Endoprostheses

How to choose an endoprosthesis

Endoprosthesis suppliers in Russia

As of July 2017, the following suppliers of the most hip arthrostheses are presented in Russia:

• Zimmer ("Zimmer");
• DePuy, Johnson & Johnson ("DePugh," owned by Johnson & Johnson Concern);
• Stryker ("Stryker");
• Smith & Nephew ("Smith & Nephew");
• Biomet ("Bayomet");
• Aesculap, B. Braun (Esculap, B Brown branch).

Almost all of them have factories in different countries, and headquarters are usually located in the United States. In large Russian cities, there are usually representatives of all listed companies.

As of mid-2017, the endoprostheses of the leading Western manufacturers practically do not differ from each other in terms of value for money, so it is reasonable to provide the surgeon with the choice of the manufacturer of hip endoprosthesis.

As of mid-2017, in the arsenal of modern and high-tech endoprosthesis, more expensive and cheaper endoprosthesis models are presented "for every taste and color" around the world. But that doesn't mean expensive models are better. Of course, by releasing a new model of the endoprosthesis, the manufacturer is forced to make it more expensive than previous models, because the development, clinical and laboratory studies of the new implant require significant financial costs. New endoprosthesis models take into account the shortcomings of previous generations, and it is likely that modern models will show themselves to be more durable and reliable.

On the other hand, innovations in endoprosthesis designs are not always a boon. It is appropriate to mention DePuy, a firm owned by Johnson & Johnson, here. This world-renowned firm, which has existed for over 100 years, launched a new cup (acetabulum component) for hip replacement called ASR in July 2003.

However, according to the endoprosthesis register Great Britain , it turned out that this dish gives an unacceptably high percentage of unsatisfactory outcomes (about 4% of the installed endoprostheses required replacement within 2 years). Similar results (3-8%) were observed in other countries. In this regard, in August 2010, DePuy decided to recall ASR cups and stopped selling them. By this time, about 93 thousand such^[1] had already been installed around the world^[1] has^[1].

So new is not always the best thing. Another example: since 1986 DePuy has been producing a leg of the hip joint Corail with hydroxyapatite coating. Since then, more than 700 thousand such legs have been installed in 75 countries, and in 2017 they are popular with doctors involved in endoprosthetics.

Attempts by the patient to independently find an endoprosthesis "better and cheaper" are deliberately meaningless, since endoprosthesis itself is needed for endoprosthesis, but also a set of special tools that are often placed in 3-8 boxes.

A set of tools for installing hip endoprosthesis.

For endoprosthesis, you need not just a few "boxes" with implants, but a full set of implants of various sizes, high-quality tools for installing an endoprosthesis, medical drills and a number of consumables, which should be supplied without problems by a representative of a company that manufactures endoprostheses.

Surgeon and proper rehabilitation is more important than endoprosthesis

Much more important is not how "cool" or "expensive" the endoprosthesis will be chosen, but the quality of the operation. As practice and life show, an incorrect installation (the notorious human factor) will not save the "best" endoprosthesis, but the correctly installed "endoprosthesis-middle peasant-generic" during the operation can confidently and without problems last for many decades.

The unshakable rule: the key to success is the surgeon, not the endoprosthesis. No need to search for the best endoprosthesis - search for the best surgeon! Older surgeons are considered experienced, and rightly so, but the surgeon's age does not always indicate his extensive experience in any particular operation. In our country, there are many thirty-year-old surgeons who operate on 3-5 hip joints every day, accumulating several hundred endoprosthetics per year.

This is an excellent indicator by world standards: the world is considered an experienced surgeon who performs more than 50 hip prostheses per year. If the annual number of operations is less, then such a surgeon will be considered "forever learning" regardless of how old he is: 30, 40, 50, 60 or even 70.

There is another important nuance. The result of endoprosthetics is determined not only by the quality of the operation itself, but also by compliance with the rules and methods of rehabilitation.

Chronicle

2023

For the first time in Russia, a sliding individual hip prosthesis of domestic production was installed

On December 19, 2023, Samara State Medical University (SamGMU) announced the installation of Russia's first domestic sliding endoprosthesis. Previously, only two foreign companies produced such implants. Read more here.

In Russia, endoprosthesis of the knee joint began with the help of a robot traumatologist

For the first time in Russia, Sechenov University performed knee replacement using a new generation robot. The university told about this in early December 2023.

According to doctors, the robot surgeon performs the most complex and highly accurate stage of the operation - planar sawdust of bone structures, so that then an endoprosthesis of the knee joint is installed in these sawdust. The use of the robot prevents any likely errors in bone processing and eliminates the risk of damage to the patient's soft tissues, the Sechenov University emphasized.

For the first time in Russia, Sechenov University performed knee replacement using a new generation robot

It is noted that the planning of such an operation begins even before the patient arrives at the clinic. Based on the patient's CT scan in a special program, a detailed reconstruction of the entire limb and the subsequent installation of the endoprosthesis on the virtual model takes place. The information is then recorded on an external medium and loaded into the robot.

