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Articulate
C
CELE orin
BRAT
ES
30
YEAR
Corin newsletter
1985–
S
2015
Issue 1 March 2015
Corin Group acquires
Australian orthopaedic
technology leader
Optimized Ortho
Corin Group PLC, a leading global manufacturer
and supplier of orthopaedic devices, has
acquired Optimized Ortho, an Australian
orthopaedics technology company that
specialises in providing surgeons with unique
state-of-the-art technologies for optimising
orthopaedic implant component positioning and
procedural innovation.
The acquisition provides Corin with an IPprotected technology that is the first of its kind
within the orthopaedic field. The combination
of the Optimized Positioning System (OPS™)
technology, alongside the company’s strong hip
and knee portfolio and rapidly expanding global
distribution network, provide a strong foundation
for future growth of the company.
Every patient has a unique pelvic motion which
influences how a total hip replacement will
function in day-to-day activities. The OPS™
technology, for the first time, gives the surgeon
the ability to identify, customise and deliver an
exact patient-specific component orientation
designed to optimise biomechanics and
functional joint performance.
continued on page 3...
Global Marketing
Director update
Corin continues to invest heavily
in its production facilities
Are all polyethylenes
created equal?
Unity Knee™
Interview with Dr Orhun Muratoglu Respecting the soft tissue
envelope - Dr Stefan Kreuzer
8
Calendar of events
Forthcoming global meeting
and exhibitions calendar
COMPANY
NEWS
USA
Corin USA
continues to expand
its presence across the
United States and over the
last five years we have seen an unprecedented
growth from our ever expanding and
innovative hip, knee and advanced bearing
portfolio. The Unity Knee™ system
continues to generate significant interest
with Equibalance™ instrumentation to
help address MCL isometry and patient
satisfaction outcomes. We are also half
way through one of our largest ever
clinical IDE investigation initiatives with
the Trinity™ ceramic-on-ceramic IDE
program. Enrolment in this IDE program
will be complete in the first half of 2015 and
we look forward to making this advanced
bearing available for the Trinity™ cup
system in the near future. To prepare for
the forthcoming release of our OPS™
technology in the USA we held a national
OPS™ training program for our distributors
and sales representatives to ensure full
support for our surgeon communities over
the coming months. We look forward to
sharing these exciting developments with you
at the forthcoming AAOS in Las Vegas.
Italy
Corin Italy opens
its doors!
Strengthening and expanding
the global reach of the Corin Group we are
delighted to announce the opening of the new
Corin Italian subsidiary based in the north of
Italy, in the province of Udine.
The opening of this subsidiary will enable
Corin Group to provide the Italian
community of surgeons with innovative and
ground breaking products. ‘Our unique
approach is focused on a responsive model’,
Mr Stefano Alfonsi, CEO and Chairman of
Corin Group said. ‘We have a lot more to do.
But by working with our Italian customers,
building powerful synergies, together we can
build many more. We are focused on what
innovation will come next to provide our
global customers with even more quality,
responsive support and responsible innovation
worldwide. We are confident that the Italian
team will contribute significantly towards
Corin’s success in 2015 and grow our presence
in the Italian market which is close to my
heart’, he added.
2
Company update
Andy Sutcliffe – Group Marketing Director
2015 is an exciting year for Corin
as we reach an important milestone
celebrating 30 years in the orthopaedic
community. Corin’s success is not least
due to its desire to continue to innovate
across our extensive hip, knee,
extremities and ligament portfolio but
in view of the exciting new phase we
are about to embark on. Orthopaedic
companies have, for many years, focussed on developing implant
solutions with little regard for some of the long standing clinical
needs associated with joint replacement. We have recognised
the need to challenge these issues head on and to find unique
solutions to help improve patient outcomes.
