implant your surgeon has determined is right for you. To help ensure your implant is positioned and aligned correctly to your anatomy, the CORI^◊ Surgical System creates a customized 3D digital model of your knee. This three-dimensional view helps your surgeon choose the right implant for you. In addition, the 3D digital model eliminates the need to get a CT scan of your knee before your surgery, which reduces your exposure to harmful radiation.

A natural fit

The benefits of robotics-assisted surgery is about more than just a detailed 3D view of your knee. The CORI^◊ Surgical System also helps ensure your procedure is performed as the surgeon planned it, giving you the benefits of enhanced accuracy when compared to traditional knee surgery. Accuracy is important because it not only helps the implant function as intended, it also helps avoid uneven wear which can shorten the longevity of an implant.

More implant options

Unlike other robotics platforms, our system works with all of our partial and total knee implants – including those made from our exclusive VERILAST Technology for added durability. This wide selection allows your surgeon to chose the right implant for you.

Higher patient satisfaction—Smoother recovery^4,5,6

The JOURNEY^◊ II Knee System has been demonstrated to improve a patient’s range of motion more quickly after surgery. This faster recovery, along with the implant’s normal pattern of motion, have been shown to lead to high levels of patient satisfaction.

What Is JOURNEY^◊ II Technology?

The JOURNEY II AKS Difference

One of the most remarkable breakthroughs in design of total knee replacements has been the creation of the JOURNEY II Active Knee Solutions. Designed using the latest in human simulation software, and built using some of the most wear-resistant materials available, this unique implant was designed to address two of the most common concerns associated with knee replacement implants: implant wear and implant feel.

Commonly described as a hinge joint, your knees actually do much more than simply swing back and forth. In fact, every time your knee bends, forces in and around the joint work together to produce a subtle and complex rotational movement that you don’t even realize is there. However, if this rotational movement is removed, the change can be felt in the muscles and ligaments through the entire leg.

An implant built to last

With Smith+Nephew knee implants, your surgeon has access to OXINIUM^◊ Oxidized Zirconium. This unique metal alloy is designed to reduce the effects of implant wear and tear. In fact, OXINIUM knee implants have been lab-tested for durability 9-times longer than the international standard for joint replacements⁷.

What is OXINIUM^◊ Oxidized Zirconium?

If it is determined that an implant made with VERILAST◊ technology is right for you, the femoral – or thighbone portion – of your implant will be made from OXINIUM Oxidized Zirconium – a patented and award winning ceramicised metal alloy that Smith+Nephew spent more than a decade developing.

During manufacture, OXINIUM implants undergo a process that transforms the implant’s surface into a hard, ceramicised metal – while still retaining all of the durability of the underlying metal. In addition to being more durable than a true ceramic, this metal implant’s ceramicised surface is more than twice as hard and therefore twice as resistant to the kind of scratching that can cause a cobalt chrome implant to wear out before its time.¹⁰

John David Burrow, MD

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Dr. John Burrow serves Newport News, VA and surrounding areas with knee replacement expertise. Dr. Burrow uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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Jeffrey R Carlson, MD

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Dr. Jeffrey Carlson combines the advanced technologies and implant options today's knee replacement patients demand. Dr. Carlson uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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Gregory Tanner, MD

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Dr. Gregory Tanner serves Richmond, VA and surrounding areas with knee replacement expertise. Knee replacement surgeon Dr. Gregory Tanner offers advanced surgical technology to patients in the greater Richmond, VA area thanks to the hand-held CORI Robotics-assisted surgical system Dr. Tanner uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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William E Nordt, MD

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Dr. William Nordt is a knee replacement surgeon serving Henrico, VA, Richmond, VA and surrounding areas. Dr. William Nordt has been trained on CORI Knee Technology and uses hand-held robotics-assisted surgery to deliver the highest quality care. Dr. Nordt uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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Aaron Marlow, MD

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Dr. Aaron Marlow serves Portsmouth, VA and surrounding areas with knee replacement expertise. Dr. Marlow uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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Stephen Cummings, MD

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Dr. Stephen Cummings serves Newport News, VA, Richmond, VA, Williamsburg, VA and surrounding areas with knee replacement expertise. Dr. Cummings uses Smith+Nephew implants and technologies, the official Joint Replacement Partner of the Pro Football Hall of Fame.

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Looking for surgeons who who offer CORI Robotics-assisted knee surgery outside the Virginia area? Click here to find a surgeon near you.