It automatically performs bone segmentation, builds the model itself. We verify this model, clarify the nuances and then position the prosthesis according to the nuances. In the current version of the robot, it takes 20 minutes, "explained Mikhail Elizarov, an orthopedic traumatologist at Sechenov University.

According to university experts, the use of a robotic installation allows you to significantly reduce the period of rehabilitation of the patient, he begins to walk on crutches for the next day. It is also added that the robot eliminates the influence of the human factor and the error of ordinary surgical instruments. Its movements are as accurate as possible, which eliminates soft tissue damage and reduces blood loss. Doctors can now perfectly install the implant and at the same time speed up the operation.^[2]

TriVerse knee replacement implant hit the market

On September 5, 2023, Exactech announced the launch of the TriVerse primary knee replacement system. This solution complements Exactech's knee-deep product range, including Truliant's award-winning primary and revision systems, and Newton's integrated bundle balancing platform. Read more here.

Knee replacement implants made of crosslinked polyethylene came out, like water pipes

On August 21, 2023, the American medical tech company Exactech announced the release of the Truliant (Truliant Knee System) knee replacement system based on advanced polyethylene Activit-E. Read more here.

An ultrasonic device has been created in Russia to replace a surgical saw during prosthetics

The Togliatti State University (TSU) has developed an ultrasonic instrument capable of replacing surgical saws and drills on joint replacement operations. This technology in August 2023 was told in the press service of the Platform of the National Technological Initiative (NTI). Read more here.

Rostov company launches the production of components for exoprostheses after attracting 1 billion rubles of investments

Aluminum Metallurg Rus (AMR) from the Rostov Region has launched a project to produce high-tech components for exoprostheses. For this, cooperation with the state corporation Rostec was launched. The press service of the latter on January 19, 2023 announced that more than 1 billion rubles of private investment were attracted for the project. Read more here.

2022

Russian doctors for the first time installed a prosthetic ankle joint of domestic production

In mid-December 2022, it became known that Russian doctors first installed a prosthetic ankle joint of domestic production. We are talking about the development of the NTI Center "Bionic Engineering in Medicine," which began to be used in the clinics of Samara State Medical University (SamGMU). Read more here.

Zimmer Biomet unveils 3D-printed tibia implant

In November 2022, Zimmer Biomet announced the release of the Persona OsseoTi tibia implant for cement-free knee replacement. Read more here.

Knee implant is released, which is customizable for each patient

On November 17, 2022, Conformis announced the start of commercial implementation of the new Imprint knee system. An orthopedic device company has developed a custom-made implant. It will become Conformis' main proposal for knee joints. Read more here.

Stryker launches 3D-printed implant to create fixed connection between vertebrae

On October 4, 2022, Stryker announced the launch of the Monterey AL system, designed for anterior lumbar interbody endoprosthesis. The implant is the latest addition to the portfolio of 3D-printed interbody devices. Read more here.

Zimmer Biomet has released a system for shoulder repair operations. This is the largest product of the company in 5 years

On September 20, 2022, Zimmer Biomet announced the entry into the market of a shoulder replacement system, which, according to the developers, will help surgeons adapt their approach to the anatomical characteristics of the patient. Read more here.

Total Hip Replacement System Released

On August 16, 2022, Exactech announced the first successful operations using Spartan Stem and Logical Cup systems. The company developed these systems for total hip arthroplasty. Read more here.

Johnson & Johnson Releases First Fully Transformable Endoprosthetics System

On May 17, 2022, the orthopedic device company DePuy Synthes, part of the Johnson & Johnson group, announced the launch of the first fully transformable arthroplasty system for total shoulder joint arthroplasty - Inhance. Read more here.

For the first time in Russia, endoprosthesis was carried out with a combination of 3D printing and a modular prosthesis

In March 2022, for the first time in Russia, endoprosthetics was carried out with a combination of 3D printing and a modular prosthesis. The operation took place at the N.N. Petrov National Medical Research Center of Oncology. Read more here.

Implantation of Stryker "sockets" began during endoprosthesis of the shoulder joint

On January 20, 2022, Stryker announced that its Patient-Matched Primary Reversed glenoid was first used in shoulder arthroplasty. The company develops custom implants using Blueprint 3D planning software. Read more here.

2021

Traumatologists from Moscow were the first in the world to endoprosthesis of the talus with bilateral damage

At the end of July 2021, it became known about a unique endoprosthetics operation, which was carried out by doctors at the S.S. Yudin Clinical Hospital in Moscow. The patient is a 69-year-old woman with a diagnosis of aseptic necrosis of the talus bones of both feet (death of bone tissues, which is located between the bone of the leg and foot).

Because of this disease, there is a gradual destruction of bone tissue and a decrease in the mobility of the joint. In particular, to the absence of the ability to move independently. As a rule, such a disease develops gradually over several years and is accompanied by severe pain in the affected limbs. The woman could no longer fully walk, she moved around the house with great difficulty and pain in her legs.