The acquisition of Optimized Ortho is one such example
and provides a world first technology to identify and deliver
an optimised implant orientation in total hip replacement
based on individual patient specific pelvic movements during
functional activities. We have also recognised the importance
of challenging patient satisfaction in knee replacement and,
working with an eminent group of global knee surgeons,
delivered innovative solutions for our Unity Knee™ platform
to help achieve functional soft tissue isometry and better
outcomes for patients. We continue to invest heavily in these
areas and focus our R&D efforts to address ongoing clinical
needs and developments that can help improve patient lives.
To support these developments we are also investing heavily
in our global infrastructure including new facilities in the US,
South Africa, Italy and Australia and a multi-million pound
state-of-the-art manufacturing facility at our headquarters in
Cirencester, UK. This will support our ever expanding global
reach (over 40 countries around the world) giving patients and
healthcare practitioners greater access to these technologies.
With our commitment to ‘Responsible Innovation’ we are
proud to support investments that can help meet the need for
improved healthcare solutions and throughout this first issue of
our newsletter we would like to share some of our developments,
success stories and continued investments we are making to
deliver best in class products, services and technologies to
support our global partners and surgeon community.
AAOS 2015
Corin is delighted to be
attending the American
Academy of Orthopaedic
Surgeons in Las Vegas with
their largest ever booth space
from Wednesday 25 to Friday
27 March. Please come
and visit us at our booth (2625) to discuss our diverse and
innovative surgical implant solutions and technologies.
Along with our hip, knee, ankle and ligament product portfolio
Corin will also be showcasing the Optimized Positioning
System (OPS™) for the first time. This technology utilises a
dynamic and functional pre-operative simulation to provide
predictive, patient-specific information, designed to optimise
in vivo component positioning and behaviour together with a
unique laser guided positioning system.
For further information please contact us at [email protected] or telephone +44 (0)1285 649 230.
Optimising outcomes
Appropriate acetabular cup orientation is an
important factor in reducing instability and
maximising the performance of the bearing
after Total Hip Arthroplasty (THA). However,
post-operative analyses of two large THA
cohorts in the US have shown that more
than half of cups are malorientated1,2.
In addition, there is no consensus as to
what inclination and anteversion angles
should be targeted, and no consensus on
which reference plane these angles should
be described3. Commonly, four reference
planes are quoted: the anterior pelvic plane,
the coronal plane when supine, the coronal
plane when in the lateral decubitus position
and the coronal plane when standing.
Frequently these reference planes are used
interchangeably, leading to significant errors
in planning and measuring cup orientation
due to the differences in pelvic tilt in each of
these positions4.
For example, a significant majority of cups
are still implanted with the patient in the
lateral decubitus position, with target angles
of 40° inclination and 15° anteversion
as defined by Lewinnek et al5. However,
Lewinnek’s recommended orientation is
referenced to the anterior pelvic plane,
an anatomical plane which is specific to
each individual, potentially offset by more
than 30° from the coronal plane and not
accurately reproducible during surgery6.
Furthermore, the post-operative analysis
will likely be performed on an X-ray with
the patient supine. Due to the differences
in pelvic tilt, the inclination and anteversion
angles of the cup when supine will appear
different to those seen on the table or in
reference to the anterior pelvic plane7,8.
Importantly, edge-loading, accelerated
wear, impingement and dislocation occur
during functional activities when the
position of the pelvis is again altered from
that seen on standard radiographs or on
the operating table6,9,10,11.
These functional pelvic rotations are specific
to each individual and change the functional
anteversion of the acetabular cup by as
much as 25°, potentially causing the cup to
be functionally malorientated when walking
or rising from a chair12,13.
Consequently, the target values for cup
orientation need to be customised for
each patient to account for these individual
functional rotations.
Trinity OPS™ is an innovative new
technology that provides the surgeon
with a pre-operative, dynamic analysis
of each patient performing a deep
flexion and full extension activity. The
software calculates the dynamic force
at the hip to be replaced and plots the
bearing contact patch, using a Hertzian
contact algorithm14, as it traces across
the articulating surface. The simulation
models multiple cup orientations and the
alignment which best centralises the load
is chosen by the surgeon from the preoperative report.
Once the optimal cup orientation has
been determined, a unique patientspecific guide is 3D printed and used
intra-operatively with a simple laserguided system to quickly and accurately
achieve the planned alignment.
