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OXINIUM

Oxidized Zirconium

OXINIUM

Algemeen

More than a decade ago, Smith & Nephew introduced OXINIUM Oxidized Zirconium. This patented metal alloy is available for all of our knee implant systems. Its combination of hardness, smoothness and scratch-resistance makes it a superior choice for hip and knee implants.

OXINIUM material—a metal alloy with the surface transformed to ceramic using a patented process—has proven to be a superior metal for use in hip and knee implants due to its reduced friction and increased resistance to scratching and abrasion. These superior properties result in significantly less wear than can be produced by cobalt-chrome alloy (historically the material of choice in hip and knee implants).


Some facts that may interest you:

  • OXINIUM material has a surface hardness that is over twice that of cobalt-chrome. OXINIUM material may last longer than other implants as it reduces more than half of the implant wear common to other knees and hips based on lab simulator studies.
  • OXINIUM material avoids the risk of brittle fracture that can occur with ceramic implants.
  • OXINIUM material is 20% lighter than cobalt-chrome.
  • OXINIUM material contains <0.0035% for detectable nickel, the leading cause of negative reactions in patients with metal allergies. 

Features

In the past, efforts to reduce wear focused on improving implant design and polyethylene quality. Now there is OXINIUM◊ Oxidized Zirconium, available exclusively from Smith & Nephew. Hardness, lubricity and abrasion resistance are all improved.  Our products may help patients live better. OXINIUM is a material that may last longer.

Features of OXINIUM include
Ceramicized metal bearing surface reduces risk of fracture
Surface transformation, not a coating
Highly wettable, abrasion resistant and low friction ceramic surface
Long term mechanical and chemical stability 
*care needs to be exercised with all bearing surfaces intra-operatively.

References

1. R.H. Zimlich, M. Levesque, W. Jones, H.D. Schutte, Jr., B.J. Livingston, W. Sauer, M. Spector, and K. Weaver, "In-vitro and in-vivo effect of particulate debris on TKA articulating surfaces", scientific exhibit SE038, 65th Ann. Mtg. Am. Acad. Orthop. Surg., New Orleans, LA, March 19-23, 1998.

2. M. Levesque, B.J. Livingston, W.M. Jones, and M. Spector, "Scratches on condyles in normal functioning total knee arthroplasty", Trans. 44th Ann. Mtg. Orthop. Res. Soc., Orthopaedic Research Society, Chicago, IL, 1998, p. 247.

3. M. Long, L. Riester, and G. Hunter, “Nano-hardness measurements of oxidized Zr-2.5Nb and various orthopaedic materials”, Trans. Soc. Biomaterials, 21, 1998, p. 528.

4. G. Hunter and M. Long, “Abrasive wear of oxidized Zr-2.5Nb, CoCrMo, and Ti-6Al-4V against bone cement”, 6th World Biomaterials Cong. Trans., Society For Biomaterials, Minneapolis, MN, 2000, p. 835.

5. G. Hunter, “Adhesion testing of oxidized zirconium”, Trans. Soc. Biomaterials, 24, 2001, p. 540.

6. S. Tsai, J. Sprague, G. Hunter, R. Thomas, and A. Salehi, “Mechanical testing and finite element analysis of oxidized zirconium femoral components”, Trans. Soc. Biomaterials, 24, 2001, p. 163.

7. L. Que, L.D.T. Topoleski, and N.L. Parks, "Surface roughness of retrieved CoCrMo alloy femoral components from PCA artificial total knee joints", J. Biomed. Mater. Res., 53 (1), 1999, pp. 111- 118.

8. J.G. Lancaster, D. Dowson, G.H. Isaac, and J. Fisher, "The wear of ultra-high molecular weight polyethylene sliding on metallic and ceramic counterfaces representative of current femoral surfaces in joint replacement", Proc. Instn. Mech. Engrs., 211 (H1), 1997, pp. 17-24.

9. J. Fisher, P. Firkins, E.A. Reeves, J.L. Hailey, and G.H. Isaac, "The influence of scratches to metallic counterfaces on the wear of ultra-high molecular weight polyethylene", Proc. Instn. Mech. Engrs., 209 (H4), 1995, pp. 263-264.

10. J.L. Hailey, E. Ingham, M. Stone, B.M. Wroblewski, and J. Fisher, "Ultra-high molecular weight polyethylene wear debris generated in vivo and in laboratory tests; the influence of counterface roughness", Proc. Instn. Mech. Engrs., 210 (H1), 1996, pp. 3-10.

11. B. Weightman and D. Light, "The effect of the surface finish of alumina and stainless steel on the wear rate of UHMW polyethylene", Biomaterials, 7 (1), 1986, pp. 20-24.

12. H. Oonishi, Y. Hanatate, E. Tsuji, and H. Yunoki, "Comparisons of wear of UHMW polyethylene sliding against metal and alumina in total knee prostheses", Bioceramics, H. Oonishi, H. Aoki, and K. Sawai (eds.), Ishiyaku EuroAmerica, Tokyo, 1989, pp. 219-224.

13. J.A. Davidson, "Characteristics of metal and ceramic total hip bearing surfaces and their effect on long-term ultra high molecular weight polyethylene wear", Clin. Orthop., 294, 1993, pp. 361-378.

14. J. Fisher and D. Dowson, "Tribology of total artificial joints", Proc. Instn. Mech. Engrs., 205 (H2), 1991, pp. 73-79.

