Thirty-year knee

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Carolina girl

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Hi, I am new to the forum but have been reading comments a lot and have found lots of good information. I am scheduled to have TKR on July 3. My doctor recommended the "Thirty-year" knee, also called Verilast. Has anyone had experience with this technology? It is called "minimally-invasive" although I cannot imagine what that means! I am having the MRI tomorrow to send to Smith and Nephew to custom make my knee prosthesis.
 
I have never heard of this knee, but I am sure it is fine. Most of the knees made nowadays have a 30 year projected life, so I am sure this one will too.
 
The Verilast has been around for quite some time. What's made it different is that Smith & Nephew recently offered a thirty year warranty on this knee making it sound like a ground breaking new implant. But the misnomer is that knees are generally lasting about thirty years anyway! But having said that, and also noting that there are no 'Rolls Royce' devices in this business, the Verilast is a pretty decent device and has as good results as any other. This is because the critical issue in all joint replacement surgery is not the device but the person putting it in - in other words, the surgeon. Devices don't fail, don't come loose or develop problems and don't get infected - that's all down to the skill of the surgeon and his surgical technique.

"Minimally invasive" is also a bit of a misnomer too. It makes it sound different and unique but it's not really. The surgery is just the same except for the size of the incision. In the old days (and I know because I was there!) surgeons made huge incision, often up to 12 inches long. But over the years, they realised that the size of the incision greatly impacted on the outcome of the procedure. So they started reducing the size from 12 to 10 to 8 and 6 inches. Now they have managed to get a TKR done through incisions as small as 4 or 5 inches which is really great. This is what they call MIS though in this old OR nurse's opinion, should more properly be called a reduced incision as the term "MIS" can lead patients to imagine they will have mini incisions.

Another thing to remember is that very often, despite a minimally invasive approach, the recovery can still be long and painful involving lots of discomfort and swelling which, in its turn, will require considerable amounts of rest, icing, elevating and pain meds.

You might like to take a browse through our set of recovery articles from our Library

First are the BoneSmart mantras ....
- rest, elevate, ice and take your pain meds by the clock
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again
- if you won't die if it's not done, don't do it
- never stand when you can sit, never sit when you can lie down, never stay awake when you can go to sleep!

And here are some very crucial articles
The importance of managing pain after a TKR and the pain chart
Myth busting: no pain, no gain
Swollen and stiff knee: what causes it?
Activity progression for TKRs

Healing: how long does it take?
Chart representation of TKR recovery
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling

Home physio (PT) and activity progress: suggestions
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it

And wise words from members who have shared their experiences ...
Where are you in recovery?? (TKR)
Five “P’s” of knee recovery
TKR: work “smarter” and not “harder”
Recovering a knee - from one who knows!
It's never too late to get more ROM!
It's worth the wait for ROM
 
no 'Rolls Royce' devices in this business, the Verilast is a pretty decent device and has as good results as any other.
This an excellent point---there are no "bargain basement" implants---no "good", "better", or "best implants---they are all very well designed, meet stringent standards, and pass rigorous tests.

This is because the critical issue in all joint replacement surgery is not the device but the person putting it in - in other words, the surgeon.
Josephine is, as usual making a very strong point here; it is not the implant, but the skill of the surgeon that is paramount. It is his skill that is of the greatest importance.
 
Well thats good news to know most last thirty years, if i get on this will take me til i am 74, sounds good to me :thumb:
 
Even 20 years puts me close to 70... While I've been pretty rough on this knee, I bet by 70 I'm toning things down a bit.
 
^I don't buy that, zjrog! You, slow down? :wink:
 
Well, I resisted replying to this thread for 10 days, but it keeps popping up and tempting me. I looked long and hard at Smith & Nephew's technology prior to my knee replacements. What Smith & Nephew calls its "Verilast" technology was introduced in the USA three years ago in the spring of 2010 and is a marriage of S & N's proprietary femoral component called "Oxinium" with a "highly cross linked poly" spacer.

The femoral component is made of an oxidized zirconium which forms a ceramic surface of a few millimeters (meant microns) and has been available in the USA for over a decade. S & N has long touted the superior wear characteristics of its proprietary femoral material. Highly cross linked poly spacers have been used by many firms also publicizing its wearing abilities.

Putting both of these together, along with extensive, successful ex-vivo testing, lead the FDA to approve S & N to market (in the USA) this product as a "30 Year Knee." I don't think this product is warrantied in the USA. If my post-TKR primary goal was to do ultradistance cycling, I might very well have chosen a top notch surgeon using this product.
 
The femoral component is made of an oxidized zirconium which forms a ceramic surface of a few millimeters
Make that one mm at most!
Putting both of these together, along with extensive, successful ex-vivo testing, lead the FDA to approve S & N to market (in the USA) this product as a "30 Year Knee."
Along with about 95% of the rest of the market! I've said it before and I'll say it again - implants don't fail. Almost all recorded 'failures' such as loosening, infection and etc., are attributable to the expertise when it was put in!
 
I was reading an article about Billy Jean King yesterday. She's had both her knees replaced with this make of implant. She still pays some tennis!
 
Make that one mm at most!

...correct, I meant to type "microns" not "millimeters", it's much less than a millimeter.

Follow up note: There is another company w/a zirconium femoral surface (Vega). So far no evidence, in any studies I am aware of, showing better in-vivo wear w/UHMW poly, but the combination of HXLP poly spacers w/ceramic femoral surfaces may eventually prove to have better wear characteristics as it very new . This will probably affect few recipients, but......
 
I meant to type "microns" not "millimeters
That's what I thought but you know what? I couldn't think of the darned word! :doh:

As for the new thing, not heard of it yet but I expect it will slot neatly into the shelf alongside all the other excellent products! :wink:
 
That's the company. By the way, a micron is 1/1000ths of a millimeter. The largest private employer in my state is named after this "micro" unit of measure (Micron Tech.).
 
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