Acetabular planning should consider the
functional range of motion of an individual’s
pelvis to reduce the risk of edge-loading
and dislocation. In addition, a simple and
accurate delivery system is required to
achieve a pre-planned target orientation.
Functional pelvic rotations are specific to each individual and change
the functional anteversion of the acetabular cup by as much as 25°.
References
1. Callanan MC et al. CORR, 2011.
2. Barrack RL et al. JBJSurg[Am], 2013.
3. Harrison CL, et al. J Arthroplasty, 2014.
4. Shon WY et al. Skeletal Radiol, 2008.
5. Lewinnek GE et al. JBJS[Am], 1978.
6. Nishihara S et al.CORR, 2003.
7. Au J et al. Hip Int, 2014.
8. Polkowski GG et al. CORR, 2012.
9. Nadzadi ME et al. J Biomech, 2003.
10.Lazennec JY et al. OTSR, 2013.
11.DiGioia AM et al. CORR, 2006.
12.Mellon SJ et al. IMechE pt H, 2013.
13.Lembeck B et al. Acta Orthop, 2005.
14.Mak MM et al. IMechE pt H, 2002.
Responsible Innovation
3
Acute ligament reconstruction using
LARS™ after knee dislocation
work and recreational sports (fig. 1).
Dr Pierre Ranger,
Hôpital du
Sacré-Coeur de
Montreal, Canada
Knee dislocation, although very rare
(accounting for 0.02% to 0.2% of
musculoskeletal injuries1), remains a
devastating injury with many complications.
Because of the numerous structures
damaged in knee dislocations, surgery can
involve using combinations of autografts,
allografts, and more recently synthetic
ligaments such as LARS™ (Ligament
Augmentation and Reconstruction System).
Synthetic ligaments offer an advantage
over auto and allografts in that they are
readily available and provide immediate
post-operative stability due to lack of a
healing period. In addition, using LARS™ in
multi-ligament reconstructions can eliminate
the need to harvest autograft tissue from the
contra-lateral leg which can lead to donor
site complications including pain and loss
of strength2. LARS™ is a third generation
synthetic scaffold incorporating a patented
design technology which allows improved
longevity and tissue in-growth over previous
generation synthetics.
Acute combined repair and reconstruction
of both cruciate ligaments, posterolateral
corner (PLC) and collateral ligaments
(LCL and MCL) using LARS™ has been
the treatment of choice for acute knee
dislocations, treated within ten days of
trauma, at our institution. We evaluated
the outcome and survival of acute cruciate
reconstruction (mean time between trauma
and surgery 11 ±8.4 days) using LARS™
ligaments after knee dislocation in 107
patients with a minimum follow-up of 24
months post-surgery. All patients underwent
reconstruction of at least both ACL and PCL
+/- reconstruction of PLC and/or collateral
ligaments.
Clinical examination at final follow-up
showed the majority of the patients had
good stability, with some
residual posterior
drawer (5-6mm)
obtained by Telos
examination.
Subjective
evaluation results
showed significant
improvement in
symptoms and that
many patients
returned to preinjury levels of
4
Questionnaires
Mean (SD)
Lysholm (n = 99)
75.4 (±17.6)
Tegner (n = 95)
4.6 (±2.0)
Meyers (n = 94)
3.1 (±0.8)
IKDC (n = 101)
63.6 (±18.9)
Figure 1. Subjective outcome scores.
Further evaluation of 54 patients at mean
9.2 (±3.5) years follow-up showed no
significant change in subjective and
objective tests indicating a persistence
of knee stability over time. In conclusion
we feel that LARS™ provides an effective
alternative in the treatment of knee
dislocations with excellent short to mid-term
clinical outcomes.
References:
1. Engebretsen L et al. Knee Surg Sport Traum Arth.
2009.
2. Ardern C et al. J Arthro Rel Surg. 2010.
Conservation and technology
in modern day THR – Hip
cadaveric workshop
Mulheim 21-22 April 2015
Following the success of our
hip cadaveric workshops
through 2014, we are proud to
announce the latest meeting for 2015.
