White Papers
This is a collection of white papers. Search to find.
Do Thin Acetabular Shells Increase the Disassociation Risk of Ceramic Liners?
The procedural standard for the fixation of metallic acetabular shells is under-reaming and impaction. Recently, concerns have arisen regarding achieving and maintaining secure ceramic liners when thin shells are deformed during normal insertion. Failure to…
Biomechanical Comparison of Proximal Radius Locking Plates Under Dynamic Loading
Proximal radius fractures are commonly encountered in general orthopaedic and upper extremity subspecialty practices. The surgical treatment of these fractures includes the anatomical reconstruction and stable fixation of the proximal radius to achieve early recovery…
Enhanced Cross-Linked Polyethylene Modular Acetabular Designs: Performance Characteristics
The classic total knee arthroplasty (TKA) mechanical alignment (MA) surgical procedure aspires to consistently establish neutral limb alignment and a coronal joint line perpendicular to the mechanical axis between hip and ankle centers. Soft tissue…
Femoral Stem Modularity: Do the Testing Standards Address the Clinical Concerns?
Femoral head modularity in total hip arthroplasty (THA) design emerged in the 1970’s as an alternative to monolithic stem designs to overcome the disadvantages of limited head size and offset availability. Through the use of…
The Influence of Contemporary Knee Design on High Flexion III: A Kinematic Comparison with the Healthy Intact Knee
Although Total Knee Arthroplasty (TKA) surgery enjoys 90% of outcomes with good to excellent results, some patients are uncomfortable adjusting their gait to accommodate the new articulations inherent in many contemporary implant designs. Paradoxical motions,…
Bone Graft Substitutes: Facts, Fictions & Applications
Excerpt goes here.It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global…
Alternative Bearing Surfaces: The Good, Bad & Ugly
The enduring success of the low-friction arthroplasty advanced by Sir John 2000, more than 270,000 hip arthroplasties were performed in the United States. Over the last three decades, patient profiles have changed substantially, resulting in…
High Flexion in Contemporary Total Knee Design: A Precursor of UHMWPE Damage?
The success of total knee arthroplasty has contributed to its widening application to a younger, more active patient population whose daily regimen includes more demanding high flexion activities. Worldwide expansion to Middle Eastern and Asian…
Musculoskeletal Allograft Tissue Safety
The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade. Surgeon knowledge of tissue bank practices in donor consent and screening, infectious disease testing and processing is important…
Musculoskeletal Allograft Tissue Safety
The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade, Surgeon knowledge of tissue bank practices in donor gifting and screening, serology testing and processing is important when…
Musculoskeletal Allograft Tissue Safety – Improving Safety by Knowing That Your Allograft Has Not Been Recalled or Quarantined
The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade. Surgeon knowledge of tissue bank practices in donor consent and screening, infectious disease testing and processing is important…
The Current State of Cervical and Lumbar Spinal Disc Arthroplasty
The growth of spinal implant and orthobiologic technologies over the last several years is increasing in tempo and fast approaching the US hip and knee markets in annual dollar sales. During this time, a number…
Scaphoid Fracture Repair: A Biomechanical Comparison of Contemporary Cancellous Bone Screws
Scaphoid fractures are common, but often challenging to treat. Clinic studies have demonstrated that both conservative treatment and internal fixation have successful long-term results with the latter providing earlier recovery of motion, decreased immobilization an…
Tibial Plateau Abrasion in Mobile Bearing Knee Systems During Walking Gait: A Finite Element Study
The abrasion observed in ultrahigh molecular weight polyethylene (UHMWPE) total knee arthroplasty component retrievals is the result of high cyclical loads, which act on the tibial plateau during daily ambulation. This dynamic process influences in…
Evaluation of a Mobile Bearing Total Ankle Replacement in Simulation and Clinical Retrieval
The use of total ankle replacements is increasing as an alternative to arthrodesis that allows patients to maintain both mobility and function concomitant with pain relief. Their success, however, remains mixed mostly attributed to the…
High Flexion in Contemporary Total Knee Design: A Precursor of UHMWPE Damage?