Moscow traumatologists from the hospital named after S.S. Yudin were the first in the world to endoprosthesis of the talus with bilateral damage

There are no cases of arthroplasty of the talus in patients with bilateral damage in domestic and foreign sources, the press service of the Moscow Department of Health emphasizes.

In orthopedic practice, there are few cases of total replacement of talus with individual prostheses based on computer modeling. The template for the manufacture of the endoprosthesis in these cases is a healthy foot. In this situation, it was impossible to copy and simulate the affected area of ​ ​ the limb due to the damage to both ramming bones, explained the head of the department of traumatology and orthopedics of the hospital named after S.S. Yudina Sargon Tamoev.

Hospital doctors attracted scientists and engineers from Tomsk who were able to make the necessary prosthesis. They managed to simulate the physiological shape of the patient's bone. Work on 3D restoration with analysis of a large number of CT images took about three months. The total individual ceramic prosthesis of the talus bone was made of an ultra-strong and biocompatible material - zirconium stabilized ceramics. The operation to prostrate the talus was successful, the patient quickly recovers from the operation.^[3]

Profemur Gladiator HA Collared Stem Announcement - Systems for Complete Hip Replacement

At the end of February 2021, the American developer of orthopedic devices and technologies MicroPort Orthopaedics released Profemur Gladiator HA Collared Stem and Profemur Gladiator Cemented Collared Stem rods for hip endoplasty. Now, the Gladiator Hip Stem System is fully equipped and can be used for complete hip replacement or to treat patients with femoral head fractures. Read more here.

2020

The production of hip endoprostheses first started in Moscow

In August 2020, for the first time in Moscow, hip arthrostheses began to be produced. It was launched at the Track-E Composite enterprise. The capital's mayor Sergei Sobyanin took part in the opening ceremony of the production line. Read more here.

Smith & Nephew Hip Replacement System Announcement

At the end of July 2020, Smith & Nephew introduced the RI Hip Navigation system, designed for complete hip replacement. This technology ensures maximum accuracy and reproducibility of surgery and assists surgeons in complex cases of complete arthroplasty. Read more here.

In Russia, the production of medical devices began, which reduce the cost of prosthetics of joints by 20%

In mid-July 2020, the Russian developer of TREK-E Composite endoprostheses signed a contract with the Belebeyevsky Avtonormal Plant (BelZAN) for the production of medical fasteners and components for endoprosthesis and traumatology. This project is expected to help reduce the cost of joint prosthetics by 20%. Read more here.

2019

Russia began to install a voice prosthesis that has no analogues in the world

In October 2019, it became known that the doctor of the city clinical oncological hospital No. 1 Leonid Kozhanov created an unparalleled voice prosthesis in the world, which has already begun to be installed in patients.

One of them was diagnosed with laryngeal sarcoma and underwent a laryngectomy, an operation to remove the larynx. parts of the voice set. After that, doctors performed tracheopesophageal bypass and endoprosthesis. Thanks to the new invention, the patient's voice fully recovered. By the end of October 2019, he lives a normal life, there is no recurrence of the disease.

In

It is noted that the voice prosthesis is a very complex and thin structure. The creation of the device began with drawings and a mold. Then the specialists conducted an acoustic analysis of the voice, measured the pressure in the voice apparatus during the operation of the prosthesis. This is necessary to create normal pressure in the trachea and larynx. The mechanism allows you to bring the sound of the voice as close as possible to the real, not robotic.

The patient takes a deep breath and on exhalation supplies about two liters of air to the prosthesis and esophagus. Thanks to this, the voice is as close as possible in sound to the usual.

Work on the creation of the prosthesis began back in 2006, after many years of clinical research, the device was patented.

The uniqueness of the solution of Russian specialists lies in its long service life. The prosthesis serves patients for a total of 12 years, while foreign analogues barely "survive" to a six-month term. Moreover, their replacement is impossible without surgery.

According to Kozhanov, by the end of October 2019, two patients are under the supervision of doctors, whose life of this prosthesis is 11 and 12 years.^[4]

Johnson & Johnson unveils cement-free knee endoprosthesis

In mid-September 2019, Johnson & Johnson's DePuy Synthes division announced the launch of an Attune knee endoprosthesis with cement-free fixation. The novelty will go on sale in several countries at once. Read more here.

2016: Medtronic buys low-cost endoprosthesis developer Responsive Orthopedics

In early June 2016, Medtronic announced the purchase of knee and hip prosthesis developer Responsive Orthopedics. The value of the deal was not disclosed. With this acquisition, Medtronic is set to enter the low-cost joint endoprosthesis market in 2017. Read more here.

2014: $7bn worth of prosthetic knee and hip surgery in the US

According to The Star Tribune, the installation of prostheses for the knee and hip joints is the most common surgical operation state under the free medical care program for the elderly in. USA In 2014 alone, about 400 thousand such operations worth more than $7 billion were carried out throughout the country. The average cost of treating and restoring one such patient ranges from $17 thousand to $33 thousand.^[5]

See also

• Bionic prostheses
• Neuroartificial limbs
• Prosthetic legs

Notes