A unique plan

Your knee replacement surgery is as unique as you are because it’s the only one that combines your knee’s anatomy with the specific implant your surgeon chooses for you. As a result, your surgery requires an individualized surgical plan to help ensure your implant is positioned and aligned correctly for your anatomy. With robotics-assisted surgery, your surgeon uses the CORI^◊ Surgical System to create a customized 3D digital model of your knee. This three-dimensional view helps your surgeon finalize and verify the right size implant for you and create a detailed surgical plan for how your replacement will be placed in order to optimize movement and function. As an added benefit, the 3D digital model eliminates the need to get a CT scan of your knee before your surgery, which reduces your exposure to harmful radiation.

Yes – you can.

It’s time to stop settling and start getting on with your life. You can take the stairs.^*8 You can go for walks. You can stop being afraid. You can – with the ultimate knee replacement experience.

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What is Knee Arthritis?

Arthritis of the knee is a disease which wears away the cartilage between the femur (thigh bone) and the tibia (shin bone) causing the two bones to scrape against each other, raw bone on raw bone.

Osteoarthritis of the Knee

Although the degenerative process may accelerate in persons with a previous knee injury, many cases of osteoarthritis occur when the knee simply wears out.

When is Knee Replacement Surgery Recommended?

Your surgeon’s recommendation for knee replacement is based mainly on your level of pain and disability; there are no absolute restrictions on age or weight.

The information listed on this site is for informational and educational purposes and is not meant as medical advice. Every patient’s case is unique and each patient should follow his or her doctor’s specific instructions. Please discuss nutrition, medication and treatment options with your doctor to make sure you are getting the proper care for your particular situation.

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References

*Journey II BCS.

Hall, et al. Unicompartmental knee arthroplasty (alias uni-knee): an overview with nursing implications. Orthopaedic Nursing. 2004;23(3):163-171. Accessed April 25, 2019.
- Based on pre-surgical pain levels in UKA patients.
Mayman DJ, Patel AR, Carroll KM. Hospital related clinical and economic outcomes of a bicruciate knee system in total knee arthroplasty patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
Nodzo SR, Carroll KM, Mayman DJ. The Bicruciate Substituting Knee Design and Initial Experience. Techniques in Orthopaedics. 2018;33(1):37-41
- Compared to non-JOURNEY II knees; Based on BCS evidence
1Short-term Range of Motion is Increased after TKA with an asymmetric bicruciatestabilized implant.AcceptedPoster Presentation, AAOS 2018 New Orleans. Kaitlin M. Carroll, Peter K. Sculco, Brian CMichaels,RichardL. Murphy, Seth A, Jerabek, David J. Mayman
2J Orthop. 2017 Jan 7;14(1):201- 206. doi: 10.1016/j.jor.2016.12.005. eCollection 2017. Bi-cruciate substituting total knee arthroplasty improved medio-lateral instability in mid-flexion range
In Vivo Kinematic Comparison of a Bicruciate Stabilized Total Knee Arthroplasty and the Normal Knee Using Fluoroscopy Trevor F. Grieco, MS a, *, Adrija Sharma, PhD a, Garett M. Dessinger, BS a, Harold E. Cates, MD b, Richard D. Komistek, PhD. The Journal of Arthroplasty, September 2017
Testing concluded at 45 million cycles, ISO 14242-1 and 14243-3 define test completion at 5 million cycles. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.
Iriuchishima T, Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. doi:10.4103/ortho.IJOrtho_392_18.
Smith JR, Picard F, Lonner J, et al. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. August 4-9, 2013. Natal, Brazil.
Zardiackas, Lyle D., Kraay, Matthew J., Freese, Howard L, editors. Titanium, Niobium, Zirconium, and Tantalum for Medical and Surgical Applications ASTM special technical publication; 1471. Ann Arbor, MI: ASTM, Dec. 2005

Additional claim statements and support regarding Smith+Nephew implants and Robotics-assisted surgery