15. M. Jasty, C.R. Bragdon, K. Lee, A. Hanson, and W.H. Harris, "Surface damage to cobalt-chrome femoral head prostheses", J. Bone Joint Surg., 76-B (1), 1994, pp. 73-77.

16. R.Barrack, F.Castro, E. Szuszczewicz, T.Schmalzried, “Analysis of Retrieved Uncemented Porous-Coated Acetabular Components in Patients With and Without Pelvic Osteolysis”, Orthopedics, 25:12, 2002, pp. 1373-1378.

17. Sychterz CJ, Engh CA Jr, Swope SW, McNulty DE, Engh CA, “Analysis of prosthetic femoral heads retrieved at autopsy”, Clin Orthop. 1999 Jan; (358):223-34.

18. R.A. Poggie, J.J. Wert, A.K. Mishra, and J.A. Davidson, “Friction and wear characterization of UHMWPE in reciprocating sliding contact with Co-Cr, Ti-6Al-4V and zirconia implant bearing surfaces”, Wear and Friction of Elastomers, ASTM STP 1145, R. Denton and M.K. Keshavan (eds.), American Society for Testing and Materials, Philadelphia, PA, 1992, pp. 65-81.

19. A.M. Patel and M. Spector, “Tribological evaluation of oxidized zirconium using an articular cartilage counterface: a novel material for potential use in hemiarthroplasty”, Biomaterials, 18 (5), 1997, pp. 441-447.

20. M. Spector, M.D. Ries, R.B. Bourne, W.S. Sauer, M. Long, and G. Hunter, “Wear performance of ultra-high molecular weight polyethylene on oxidized zirconium total knee femoral components”, J. Bone Joint Surg., 83-A (S2), 2001, pp. 80-86.

21. N.J. Hallab, K. Merritt, and J.J. Jacobs “Metal sensitivity in patients with Orthopaedic implants”, J. Bone Joint Surg., 83-A, March, 2001, pp. 428-436.

22. G. Hunter, W.M. Jones, and M. Spector, “Oxidized zirconium”, Total Knee Arthroplasty, J. Bellemans, M.D. Ries, and J. Victor (eds.), Springer Verlag, Heidelberg, Germany, 2005, pp. 370-377. Jani et al, ORS, 49, 2002.

23. Good V, Ries M, Barrack RL, Widding K, Hunter G, Heuer D, Reduced Wear with Oxidized Zirconium Femoral Heads, JBJS in print, 2003. M.D. Ries, W.L. Sauer, S.A. Banks, M. Anthony, and K. Weaver, "Effect of femoral component scratches on wear in total knee arthroplasty", Am. Acad. Orthop. Surg. 66th Ann. Mtg. Proc., American Academy of Orthopaedic Surgeons, Rosemont, IL, 1999, p. 231.

24. M. Ries, S. Banks, W. Sauer, and M. Anthony, "Abrasive wear simulation in total knee arthroplasty", Trans. 45th Ann. Mtg. Orthop. Res. Soc., Orthopaedic Research Society, Chicago, IL, 1999, p. 853.



Living Proof Data
1. Smith and Nephew (2009). The Genesis II Total Knee. Available at:http://global.smith-nephew.com/us/GENESIS_II_TOTAL_KNEE_2968.htmAccessed, November 30, 2009.

2. Smith and Nephew Wins Gender Knee System Clearance (2009). Available at: http://www.allbusiness.com/health-care/medical-practice-orthopedics/5248770-1.html Accessed, December 7, 2009.

3. Bourne RB, Laskin RS, Guerin JS (2007). Ten-year results of the first 100 Genesis II total knee replacement procedures.

4. Orthopedics; 30:83-85.

5. H aas SB, Cook S, Beksac B (2004). Minimally invasive total knee replacement through a mini-midvastus approach: a comparative study. Clin Orthop Relat Res; 428:68-73.

6. H arato K, Bourne RB, Victor J, et al (2008). Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the Genesis II prosthesis. A multicenter prospective randomized clinical trial. Knee; 15:217-221.

7. Karachalios T, Giotikas D, Roidis N, et al (2008). Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomized clinical and radiological trial. J Bone Joint Surg Br; 90:584-591.

8. Laskin RS, Maruyama Y, Villaneuva M, et al (2000). Deep-dish congruent tibial component use in total knee arthroplasty: a randomized prospective study. Clin Orthop Relat Res; 36-44.

9. Laskin RS (2003). An oxidized Zr ceramic surfaced femoral component for total knee arthroplasty. Clin Orthop Relat Res; 191-196.

10. Laskin RS, Davis J (2005). Total knee replacement using the Genesis II prosthesis: a 5-year follow-up study of the first 100 consecutive cases. Knee; 12:163-167.

11. Laskin RS (2006). Reduced-incision total knee replacement through a mini-midvastus technique. J Knee Surg; 19:52-57.

12. Laskin RS (2007). The effect of a high-flex implant on postoperative flexion after primary total knee arthroplasty. Orthopedics;30:86-88.

13. McCalden RW, MacDonald SJ, Bourne RB, et al (2009). A randomized controlled trial comparing „high-flex“ vs „standard“ posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty. J Arthroplasty; 24:33-38.

14. Rothwell A, Taylor J, Wright M, et al (2009). New Zealand Orthopaedic Association: New Zealand Joint Registry Ten Year Report. October 2009.http://www.cdhb.govt.nz/njr/reports/A2D65CA3.pdf Accessed June 6, 2010

15. Emsley D, Newell C, Pickford M, et al (2009). National Joint Registry for England and Wales: 6th Annual Report. www.njrcentre.org.uk Accessed June 6, 2010