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Aesculap Implant Systems

Aesculap Implant Systems, LLC, part of the B. Braun group of companies, is part of a 175-year-old global organization focused on delivering products and services that improve the quality of patients’ lives.

With over 34,000 successful surgeries worldwide, now is the perfect time to learn more about Aesculap’s gold knee and its patented seven-layer Advanced Surface Technology. Why take a chance with anything else?




When faced with the possibility of knee surgery, you want confidence in your implant. The Aesculap Gold Knee with its seven-layer Advanced Surface Technology offers enhanced protection against the top reasons for implant failure and revision: metal ion release and wear.1



Aesculap’s Gold Knee with Advanced Surface Technology is a ceramic, multilayered material applied to all metal parts of the knee implant. The gold you see is the top layer of zirconium nitride – a ceramic metal alloy. Zirconium itself is one of the most biocompatible metals available. Aesculap is the only manufacturer offering a complete range of knee implants where no metal is exposed.2


As your knee moves during daily activities, the friction from the surfaces of the knee implant rubbing together can cause the components to scratch and wear away, similar to wearing away the bottom of a shoe. Wear is the top reason for revision surgery. Advanced Surface Technology is the hardest material used in orthopaedic devices today – eight times harder than a standard Cobalt-Chromium surface and, therefore, eight times more resistant to the kinds of scratches that cause those implants to wear.3-8


Metals such as nickel and cobalt chromium are widely used in artificial joints. Inside the body, all metals corrode, which can lead to the release of metal ions into surrounding tissue and the bloodstream. These metal ions can cause adverse reactions such as joint dysfunction or persistent pain in some patients, which can be a reason for implant failure and revision. Advanced Surface Technology features seven layers to act as a potential barrier to the release of metal ions.4,9


Aesculap has created Advanced Surface Technology to improve the longevity of an implant and optimize implant performance. Advanced Surface Technology is an extremely hard, scratch-resistant surface designed to lubricate and glide across the polyethylene. Exposure to scratches can accelerate the wear of the implant. The top layer of Advanced Surface Technology is ceramic which is an extremely hard material.

Advanced Surface Technology is a 7-layer technology applied to all Aesculap metal knee implants within each respective system. This patented premium technology was designed to create a barrier to help reduce the potential for metal ion release and reduce wear for longevity of the implant. Aesculap Implant Systems has been applying this technology to knee implants since 2007. Aesculap is the only manufacturer that has this premium technology on both the femoral and tibial implant, as well as other metal implant components that may be used during surgery.

In your natural knee, the end of your thigh bone rubs against your meniscus and causes friction. The friction applied by your knee causes osteoarthritis which over time may result in the need for a knee replacement. In a knee implant, the femoral component (which covers the end of your thigh bone) rubs against the plastic middle component. As your body moves through natural movements from daily activities, the friction caused by joint surfaces rubbing together can cause the polyethylene component to wear away, similar to wearing away the bottom of a shoe. Wear and aseptic loosening caused by debris, such as cement components, is the number one reason for revision surgery. It is extremely important to have a femoral implant and polyethylene designed to mitigate the amount of wear. Mitigating wear helps to reduce the need for revision surgery.10

The Advance Surface Technology in conjunction with the design of the implant increases the longevity of your prosthetic.
On a hot day, pavement on roadways can crack from forces applied by cars. When a pavement cracks, small debris and rocks can surface and cause additional damage. In a knee implant, forces applied from daily activities can cause microfractures of the implant which can lead to metal ions being released into the bloodstream. The multi-layers of the Advanced Surface Technology gradually move from an extremely hard material to a soft base material and act as a potential buffer to trap ions from being released into the bloodstream. The hard top layer of Advanced Surface Technology reinforces the subsequent layers below and acts as a final potential barrier to metal ion release. This gradual adjustment in hardness makes Advanced Surface an extremely resilient product and potentially resistant to cracks.11,12


Talk to your healthcare provider to see if the Aesculap Gold Knee with Advanced Surface Technology is right for you.

Aesculap Product Brochures

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1 The results of in vitro testing have not been proven to quantitatively predict clinical performance with regard to implant wear or metal ion release. The absolute concentration that can trigger a hypersensitivity reaction to metal ions is unknown. A clinical evaluation of metal sensitivity was not performed with respect to Advanced Surface Technology.2 Based on an extensive review of publicly available literature and promotional information accessed through 10/16/18. Metal polyethylene insert markers and metal patella marker are not available in Advanced Surface Technology.3 Reich, J. et al. (2010). Preclinical Evaluation of Coated Knee Implants for Allergic Patients. Der Orthopade, 39(5). doi:10.1007/s00132-009-1581-9.4 AS Advanced Surface: ZrN: Coating Portfolio, 30.3.2011.5 Oxinium®: Made for Life Image brochure S&N.6 CoCr: Hardness of CoCrMo Implants: Aesculap data on file.7 Luetzner, J. et al. (2015). SE12: Pre-Clinical Testing and Clinical Results of a Novel Coating for TKA Implant. This Scientific Exhibit is Presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons in Las Vegas, NV, USA.8 Affatato, S. et al. (2010). Can the Method of Fixation Influence the Wear Behavior of ZrN Coated Unicompartmental Mobile Knee Prostheses? Clin Biomech. doi:10.1016/j.clinbiomech.2010.09.010.9 Grupp, T.M. et al. (2013) Biotribology of a New Bearing Material Combination in a Rotating Hinge Knee Articulation. Acta Biomaterials. Joint Registry of England and Wales 201011Reich J., Hovy L., Lindenmaier H.-L., Zeller R., Schwiesau J., Thomas P., Grupp T. M. Preclinical Evaluation of Coated Knee Implants for Allergic Patients. Der Orthopäde. Volume 39; Number 5; 2010 May
12Santana AE. Relating hardness-curve shapes with deformation mechanisms in TiAlN thin films indentation. Materials Science and Engineering A 406(2005) 11-18