The success of total knee arthroplasty has contributed to its widening application to a younger, more active patient population who daily regimen includes more demanding high flexion activities. Worldwide expansion to Middle Eastern and Asian…
Evaluation of Total Disc Replacements with a Novel Multi-Axis Spine Simulator: An A Priori Requirement
The evolvement of cervical and lumbar disc replacement designs as alternatives to spinal fusion has resulted in a significant number of ongoing FDA-sponsored clinical trials. While these seek to establish “safety and effectiveness”, they are…
The Influence of Antibiotics on the Fatigue Life of Acrylic Bone Cement: Assuring Clinical Structural Integrity
Aseptic loosening attributed to cement fracture and the subsequent disruption of fixation interfaces remains a major long-term failure mode of cemented arthroplasty. Knowledge of the fracture strength of bone cement, especially in fatigue, is an…
Antibiotic-Loaded Bone Cement in Aseptic Total Joint Arthroplasty: Whys, Wherefores & Caveats
Deep wound infection following joint replacement is one of the most devastating complications facing both the physician and patient. The use of antibiotic-loaded bone cement (ALBC) is a well-accepted adjunct for treatment of an established…
New Polys for Old: Contribution or Caveat?
The enduring success of the low-friction arthroplasty first advanced by Sir John Charnley as a solution for severe hip arthritic problems may be appreciated from the fact that in 2001 more than 600,000 hip and…
New Polys for Old: Contribution or Caveat?
The enduring success of the low-friction arthroplasty first advanced by Sir John Charnley as a solution for severe hip arthritic problems may be appreciated from the fact that in 2000 more than 600,000 hip and…
The Evolving Role of Bone-Graft Substitutes
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
Highly Crosslinked Polyethylenes: Hopes vs. Realities
The enduring success of the low-friction arthroplasty first advanced by Sir John Charnley as a solution for severe hip arthritic problems may be appreciated from the fact that in 2003 more than 800,000 hip and…
Articular Cartilage Restoration: A Review of Currently Available Methods for Repair of Articular Cartilage Defects
Articular cartilage repair and restoration is an emerging clinical treatment option for patients with injury or disease of articular cartilage. An increasing body of clinical and scientific experience, as well as published literature, supports the…
The Influence of Antibiotics on the Fatigue Life of Acrylic Bone Cement: Assuring Clinical Structural Integrity – Series II
Aseptic loosening attributed to cement fracture and the subsequent disruption of fixation interfaces remains a major long-term failure mode of cemented arthroplasty. Knowledge of the fracture strength of bone cement, especially in fatigue, is an…
Biomechanical Properties of Fixed-Angle Volar Distal Radius Plates Under Dynamic Loading
Distal radius fractures are commonly encountered in general orthopaedic and hand subspecialty practices. Most surgeons are comfortable with both operative and nonoperative management of these fractures. Treatment options have evolved with fracture pattern governing the…
New Polys for Old: Contribution or Caveat?
The enduring success of the low friction arthroplasty first advanced by Sir John Charnley as a solution for severe hip arthritic problems may be appreciated from the fact that in 1999 over 500,000 hip and…
Evaluation of the S.T.A.R. Total Ankle Replacement: An Evolution in Design
The use of total ankle replacements is increasing as an alternative to arthrodesis that allows patients to maintain both mobility and function concomitant with pain relief. Their success, however, remains mixed mostly attributed to the…
Musculoskeletal Allograft Tissue Safety
The use of Musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade, Surgeon knowledge of tissue bank practices in donor gifting and screening, serology testing and processing is important when…
Alternative Bearing Surfaces: The Good, Bad & Ugly
The enduring success of the low friction arthroplasty advanced by Sir John Charnley as a solution for hip problems may be appreciated by the fact that in 1999, over 270,000 hip arthroplasties were performed in…
Tibal Plateau Abrasion in Mobile Bearing Knee Systems During Walking Gait III: A Finite Element Study
The abrasion observed in ultrahigh molecular weight polyethylene (UHMWPE) total knee arthroplasty component retrievals is the result of high cyclical loads, which act on the tibial plateau during daily ambulation. This dynamic process influences in…
The Influence of Kinematic Alignment on Total Knee Replacement Performance During Walking Gait
The goals of total knee arthroplasty (TKA) are to eliminate pain and restore knee function to enable a return to daily activities. The classic mechanical alignment (MA) surgical procedure aspires to consistently establish neutral limb…
Polymer Insert Stress in Total Knee Designs During High Flexion: A Finite Element Study
The success of total knee arthroplasty has contributed to its widening application to a younger, more active patient population who daily regimen includes more demanding high flexion activities. Worldwide expansion to Middle Eastern and Asian…
Preclinical Computational Models: Predictors of Tibial Insert Damage Patterns in TKA
Manufacturers and regulatory agencies share a common goal of having safe and effective total knee arthroplasty (TKA) products available in the global marketplace. Several preclinical methods of testing TKA designs, inclusive of virtual computational models…
Orthopaedic Infection: Community-Associated and Healthcare-Associated MRSA
Methicillin-resistant Staphylococcus aureus (MRSA) is a strain of the staph infection resistant to beta-lactam antibiotics (penicillin, oxacillin, amoxicillin, and methicillin). MRSA is a bacterium commonly carried on the skin or in the nose of healthy…
Preclinical Computational Models: Promise and Progress in Total Knee Arthroplasty Design
Clinicians, manufacturers and regulatory agencies share a common goal of having safe and effective total knee arthroplasty (TKA) products available in the global marketplace. Preclinical computational modeling of new, innovative knee designs allows dynamic visualization…
Bone Graft Substitutes: Facts, Fictions & Applications
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
The Effects of Walking Gait on UHMWPE Damage in Unicompartmental Knee Systems: A Finite Element Study
There is increasing re-interest in the use of unicompartmental knee replacement as a remedy of choice for isolated compartment disease, although there is debate regarding its role as a temporizing or definitive procedure. The popularization…
Does Patient Specific Total Knee Arthroplasty Add Value?
