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generic background for product detail page Prosthesis system for hip replacement

BONEPRESERVATION

Why the system as a whole?

Because with a system, efforts can be directed toward a solution of the challenges:



In that the individual biomechnics of the patient,

Is reconstructed (no change of the position of the femur to the acetabulum – retaining the offset) and therefore no change to bone quality

By reducing wear to below 0.05 mm per year over time,

Through further development of polyethylene to vitamys (vitamin E reduces the aging process of the polyethylene

Through further development of medical ceramics

To optimise the bearing

About

WHY BONE PRESERVATION? The requirements for artificial joint replacements are steadily increasing – the challenges often remain the same: Abrasion particles that cause osteolysis and stress shielding affect bone preservation, the quality of the joint replacement and the long-term stability of the prostheses. Solutions such as bone-preserving design, reduction of abrasion by novel technologies and reconstruction of the patient’s individual anatomy and biomechanics are addressed with the Bonepreservation system.

Optimys

Individual solution for the patient

The optimys was developed to enable the individual reconstruction of the patient’s anatomy, whereby the main construct is the femoral neck. The centre of rotation and the offset are independently retained, irrespective of the initial situation (varus or valgus of the femoral neck).

The design of the short stem and the reconstruction of the individual anatomy enable an improvement of the force distribution in the bone and reduce the stress shielding 1.

RM Pressfit vitamys

Innovation based on clinical evidence

Robert Mathys senior was the first to describe the isoelasticity of standard polyethylene cups, titanium RM cups and human bone1. The wear resistance was further improved through the introduction of vitamys (2009) reducing oxidation of polyethylene, by which osteolysis in the long term is virtually ruled out2.

ceramys

A pearl of ceramics

The quality of medical ceramics and the better wettability virtually rule out wear on ceramic-ceramic bearings and reduce the wear against standard PE to 1/10th1. The advantage of the ceramic-ceramic bearing with regard to wear is counteracted by the need for an additional metal fixation, with the consequence that there is an increase in stress shielding 2. Thus today as an optimum solution Mathys recommends the hard-soft coupling, i.e. ceramys head and RM Pressfit vitamys (highly crosslinked PE stabilised with vitamin E).

