CoMplete

Discussion in 'DePuy Ortho' started by Anonymous, May 16, 2013 at 8:52 AM.

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  1. Anonymous

    Anonymous Guest

    I guess this didnt pan out... I thought it was supposed to be the 'best of both worlds'?
     

  2. Anonymous

    Anonymous Guest

    another feather in Kilburn's cap
     
  3. Anonymous

    Anonymous Guest

    Don't be so quick to blame Kilburn for all DePuy's failures. The bigger underlying problem that should concern DePuy employees and customers particularly is the failure of the research and development teams to accurately predict and pick the winning technologies that will actually provide benefit to patients. How long can sales and marketing and surgeon customers continue to trust our research scientists and engineers? Mobile bearing knees, Metal on Metal Hips, Ceramic on Metal hips.

    The research teams and engineers trusted by DePuy leadership have been in place longer than any executive. Fisher has been touting 10 fold reductions in ion levels of COM for over a decade based on simulator testing that was not supported by the PMA of this device. If a surgeon is using COM then he/she has not been presenting with all the information available to make an informed decision (see PMA for this device). Rather he/she has relied on the expertise of the company's top scientists who continue to fall short of actually delivering products with realized benefits. At worse they are delivering products that are being revised at greater rates than alternative devices that are harmful to patients and the future of DePuy.
     
  4. Anonymous

    Anonymous Guest

    We were told that Ultamet was a great product, why are we exiting thisif there is no problem with it? Maybe there are more issues than are being reported with Pinnacle.
     
  5. Anonymous

    Anonymous Guest

    Lack of sales. That's all. Just like ASR.
     
  6. Anonymous

    Anonymous Guest

    please do not lump RP in with this discussion. It has been around 35+ years.
     
  7. Anonymous

    Anonymous Guest

    Looks like Pinnacle will now be under the miroscope. Depuy is not telling us the CoMplete story.
     
  8. Anonymous

    Anonymous Guest

    No shit...
     
  9. Anonymous

    Anonymous Guest

    I will not argue the heritage of mobile bearing knee designs. They have been available for a long time. Certainly long enough to be able to 'prove' superiority over fixed bearing designs. In reality, there has been a lack of any data showing that these designs offer any benefit. Even the staunchest supporters can not show superiority but rather they may perform as well as some earlier fixed bearing designs.

    Regardless of theoretical benefits, mobile bearing knees including the older LCS are revised at approximately 2x the rate as fixed bearing knees. This is hardly beneficial despite JNJs longstanding support of this technology. It lends further support to the notion that JNJ continues to dump resources into losing technologies. Mobile bearing knees at one time may have offered a benefit as it pertains to the performance of historical bearing materials and poor tibial locking mechanisms. Oxidative embrittlement and delamination of polyethylene is no longer a relevant failure mechanism in total knee arthroplasty.
     
  10. Anonymous

    Anonymous Guest

    well said.
     
  11. Anonymous

    Anonymous Guest

    "Oxidative embrittlement and delamination of polyethylene is no longer a relevant failure mechanism in TKA". I have to disagree with that statement, what do you base that statement on. Why are all companies working on antioxidant poly and improving locking mechanisms. Wear may be less of a concern now than it has been, but it is still a concern.
    If you look specifically at PS knee designs we know that post wear/articulation and breakage is an issue. RP designs help mitigate these concerns because of their Kinematics.

    According to the NIH study The Epidemiology of Revision Total Knee Arthroplasty in the United States the number 1 reason for revision is infection (25.2%) number 2 was implant loosening (16.1%). Clearly we need to do better in terms of fixation. RP knees at least address the issue of tibial loosening due to stresses transmitted through the tibia.

    I would take my chances with an LCS knee put in by a guy who understands soft tissue balancing and gap balancing over anything currently available on the market. Ya I drank the coolaid but I believe in it for the above reasons and more. I also believe that in the future you will see long term studies that do indicate that RP knees do better when put into a similar patient cohort. Just sayin
     
  12. Anonymous

    Anonymous Guest

    RP knees have been out for 30+ years. If what you say is true, FB knees would be obsolete.

    -RP can help w post wear, but no more than modern FB implant designs.
    -when I worked at Depuy this too made sense, until I started asking myself why RP's had no better tibial loosening revision rates and FB designs (including mbt revision trays)
    -there have been numerous studies showing RP designs function no better, no less then FB designs.
    -yes, you have drank the kool-aid.

    I'm not saying RP knees are bad, I just have never seen anything that supports them over FB. The LCS works well, but isn't designed for the expectations of todays younger patients. The LCS revision system has less flexibility than the sigma (which isn't saying much), but does have the VVC. The sigma RP has way to many kinematic issues (specifically way more instances of patella clunk over the FB). The sigma in general has turned into a mess over the past 5-6 yrs with its "line extensions".
    It's no wonder Depuy surgeons are raving over Attune.