The classic total knee arthroplasty (TKA) mechanical alignment (MA) surgical procedure aspires to consistently establish neutral limb alignment and a coronal joint line perpendicular to the mechanical axis between hip and ankle centers. Soft tissue…
Classification of Mobile Bearing Knee Design: Mobility and Constraint Results
Restoration of normal knee joint function through surgical reconstruction is dependent upon load sharing between the implant and surrounding soft tissue structures. Mobile bearing knee designs offer the advantage of maximum conformal geometry while diminishing…
Adverse Event Reporting – An FDA Requirement: What, When, Who & How
Most orthopaedic surgeons in the course of their practice will encounter and explant medical devices which have failed. Such failures may simply result from long-term in-vivo device usage, component material breakdown, technique at the time…
Orthopaedic Infection Prevention and Control: An Emerging New Paradigm
More than 65 million inpatient and outpatient surgeries are done each year at U.S. hospitals. The Centers for Disease Control and Prevention (CDC) estimate that the rates of surgical site infection (SSI) range from 2%…
The Influence of Antibiotics on the Fatigue Life of Acrylic Bone Cement: Assuring Clinical Structural Integrity
Aseptic loosening attributed to cement fracture and the subsequent disruption of fixation interfaces remains a major long-term failure mode of cemented arthroplasty. Knowledge of the fracture strength of bone cement, especially in fatigue, is an…
Assuring Cement Fixation: All Mixing Systems are NOT the Same
Aseptic loosening attributed to cement fracture and the subsequent disruption of fixation interfaces remains a major long-term failure mode of cemented arthroplasty. Knowledge of the fracture strength of bone cement, especially in fatigue, is an…
Adverse Event Reporting – An FDA Requirement: What, When, Who & How
Most orthopaedic surgeons in the course of their practice will encounter and explant medical devices which have failed. Such failures may simply resuMost orthopaedic surgeons in the course of their practice will encounter and explant…
Musculoskeletal Allograft Tissue Safety
The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade. Surgeon knowledge of tissue bank practices in donor consent and screening, serology testing and processing is important when…
Musculoskeletal Allograft Tissue Safety
The use of Musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade, Surgeon knowledge of tissue bank practices in donor gifting and screening, serology testing and processing is important when…
Femoral Neck Modularity in THA: Not a Bridge Too Far?
Femoral neck modularity in total hip arthroplasty design is receiving increased citation in the clinical literature. The advantages of these systems include a potential reduction in the occurrence of femoro-acetabular impingement and its consequences as…
Tibal Plateau Abrasion in Mobile Bearing Knee Systems During Walking Gait II: A Finite Element Study
The abrasion observed in ultrahigh molecular weight polyethylene (UHMWPE) total knee arthroplasty component retrievals is the result of high cyclical loads, which act on the tibial plateau during daily ambulation. This dynamic process influences in…
Patello-Femoral Replacement Polymer Stress During Daily Activities: A Finite Element Study
Isolated, patello-femoral arthritis, although uncommon, has been reported to affect 8% of women and 2% of men over the age of 55. Both conservative and surgical non-arthroplasty interventions have been advocated, however, their reports suggest…
Bone Graft Substitutes: Facts, Fictions & Applications
Excerpt goes here.Estimates of over 500,000 bone grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
Antibiotic-Loaded Bone Cement in Aseptic Total Joint Arthroplasty: Whys, Wherefores & Caveats
Deep wound infection following joint replacement is one of the most devastating complications facing both the physician and patient. The use of antibiotic-loaded bone cement (ALBC) is a well-accepted adjunct for treatment of an established…
Adverse Event Reporting – An FDA Requirement: What, When, Who & How
Most orthopaedic surgeons in the course of their practice will encounter and explant medical devices which have failed. Such failures may simply result from long-term in-vivo device usage, component material breakdown, technique at the time…
The Influence of Contemporary Knee Design on High Flexion IV: A Kinematic Comparison with the Heathly Intact Knee
Although Total Knee Arthroplasty (TKA) surgery enjoys 90% of outcomes with good to excellent results, some patients are uncomfortable adjusting their gait to accommodate the new articulations inherent in many contemporary implant designs. Paradoxical motions,…
Clinical Retrieval and Simulator Comparison of an Investigational Cervical Disc Replacement