Optimys [1] Bieger R., Ignatius A., Reichel H., Dürselen L. Biomechanics of a short stem: In vitro primary stability and stress shielding of a conservative cementless hip stem. J Orthop Res, 2013. 31(8): p. 1180-6. [2] Kutzner K.P., Kovacevic M.P., Roeder C., Rehbein P., et al. Reconstruction of femoro-acetabular offsets using a short-stem. Int Orthop, 2015. 39(7): p. 1269-75. [3] Kutzner K.P., Freitag T., Donner S., Kovacevic M.P., Bieger R., et al Outcome of extensive varus and valgus stem alignment in short stem THA: clinical and radiological analysis using EBRA-FCA. Arch Orthop Trauma Surg, 2017. 137(3): p. 431-439. [4] Overgaard S. Calcium phosphate coatings for fixation of bone implants: Evaluated mechanically and histologically by stereological methods. Acta Orthopaedica Scandinavica, 2000. 71(6): p. 1-74. [5] Kutzner K.P., Pfeil D., Kovacevic M.P., Rehbein P., et al. Radiographic alterations in short-stem total hip arthroplasty: a 2-year follow-up study of 216 cases. Hip Int, 2016. 26(3): p. 278-83. [6] Szmukler-Moncler S., Perrin D., Ahossi V., Pointaire P. Evaluation of BONIT®, a fully Resorbable CaP Coating Obtained by Electrochemical Deposition, after 6 Weeks of Healing: A Pilot study in the Pig Maxilla. Key Eng Mater, 2001. 192-195: p. 395-398 [7] Kutzner K.P., Donner S., Loweg L., Rehbein P., et al. Mid-term results of a new-generation calcar-guided short stem in THA: clinical and radiological 5-year follow-up of 216 cases. J Orthop Traumatol, 2019. 20(1): p. 31. [8] Jerosch J. Kurzschaftendoprothesen an der Hüfte. 2017: Springer. 315 [9] Kutzner K.P., Donner S., Schneider M., Pfeil J., et al. One-stage bilateral implantation of a calcar-guided short-stem in total hip arthroplasty. Operative Orthopädie und Traumatologie, 2017. 29(2): p. 180 - 92. [10] Hochreiter J., Hejkrlik W., Emmanuel K., Hitzl W., et al. Blood loss and transfusion rate in short stem hip arthroplasty. A comparative study. Int Orthop, 2017. 41(7): p. 1347-53. [11] Anderl C., Johl C., Kruger T., Hubel W., et al. Subsidence after calcar-guided short stem total hip arthroplasty: five-year results of a prospective multicentre study. Int Orthop, 2023 [Online ahead of print] [12] Anderl C., Steinmair M., Hochreiter J. Bone Preservation in Total Hip Arthroplasty. J Arthroplasty, 2022. 37(6): p. 1118-23. RM Pressfit Vitamys [1] Mathys R. History - How the success story of the RM classic cup started. In: Horne G, editor. The RM Cup - Long-term experience with an elastic Monobloc acetabular implant: Einhorn-Presse Verlag; 2008. p.11 – 15. [2] Beck M, Delfosse D, Lerf R, Becker R, French G, Hollmann L, et al. Oxidation Prevention with Vitamin E in a HXLPE Isoelastic Monoblock Pressfit Cup: Preliminary Results. In: Knahr K, editor. Total Hip Arthroplasty: Springer Berlin Heidelberg; 2012. p. 21-31. [3] Ihle M., Mai S., Pfluger D., Siebert W. The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br, 2008. 90(10): p. 1284-90. [4] Beck M., Delfosse D., Lerf R., Becker R., et al. Oxidation Prevention with Vitamin E in a HXLPE Isoelastic Monoblock Pressfit Cup: Preliminary Results, in Total Hip Arthroplasty, K. Knahr, Editor. 2012, Springer Berlin Heidelberg. p. 21-31. [5] Halma J.J., Eshuis R., Vogely H.C., van Gaalen S.M., et al. An uncemented iso-elastic monoblock acetabular component: preliminary results. J Arthroplasty, 2015. 30(4): p. 615-21. [6] Scemama C., Anract P., Dumaine V., Babinet A., et al. Does vitamin E-blended polyethylene reduce wear in primary total hip arthroplasty: a blinded randomised clinical trial. Int Orthop, 2016. [7] Rochcongar G., Remazeilles M., Bourroux E., Dunet J., et al. Reduced wear in vitamin E-infused highly cross-linked polyethylene cups: 5-year results of a randomized controlled trial. Acta Orthop, 2021. 92(2): p. 151-155. [8] Ihle M., Mai S., Pfluger D., Siebert W. The results of the titanium-coated RM acetabular component at 20 years: a long-term follow-up of an uncemented primary total hip replacement. J Bone Joint Surg Br, 2008. 90(10): p. 1284-90. [9] Erivan R., Eymond G., Villatte G., Mulliez A., et al. RM Pressfit® cup: good preliminary results at 5 to 8 years follow-up for 189 patients. Hip Int, 2016. 26(4): p. 386-91. [10] Mahmood F.F., Beck M., de Gast A., Rehbein P., et al. Survivorship and Patient-Reported Outcomes of an Uncemented Vitamin E-Infused Monoblock Acetabular Cup: A Multicenter Prospective Cohort Study. J Arthroplasty, 2021. 36(5): p. 1700-6. [11] Rochcongar G., Buia G., Bourroux E., Dunet J., et al. Creep and Wear in Vitamin E-Infused Highly Cross-Linked Polyethylene Cups for Total Hip Arthroplasty: A Prospective Randomized Controlled Trial. J Bone Joint Surg Am, 2018. 100(2): p. 107-114. Ceramys [1] Willmann G. Improving Bearing Surfaces of Artificial Joints; Advanced Engineering Matrials, 2001. 2(3): p 135-41. [2] Huiskes R., Weinans H., van Rietbergen B. The relationship between stress-shielding and bone resorption around total hip stems and the effects of flexible materials. Clin Orthop, 1992. 274: p. 124–34. [3] Al-Hajjar M., Jennings L.M., Begand S., Oberbach T., Delfosse D., Fisher J. et al. Wear of novel ceramic-on-ceramic bearings under adverse and clinically relevant hip simulator conditions. Biomed Mater Res B Appl Biomater. 2013 Nov;101(8). [4] Data on File at Mathys Ltd Bettlach [5] Oberbach T., Begand S., Glien W., Kaddick C. Luxation Test of Different Ceramic on Ceramic Coupling. Key Eng Mater, 2007. 330-332: p. 1235-1238. [6] Begand S., Oberbach T.,Glien W. ATZ – A new material with a high potential in joint replacement Key Eng Mater, 2005. 284-286: p.;983-986.

Clinical Papers

Karl Philipp Kutzner, Steven Mark Maurer, Ingmar Meinecke, Guido Heers, Dominique Bosson

Survivorship, complications and patient‑reported outcomes in calcar‑guided short‑stem THA: prospective mid‑term multicenter data of the frst 879 hips. Arch Orthop Trauma Surgery (2023) 143:1049–1059

Conrad Anderl, Martin Steinmair, Josef Hochreiter

Bone Preservation in Total Hip Arthroplasty. J Arthroplasty. 2022 Jun;37(6):1118-1123.

Az-Eddine Djebara, Abdelkader El Yagoubi, Patrice Mertl, Bachar El Fatayri, Massinissa Dehl, Antoine Gabrion

Comparison of periprosthetic bone mineral density between two types of short-stems in total hip arthroplasty with a mean follow-up of 4 years. Orthop Traumatol Surg Res. 2022; 108(1):103044

Steffen Brodt, Benjamin Jacob, Dimitri Nowack, Timo Zippelius, Patrick Strube, Georg Matziolis

An Isoelastic Monoblock Cup Retains More Acetabular and Femoral Bone Than a Modular Press-Fit Cup: A Prospective Randomized Controlled Trial.J Bone Joint Surg Am. 2021 Jun 2;103(11):992-999.

Peter S Young, Daniela T Macarico, Robert K Silverwood, Omer M Farhan-Alanie, Aslam Mohammed, Kumar Periasamy, Alice Nicol, R M Dominic Meek

Anatomical pelvic loading of a monoblock polyethylene acetabular component. Bone Joint J. 2021 May;103-B(5):872-880.

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