This year
we are
extending the
outstanding
programme
to address
some of the latest developments in
hip replacement today, and additions
to Corin’s technology portfolio.
This meeting will provide an open
and interactive platform to discuss
and interrogate conservative hip
replacement and optimised implant
orientation.
There will be a hands-on cadaveric
training session with state-of-the-art
facilities, with Corin’s hip portfolio
(including MiniHip™ and TriFit TS™),
and our latest technology offering,
Optimised Positioning System (OPS™)
available for hands on training.
We are looking forward to this meeting
building on the success of previous
years, and in welcoming delegates
and faculty from around the world to
join us in sharing best practice in total
hip replacement surgery today. For
further information please go to
www.corinacademy.com.
Are all
polyethylenes
created equal?
Interview with
Dr Orhun Muratoglu
For many years
surgeons have
been debating
the balance
between hip
bearing stability
and polyethylene
wear.
Advancements
in polyethylene have been made over the
years, from ultra high molecular weight
polyethylene (UHMWPE) to highly crosslinked polyethylene (HXLPE), and more
recently vitamin E polyethylenes.
Corin has had the unique opportunity to
collaborate closely with Massachusetts
General Hospital (MGH) in the
development and commercialisation of a
next-generation vitamin E polyethylene.
ECiMa™ is the most advanced
polyethylene of its kind, and is only
available with Corin’s Trinity™ advanced
bearing acetabular system. This interview
talks to Dr Orhun Muratoglu about the
latest advancements in this technology.
ECiMa™ is the most advanced
polyethylene of its kind
What has driven you and your
institution to re-visit HXLPE and further
improve on existing technology?
We are pleased with the success of
the first generation, irradiated and
remelted HXLPE. It helped to alleviate
a major problem with conventional PE
components – that is, osteolysis due
mostly to particulate debris generated
by excessive wear necessitating revision
surgery. For our laboratory the natural
next step was to further improve on the
existing technology so as to obtain higher
strength and fatigue resistance along with
low wear and low oxidation.
What advantages do you think
ECiMa™ offers over other modern day
polyethylenes?
What are the methods of producing
HXLPE and the down-sides?
Cross-linking is achieved by radiation,
which also results in residual free radicals.
These free radicals are responsible for
oxidation and embrittlement of
polyethylene components both on the
shelf and in the patients. First generation
highly cross-linked polyethylenes were
either remelted or annealed below the
melt temperature to improve oxidative
stability. Remelting was successful in
quenching all of the detectable free
radicals. On the other hand, annealing
only reduced the concentration of the free
radicals and as a result irradiated and
annealed polyethylene components
showed high levels of oxidation in vivo in
less than five years. Irradiated and
remelted polyethylene components are
showing no detectable oxidation up to ten
years of in vivo service; beyond ten years
there appears to be some early signs of
potential oxidation. While remelting was
thought to mostly eliminate the oxidation
caused by the residual free radicals, this
late onset oxidation is puzzling. We
hypothesise that cyclic loading and/or
absorbed lipids initiate and progress
oxidation in these components.
What is special about the processing
of ECiMa™ that means free radicals
are eliminated but the mechanical
properties are maintained?
ECiMa™ material is irradiated for crosslinking and reduction in wear, followed
by mechanical deformation to anneal or
quench the free radicals responsible for
oxidation. In addition ECiMa™ contains
an antioxidant, vitamin E, to protect the
polymer against any oxidative attack
in vivo. ECIMa™ is not remelted after
irradiation, therefore retains its mechanical
properties.
What is so important about vitamin E
and mechanical annealing?
The contained vitamin E actively protects
the component from oxidation. This active
protection is unlike the first generation
technology, which relied on initially
reducing/eliminating the free radical
burden to impart oxidative stability. The
joint fluid contains potential oxidisers,
such as lipids, that can be absorbed
over time during in vivo use, challenging
the oxidative stability of the component.