Implants that are built to last
- Learn More
LEGION^◊CR Knee with VERILAST^◊ technology was lab-tested for 45 million cycles (estimating 30 years of wear performance) and showed 81% less wear than similar 5-million cycle cobalt chrome implant.
- Learn More
  - ISO 14243-3
  - VERILAST knee wear testing and results apply only to the VERILAST LEGION CR Primary Knee System only. Extended lab-testing for other VERILAST knee systems have not been performed. The results of laboratory wear simulation testing have not been proven to predict actual joint durability and performance in people. A reduction in wear alone may not result in improved joint durability and performance because other factors, such as bone structure, can affect joint durability and performance and cause medical conditions that may result in the need for additional surgery. These other factors were not studied as part of the testing.
Smith+Nephew implants may offer a more normal feeling knee
- Based on JOURNEY^◊ II BCS knee implant
- Learn More
  - Verstaete MA, Van Onsem S, Zambianchi F, et al. Multi-centre evaluation of knee kinematics during different activities for anatomic total knee design. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
  - Sharma A, Dessinger G, Cates H, Komistesk R. In vivo kinematic comparison for subjects having a bi-cruciate substituting TKA vs the normal knee. Poster presented at: 2nd World Arthroplasty Congress; 19-21 April, 2018; Rome, Italy.
  - Kosse NM, Heesterbeek PJC, Defoort KC, Wymenga AB, van Hellemondt GG. Improved maximal flexion after minor adaptations in implant design bicruciate-substituted total knee arthroplasty. Poster presented at 19th Congress of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT); May 30 – June 1 2018; Barcelona, Spain.
89% of patients were able to take the stairs again after surgery.
- Based on JOURNEY^◊ II BCS knee implant patients
  - Iriuchishima T and Ryu K. Bicruciate substituting total knee arthroplasty improves stair climbing ability when compared with cruciate-retain or posterior stabilizing total knee arthroplasty. Indian J Orthop. 2019. DOI:10.4103/ortho.IJOrtho_392_18
A robotics-assisted knee replacement with Smith+Nephew implants may get you back in the game six months sooner than traditional knee replacement surgery
- Based on UKA patients
  - Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771
Over 90% of patients who had a Smith+Nephew knee replacement surgery returned to work within 6 months.
- - Harris AI, Luo TD, Lang JE, Kopjar B. Short-term safety and effectiveness of a second-generation motion-guided total knee system. Arthroplast Today. 2018;4:240–243. 1
Robotics-assisted surgery with Smith+Nephew implants may lead to a faster rehabilitation and shorter recovery time than traditional knee surgery when following your doctor’s recovery plan and physical therapy recommendations.
- Claim 19 & 20 (PCS REC.015)
Due to its improved accuracy, Smith+Nephew robotics-assisted UKA has lower revision rates* compared to conventional techniques
- Shown in clinical studies with follow-up of up to 5.5 years
  - Batailler C, White N, Ranaldi FM, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1232-1240.
  - Battenberg AK, Netravali NA, Lonner JH. A novel handheld robotic-assisted system for unicompartmental knee arthroplasty: surgical technique and early survivorship. J Robot Surg. 2019;14(1):55-60.
  - Gregori A. 5 Yr Experience Semi Active Robotic Partial Knee Replacement: The Financial Impact. Poster presented at: SICOT;October, 2018; Montreal, Canada.
A study has shown Smith+Nephew robotic technology has demonstrated faster return to sport (4.2 vs 10.5 months) when compared to conventional techniques*
- - - *n= 28 (n=11 robotic procedures), p<0.01
      - Canetti R, Batailler C, Bankhead C, Neyret P, Servien E, Lustig S. Faster return to sport after robotic-assisted lateral unicompartmental knee arthroplasty: a comparative study. Arch Orthop Trauma Surg. 2018;138(12):1765-1771

Robotics-assisted surgery with Smith+Nephew implants may help patient get discharged sooner
- Study of UKA patients
  - Sephton BM, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
  - Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.
Robotics-assisted surgery with Smith+Nephew implants may provide patients with a smoother recovery
- Based on JOURNEY II family of implants
  - Mayman DJ, Patel AR, Carroll KM. Hospital Related Clinical and Economic Outcomes of a Bicruciate Knee System in Total Knee Arthroplasty Patients. Poster presented at: ISPOR Symposium; May 19-23, 2018; Baltimore, Maryland, USA.
Robotics-assisted surgery with Smith+Nephew implants may help patients regain function faster
- - Shearman AD, et al. EKS Arthroplasty Conference. May 2-3, 2019; Valencia, Spain.

Additional statements and support regarding Knee Replacement

More than 90% of people who have knee replacement surgery experience dramatic relief in knee pain and are better able to perform common activities.
- Based on pre-surgical pain levels
  - American Academy of Orthopaedic Surgeon website, http://orthoinfo.aaos.org/topic.cfm
The majority of patients experience profound improvements in their physical activity after having knee replacement surgery.
- Based on pre-surgical activity levels
  - Brandes M, et. al., “Changes in physical activity and health-related quality of life during the first year after total knee arthroplasty.” Clin Orthop Relat Res. 1991 Dec;(273):151-6. https://www.ncbi.nlm.nih.gov/pubmed/20981812 Accessed Wednesday, April 17, 2019

Knee Replacement Questions?

Official joint replacement
technology of the
Pro Football Hall of Fame