The evolvement of cervical and lumbar disc replacement designs as alternatives to spinal fusion has resulted in a significant number of ongoing United States Food and Drug Administration (USFDA)-sponsored clinical trials. While these seek to…
Virtual Geometric Constraint of Total Knee Arthroplasty Designs: Addressing Patient Needs
Restoration of normal knee joint function through surgical reconstruction is dependent upon load sharing between the implant and surrounding ligamentous and other supporting structures. Pathological weakening or surgical excision of these structures imposes an increased…
Bone Graft Substitutes: Facts, Fictions & Applications
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
Bone Graft Substitutes: Facts, Fictions & Applications
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
The Influence of Contemporary Knee Design on High Flexion: A Kinematic Comparison with the Normal Knee
Although Total Knee Arthroplasty (TKA) surgery enjoys 90% of outcomes with good to excellent results, some patients have difficulty adjusting their gait to accommodate the new articulations inherent in contemporary implant designs. Paradoxical motions inclusive…
Bone Graft Substitutes: Facts, Fictions & Applications
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
Musculoskeletal Allograft Tissue Safety
The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade. Surgeon The use of musculoskeletal allograft tissue in reconstructive orthopaedic procedures has markedly increased over the last decade,…
Do Thin Acetabular Shells Increase the Disassociation Risk of Ceramic Liners?
The procedural standard for the fixation of metallic acetabular shells is under-reaming and impaction. Recently, concerns have arisen regarding achieving and maintaining secure ceramic liners when thin shells are deformed during normal insertion. Failure to…
The Influence of Contemporary Knee Design on High Flexion II: A Kinematic Comparison with the Normal Knee
Although Total Knee Arthroplasty (TKA) surgery enjoys 90% of outcomes with good to excellent results, some patients have difficulty adjusting their gait to accommodate the new articulations inherent in contemporary implant designs. Paradoxical motions inclusive…
Antibiotic-Loaded Bone Cement in Aseptic Total Joint Arthroplasty: Whys, Wherefores & Caveats
Deep wound infection following joint replacement is one of the most devastating complications facing both the physician and patient. The use of antibiotic-loaded bone cement (ALBC) is a well-accepted adjunct for treatment of an established…
Cervical Artificial Disc Wear: The Influence of Surgical Placement
Relative motion at interacting implant surfaces generates wear debris over time leading to periprosthetic osteolysis and device failure. Factors related to implant design, patient habitus and surgical approach will impact the generation of wear debris…
Articular Cartilage Restoration: A Review of Currently Available Methods
Articular cartilage repair and restoration is an emerging clinical treatment option for patients with injury or disease of articular cartilage. An increasing body of clinical and scientific experience, as well as published literature, supports the…
Highly Cross-Linked Polythethylene Modular Acetabular Designs: Performance Characteristics
Modular acetabular designs enjoy widespread use in THA procedures and demonstrate versatility in accommodating musculoskeletal acetabular pathologies. Their mechanical performance has continually improved through enhanced locking mechanism assemblies and shell-liner conformity. Recently, a number of…
The Influence of Mechanical Versus Kinematic Alignment on Knee Design Performance During Walking Gait
Relative motion at interacting implant surfaces generates wear debris over time leading to periprosthetic osteolysis and device failure. Factors related to implant design, patient habitus and surgical approach will impact the generation of wear debris…
Fracture of Highly Crosslinked UHMWPE Acetabular Liners
Four well-placed crosslinked UHMPWE acetabular liners of distinct design were retrieved subsequent to fracture failure of the rim. In each case, electron microscopy of the fracture surface revealed fatigue initiation markings associated with a stress…
Bone Graft Substitutes: Facts, Fictions & Applications
It is estimated that more than 500,000 bone-grafting procedures are performed annually in the United States, with approximately half of these procedures related to spine fusion. These numbers easily double on a global basis and…
The High Performance Modular Hip: What a Surgeon Should Know
Modularity in total hip arthroplasty design has received increased citation in the clinical literature. The advantages of these systems include off-the-shelf flexibility for customizing proximal and distal canal filling, preservation of soft tissue structures, biomechanical…