The contained vitamin E will continuously
combat these oxidisers and keep the
component oxidatively stable. Mechanical
annealing helps to reduce residual free
radicals in the irradiated material without
remelting it, making it oxidatively stable
while retaining mechanical properties.
How can the surgeon be sure that the
body can tolerate extra vitamin E in the
body?
We have done multiple in vitro tests
assessing the possible release of vitamin E
from a component under various adverse
conditions – at elevated temperatures and
in aqueous environments – and under
simulated gait. The calculated worst-case
values of vitamin E elution in these tests
appear to be very low – substantially
less than natural plasma vitamin E
levels in most adults. Plus, at a nominal
concentration of 0.1 wt.% of vitamin E,
a relatively large, 50g component would
only contain 50mg of vitamin E. Vitamin
E toxicity has been associated with large
doses (>400 IU/day) over a prolonged
period of time; even if all 50mg of vitamin
E from the component were somehow
lost in a single day, it would still equate to
less than 400 IU. In addition the animal
studies that we carried out have shown
that any vitamin E that might elute out of
the components will not adversely affect
bone ingrowth and will not cause any
adverse tissue reaction.
There are many modern day polyethylenes
using different methods to try and
overcome the issues. Some use no
antioxidant, like X3, others use an
antioxidant, typically vitamin E. Vitamin E
can be blended at the start of the process
or doped at the end of the process. X3 is
sequentially irradiated and annealed, as
a result it contains residual free radicals,
explanted X3 acetabular liners and tibial
inserts are showing in vivo oxidation. The
observations from explanted components
would indicate that X3 is not resistant
to oxidation in vivo. In contrast, vitamin
E stabilised irradiated UHMWPE has
shown resistance toward oxidation in
laboratory experiments under aggressive
aging environments. We have analysed
a small number of vitamin E stabilised
bearings retrieved at revision surgery (the
reason for revision was not related to the
polyethylene bearing) and they showed
no detectable oxidation up to two years
in vivo.
ECiMa™ is a blended vitamin E which
offers the advantages of uniform
distribution of the vitamin E throughout
the polyethylene and minimises the
elution effect
ECiMa™ has shown improved strength
and fatigue resistance whilst reducing
wear and oxidation in comparison to other
modern day polyethylenes.
Will vitamin E simply elute out of the
device over time and then leave the
liner susceptible to future oxidation?
We have very strong laboratory data that
indicates that vitamin E elution will be
minimal. During irradiation, some of the
vitamin E becomes chemically linked or
grafted to the polyethylene molecules.
The grafted vitamin E still protects the
polyethylene against oxidation based on
our laboratory studies.
Responsible Innovation
5
COMPANY
NEWS
Respecting the soft
tissue envelope: Is it
a factor in improving
patient satisfaction?
Stefan Kreuzer, MD PhD
Australia
Corin Australia continues to develop rapidly
with the Sydney offices now expanding
to include the global OPS™ production
headquarters. The significant uptake of this
new technology in combination with the
Corin implant range has seen approximately
1000 hips ‘optimized’ over the last 18
months. In combination with the emerging
interest in a variety of applications for the
LARS™ ligament (including gluteal tendon
repair, MCL, PCL, PLC, augmented ACL,
and ACJ reconstruction) and the launch of
the Zenith™ ankle replacement following
reimbursement being granted on 18 March
– 2015 will be another exciting year for the
Australian business.
Forthcoming events supported by an
International faculty:
LARS™ Cadaver Lab Roadshow 20, 21 &
23 May - Brisbane, Sydney & Melbourne
MIAA Masterclass 1-5 June – Adelaide,
Melbourne & Sydney
United
Kingdom
Corin UK is proud to be the first team
outside of Australia to utilise Optimized
Orthopaedics providing this new and
innovative service for a challenging case
at the Nuffield Orthopaedic Centre in
Oxford in February this year. Further cases
have already been booked at a number
of other centres in the UK as interest in
this technology grows. Corin, within the
UK market, has long been regarded as a
provider of hip systems but the introduction
of the Unity Knee™ has helped surgeons
in a number of key centres to focus on soft
tissue balancing and a better outcome for
the patient. With the patients’ outcome as
the primary motivation, OPS™ and Unity
Knee™ are poised to give the UK market
a step change in technology and promises
to deliver another successful year for Corin
business.
