Advanced Oxinum knee launched in Chennai

Published: 07th May 2010
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An advanced Knee replacement manufactured from a revolutionary material called Oxinium was launched in Chennai a year ago. Since the introduction in November 2008, orthopedic surgeon Dr.A.K.Venkatachalam has been implanting it successfully mostly in young and middle aged patients. Two designs called the Genesis II Oxinium knee and the Journey Oxinium knee have been placed in several patients from Europe, Iraq, Mexico & the US. The first patient was a Dutch male who had his left knee replaced in November 2008. The second was a female Indian. Her surgery was the first live Twitter cast from India on the 19th June 2009. Subsequently 3 patients from Iraq had both their knees replaced with the latest design of Oxinium Journey knees. Towards the end of the year, an English gentleman Mr. Paul Jackman Graham had both knees replaced with Oxinium Journey knees. The latest patient is a 59 year old American citizen, Nancy Tomberlin who underwent bilateral Oxinium Journey knee replacements on the 4th and 8th of February 2010. She is currently recuperating at a seaside resort in Mahabalipuram.



'There is a spurt in demand for Knee replacements from young patient's world wide' says orthopedic surgeon Dr.Venkatachalam. This is reflected in the Joint registries of Australia and also from projected statistics in the US. Even in India, many young patients have consulted me for Knee replacements. Most of these are young men & women with rheumatoid arthritis, post traumatic arthritis. The first patient for whom an Oxinium knee replacement was introduced was a Dutch male only 34 years old. His knee had born the brunt of several failed surgeries in The Netherlands and he failed to get a satisfactory answer over there. Since he was in severe pain, there was no option but to give him a knee replacement with the revolutionary Oxinium knee. This was implanted with computer assisted surgery to ensure accurate positioning of the components.

Since then three Iraqi women including a dentist have received double Journey Oxinium knee replacements.

The other patients include British, Indian and American patients. The latest patient to receive bilateral Journey Oxinium knee replacements is Nancy Tomberlin, a 59 year old American citizen, resident in Mexico.



Knee replacements in Young



Historically, total knee replacements are known to have poor outcomes in the young due to their higher activity levels compared to older patients. Normally a knee implant is expected to survive for 10 to 15 years and hence surgeons are reluctant to place them in younger patients as they are bound to outlive their implants.

Better materials

With the advent of newer materials and designs of knee prostheses, these perceptions are changing. The biggest advance is the availability of newer materials like Ceramic for knee replacements. Pure ceramic or ceramic coatings on metal are the latest in technology.

Titanium carbide has been used for dental implants but its use as a bearing surface

in hip & knee prostheses is not widespread.

Knees made of ceramic are in restricted use. Implantation of pure ceramic knees requires specialized instrumentation.



Oxinium Knee & Hip implants



Oxinium or Oxidised Zirconium is the wonder material that has been used successfully for knee & hip implants. It is a metal with a coating of ceramic. To the laymen Zirconium is the material in American diamonds used in jewels. In the manufacturing process, prosthetic components made of Zirconium are heated and infused with oxygen to create a ceramic surface on metal. This ceramic surface is more durable than normal metals. This material received FDA approval in 1996. After rigorous testing, this material received approval for use in knees.



Advantages of Zirconium knees



The significant advantage of Zirconium knee implants is that they are considerably harder. On testing it lasts 85 times longer in tests.

Additional advantages are scratch resistance. When it is wet, ceramic can glide smoothly along plastic, making for smoother motion than with metal-on-plastic. As a result, the Oxinium total knee replacement will not generate the quantity of plastic wear debris that cobalt chrome will, and the implants should last considerably longer.

Zirconium is one of the six most biocompatible elements know to man. So, your immune system will more easily tolerate your new implant.

Lastly, patients who are allergic to nickel, the metal most often used in the current implants, cannot currently receive total knee replacements. The ceramic implant, however, can be implanted safely in patients with nickel allergies, since it uses a zirconium alloy with no nickel. Implants made of Oxinium have been implanted in larger number of patients in the UK Australia and the US with great success.

Who would benefit most from an Oxinium total knee replacement?



Three types of patient have been identified as the "best" candidates for an Oxinium total knee replacement.

"Younger" patients: Because Oxinium knee implants offer significantly less wear compared to cobalt chrome implants, they are expected to last considerably longer. In the past, orthopedic surgeons have advised patients less than 65 years of age to wait to have knee replacement surgery because the life span of the cobalt chrome knee implants is only 10-15 years. Now, surgeons have a viable option for a younger patient who previously would not be a candidate for a total knee replacement because the Oxinium knee implants should last much longer. Therefore, a patient under the age of 65 who has advanced arthritis of the knee no longer has to suffer for years until he reaches an appropriate age for total knee replacement surgery.

"Active" patients: Patients, who desire to return to an active lifestyle, including sports, dancing, gardening, or other strenuous activities, may also benefit from an Oxinium knee replacement. As a result of their high activity level, this patient population will put more "wear and tear" on their knee replacement, which can cause the implants to wear more quickly. An Oxinium knee is better able to tolerate this high activity level and last longer that the traditional cobalt chrome knee.

Metal allergy patients: Because Oxinium is one of the most biocompatible materials known to man, it is the only choice for patients who exhibit metal allergies. Patients who have needed total knee replacement surgery, but could not tolerate the cobalt chrome implants due to their nickel content, can now have the surgery they need to return to an active lifestyle without the fear of an allergic reaction.



Three designs are available, the Genesis knee, Journey knee and the Legion knee, according to the manufacturer, Smith & Nephew.

In India, the Journey & Genesis knees in Oxinium are being used in Chennai by Dr.A.K.Venkatachalam since Novmber 2008.The Legion knee is also available for selected use. The Genesis knee is the cheapest whereas the other two are more expensive.



About the author- Dr.A.K.Venkatachalam is a consulant Orthopaedic surgeon at the Chettinad health city.

His practice consists of Joint replacements of Hip, knee & shoulder.

To book a surgery he can be contacted by e mail at drvenkat@kneeindia.com

His websites are www.kneeindia.com

www.hipsurgery.in

& www.shoulderindia.com








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