6
Whilst total knee
arthroplasty
demonstrates
excellent longterm survivorship,
patient satisfaction
is still a prevalent
issue with over
20% of patients
exhibiting patient dissatisfaction post TKR.
In particular anterior knee pain and instability
post surgery are some of the most common
causes for patient dissatisfaction. Bourne
et al demonstrated that over 18-28% of
patients experience pain post total knee
surgery. In addition mediolateral or varusvalgus instability is the most common cause
of instability and leading cause of early
clinical failure post total knee arthroplasty
(Fehring and Valadie 1994, Fehring 2001,
Sharkey 2002). Recent studies (Delport and
Bellemans 2014) have demonstrated that
collateral ligament strains alter post TKR
which may lead to laxity and/or tightness
of the ligaments and subsequent instability
and loss of motion. In order to prevent
patient discomfort, pain, stiffness and/or
instability post TKR it may be beneficial to
consider the soft tissue envelope, ensuring
ligamentous strains after TKR are similar or
close to the native situation.
Several factors contribute to the state of
the soft tissue envelope post total knee
arthroplasty; some of these factors are
surgeon dependent such as nature and
extent of ligamentous releases performed,
whilst others are attributable to the implant
and instrument system employed during
surgery.
Our objective with the Unity Knee™
system was to build on over 20 years of
extensive knee research, collaborate with
a multi-disciplinary team at Corin and a
knee specialist surgeon team from USA,
Germany, Austria and UK, to design a
modern knee system, based on scientific
findings, which not only optimises implant
geometry but also incorporates advanced
instrument
concepts to help facilitate soft tissue
balance during total knee replacement.
We focussed on three fundamental areas
for innovation when developing the Unity
Knee™ system:
1. Optimising MCL isometry
2. Balancing the extensor mechanism
3. Balancing the soft tisse envelope
In this article we review the concept of MCL
isometry and its relevance to total knee
replacement:
1. Optimising MCL isometry
Modern single radius TKR implants have
demonstrated the ability to improve
mid-flexion stability and reduce anterior
knee pain, attributable to improvements
in collateral isometry and prevention of
paradoxical anterior movement of the femur
during flexion (Banks 2007, Mahoney 2002,
Blom 2014). However, there have also
been studies which do not demonstrate an
improvement in function of these designs
over traditional knee systems (Hall et al).
Fig. 1 The flexion joint-line orientation is altered during TKA.
We believe that it is not just the implant
geometry which influences isometry of the
MCL. Joint-line restoration is crucial to
ensure MCL isometry is as near as possible
to the physiological condition. However,
the native joint-line orientation (varus) is
invariably altered during knee surgery as we
resect unequal medial and lateral condylar
bone to replace them with equal thickness
medial and lateral implant condylar shapes.
Therefore, it is difficult to ensure both
medial and lateral joint-line is maintained
through the range of motion post total knee
arthroplasty. We believe that since the MCL
is the most important stabiliser post TKR,
maintaining the medial joint-line should be
prioritised during total knee arthroplasty.
However, traditional knee surgery
instruments incorporate external rotation
guides which pivot around a single
central axis when dialling
in external rotation,
resulting in elevation of
the medial joint-line.
We believe that this
shift in the posterior
medial joint-line
can lead to midflexion laxity and deep-flexion
tightening of the MCL.
With this in mind, the
Unity Knee™ not only
optimises the implant geometry
In conclusion, whilst there are several
factors which can impact patient
satisfaction, joint-line preservation and
soft tissue balance certainly play a role in
improved patient function and knee joint
stability post surgery. Since these factors
can be impacted by the type of implant and
instrumentation employed by the surgeon,
we urge caution to surgeons when
choosing a TKR system to ensure that both
the implant and the instrument platform are
given considerable thought and to confirm
that each of them assist the surgeon in
preserving the femoral joint-line throughout
range of motion and
minimise strains on the
soft tissue envelope
in order to optimise
stability post TKR.
Transepicondylar axis
Natural joint line
Raised joint line using conventional instruments
Conventional resection
True medial joint line using EquiBalance™
instruments
EquiBalance™ resection
Fig. 2. Conventional external rotation guides (left)
pivot about a central axis elevating the medial jointline when rotated. In contrast, Unity EquiBalance
instruments accommodate preservation of the
posterior medial jointline by incorporating a medial
axis of rotation (right).
to achieve MCL isometry post TKR but
also incorporates an advanced innovative
femoral alignment system which allows
maintenance of both the distal and posterior
medial joint-line throughout range of motion
thereby consistently restoring the patient’s
natural posterior condylar offset so as to
optimise post-operative function.
COMPANY
NEWS
Corin is proud to
announce the launch
of the “myminihip.
com” website.
Surgeons who
perform THA utilising this unique total
hip solution can either talk through this
information with their patients or direct
them to this valuable resource to find out
more about their upcoming MiniHip™
procedure. The site includes;
■■
A patient guide on the MiniHip™
system which can be downloaded
directly from the site to read later.
■■
A useful ‘find a doctor’ area
where patients who get to the
site independently can search for
surgeons in the USA who carry out
the MiniHip™ procedure. We will
be expanding this to include other
geographies in due course.
■■
Patient stories featuring individual
patients experience with their
MiniHip™ and here they discuss the
effect the surgery has had on their
lives. We would be pleased to hear
from you with suitable patients and
their stories.
■■
Further information available
on the site includes sections on
understanding arthritis, common
conditions affecting the hip, what to
expect from surgery and useful links
to other relevant websites.
We would encourage you to visit
myminihip.com and give us your
feedback, as we continue to develop the
site over the coming months.
Conformity | Versatility | Stability
TriFit TS™ is the latest addition to the
Corin primary hip continuum of care,
with the first implantation in September
2012 and over 3000 implantations to date.
TriFit TS™ was developed with a world
leading developer group and is one of the
most advanced cementless tapered stems
on the market today.
Combined with the Trinity™ cup we
are able to offer a world leading hip
replacement system incorporating
advanced bearing technologies and
one of the most advanced stem/cup
combinations on the market. Please visit:
www.coringroup.com/trifitts
Responsible Innovation
7
Zenith™ – overcoming issues in Total
Ankle Replacement
Ian Winson
Fusion has long
been considered
the treatment
gold standard
for ankle arthritis.
However, loss of
joint motion and
resultant abnormal gait patterns can lead to
significant functional restrictions on patients’
activities and overloading of adjacent, often
already arthritic joints. Whilst historical
results with Total Ankle Replacement (TAR)
have demonstrated poor survivorship, more
recent developments in implant design and
instrumentation mean that arthroplasty can
now be seen as a viable alternative to fusion.
Third generation TAR Zenith™, introduced
in 2007, was designed specifically to
overcome the early issues surrounding ankle
replacement.
State-of-the-art instrumentation allows
reproducible, parallel tibia and talus resection
referenced from the joint-line. An innovative
talus design, incorporating two anterior pegs
and chamfer resection with an open wedge
effect, provides primary and rotational stability.
Innovative fixation technology incorporating
Biomimetic Cementless Coating Technology
allows optimal short and long-term osseointegration. The proven TiN bearing surface
coating reduces wear by up to 98%.
Since 2007, we have implanted more
than 100 Zenith™ ankles in Bristol with
greater than 96% survivorship at up to
five years. Corin’s support and strong
focus on surgeon education – through
cadaveric teaching courses
and Centre of Excellence
surgeon visits – has
allowed us to advocate the
use of Zenith™ through
comprehensive surgical
skills labs to
ensure responsible
implantations
worldwide.
Calendar of events 2015
Venue
Dates
DAF Kongress
University of Bayreuth, Germany
20 - 21 Mar
AAOS Annual Meeting
Sands EXPO, Las Vegas, NV, USA
25 - 27 Mar
Optimizing orthopaedics - Advancing technology,
defining solutions: Meet the experts sessions
Corin booth 2625, Hall B, Sands EXPO,
Las Vegas, NV, USA
25 - 27 Mar
Optimizing orthopaedics - Advancing technology,
defining solutions: Welcome reception
Vinoly Grand Ballroom, Vdara Hotel, Las
Vegas, NV, USA
25 Mar
Cadaver LAB Shoulder
Lyon, France
3 Apr
London Hip Meeting
QEII Conference Centre, London, UK
9 Apr
23rd Biennial Congress of the SAAS
Wild Coast Sun, Kwazulu Natal, South Africa 15 - 18 Apr
ICJR World Arthroplasty Congress
Palais des Congrès, Paris, France
16 - 18 Apr
Shoulder Congress
Berlin, Germany
21 - 22 Apr
Conservation and Technology in Modern Day THR MEDucation Centre, Mulheim, Germany
21 - 22 Apr
Jahrestagung der Vereinigung Süddeutscher
Orthopäden und Unfallchirurgen e.V.
Kongresshaus, Baden-Baden, Germany
30 Apr - 2 May
Zenith Total Ankle Replacement LAB
Vesalius Clinical Training Centre, Bristol, UK
8 May
LARS Cadaveric LAB Roadshow
Brisbane, Sydney and Melbourne, Australia
Current Concepts and Controversies Knee Meeting Sixways Stadium, Worcester, UK
20, 21 & 23 May
20 - 21 May
88th Annual Meeting of the JOA
Kobe International Conference Center, Japan
21 - 24 May
MIAA Masterclass
Adelaide, Melbourne and Sydney, Australia
1 - 5 June
Cadaver LAB Shoulder
Nice, France
5 Jun
11th Symposium on Joint Preserving and
Minimally Invasive Surgery of the Hip
Fairmont Chateau Laurier, Ottawa, Canada
4 - 6 Jun
10th Biennial ISAKOS Congress
Lyon Convention Centre, Lyon, France
7 - 11 Jun
The Great Debate
Mermaid Conference & Events Centre,
London, UK
18 - 19 Jun
Welsh Orthopaedic Society - Pan Celtic Meeting
Vale of Glamorgan Hotel, Nr Cardiff, UK
18 - 19 Jun
Annual Meeting Swiss Orthopaedics
Basel, Switzerland
24 - 26 Jun
DVSE-Congress
Mannheim, Germany
25 - 27 Jun
The 128th Annual Meeting of the AOA
The Westin Providence, Providence, RI, USA 24 - 27 Jun
Important: Not all products are available or cleared for distribution in all international markets. For more details, please
contact your local subsidiary or distributor by visiting the Corin worldwide section.
www.coringroup.com
www.linkedin.com/company/corin-uk-ltd
[email protected]
www.youtube.com/user/coringroup/
+44 (0) 1285 658 960
http://bit.ly/Zvic7H
INTERACTIVE
UPDATES
Having a say
“Do you feel that your work positively
impacts people’s lives?” This, and
many more questions recently
formed a broad-ranging survey aimed
at Corin’s workforce worldwide,
encouraging everyone to share their
opinions of what they think and value.
Opinions were sought across a broad
spectrum from work environment,
management and communication to
motivation, reward and recognition.
The results will be shared with all
employees and will help gain a better
understanding of morale, satisfaction,
and engagement.
It will also help
Corin to bring
about meaningful
improvement
to all areas of
the business by
focusing on positive
changes that really matter to staff.
New ECiMa™ key
features animation
www.youtube.com/
user/coringroup/
ECiMa™ vitamin E highly cross-linked
polyethylene (HXLPE) represents a
new generation in orthopaedic bearing
technology.
Surgeon Resource Hub
Download our iPad app
from the iTunes App
Store searching Surgeon
Resource Hub.
http://bit.ly/Zvic7H