VERILAST^◊ Technology for Knees

What is VERILAST^◊ Technology for Knees?

VERILAST technology is the first device to combine an OXINIUM^◊ Oxidized Zirconium femoral component with a highly crosslinked ultra-high molecular weight polyethylene (UHM-WPE) tibial insert to form an advanced TKA bearing.

• Lab-tested to simulate the number of steps the average person takes in 30 years* 
• Offers the younger, more active patients a TKA solution designed to address their increased expectations for wear performance. 
• An often used solution in total knee replacement for patients with metal sensitivity.

VERILAST Technology is offered for the following knee implants:

• GENESIS^◊ II
• LEGION^◊ CR
• LEGION^◊ PS
• JOURNEY^◊ II BCS
• JOURNEY^◊ II CR

When used with our LEGION ^◊ Total Knee System , it demonstrated an impressive 81% reduction in wear in simulated lab testing compared to conventional materials. Plus, wear simulation indicates that the LEGION Cruciate Retaining Knee System with VERILAST Technology may last up to 30 years of wear - that's twice the current industry standard of 15 years.*

Learn more about LEGION Total Knee System here

*Based on in-vitro wear simulation testing, the LEGION^◊ CR Primary Knee System with VERILAST technology is expected to provide wear performance sufficient for 30 years of actual use under typical conditions. The results of in-vitro wear simulation testing have not been proven to quantitatively predict clinical wear performance. Also, a reduction in total polyethylene wear volume or wear rate alone may not result in an improved clinical outcome as wear particle size and morphology are also critical factors in the evaluation of the potential for wear mediated osteolysis and associated aseptic implant loosening. Particle size and morphology were not evaluated as part of the testing.

VERILAST^◊ Research 

	VERILAST 2010 Wear-Reduction History White Paper   History of Wear-Reduction Technology in Total Knee Arthroplasty To reduce the number of TKA revisions, sustainable improvements in the longevity of total knee arthroplasty require a system-wide approach of optimizing the design along with using advanced bearings. VERILAST Technology in the LEGION Primary Knee System is the only TKA solution available that has United States and European Union claims for expected wear performance that is sufficient for 30 years of actual use under typical conditions Download the VERILAST 2010 Wear-Reduction History White Paper
	VERILAST - An Advanced Bearing System for TKA White Paper Morrison, Mark, PhD.; Parikh, Amit, BS; Jani, Shilesh, MS   Implant design and materials selection play an important role in the wear-related performance of TKA. It is widely recognized that excessive wear of UHMWPE tibial inserts can result in mechanical implant instability and, in some instances, catastrophic wear.  Download the Advanced Bearing System for TKA White Paper

*Based on in-vitro wear simulation testing, the LEGION^◊ CR Primary Knee System with VERILAST technology is expected to provide wear performance sufficient for 30 years of actual use under typical conditions. The results of in-vitro wear simulation testing have not been proven to quantitatively predict clinical wear performance. Also, a reduction in total polyethylene wear volume or wear rate alone may not result in an improved clinical outcome as wear particle size and morphology are also critical factors in the evaluation of the potential for wear mediated osteolysis and associated aseptic implant loosening. Particle size and morphology were not evaluated as part of the testing. 

Every TKA implant is composed of two bearing surfaces:

1. Polymeric tibial component
2. Hard femoral component.

Previous attempts to improve wear resistance only involved the polymeric tibial component, but both components affect the wear performance of the couple. Ceramics have shown superior wear in hips ²⁵, and Smith & Nephew is the only company that can provide a ceramic bearing surface for TKA.

By improving both bearing components, we created a system-wide solution with industry-leading wear resistance. The result? VERILAST^◊ Technology, the only advanced bearing couple for TKA, which features OXINIUM^◊ Oxidized Zirconium femoral components used in conjunction with 7.5 Mrad highly crosslinked, re-melted UHMWPE tibial inserts.

VERILAST technology combines Cross Linked Polyethylene with our OXINIUM Technology which has been proven to be twice as hard as CoCr but 49 times more abrasive resistant than CoCr, which reduces wear in both pristine and roughened conditions.

Smith & Nephew XLPE for TKA is manufactured from compression molded GUR 1020, and is gamma - irradiated at 7.5Mrad and subsequently re-melted. It has been proven to balance significant wear reduction but also maintains mechanical properties. We have done this with our high flex designs, which minimize the potential for sheer forces.

For more detailed information, contact your local sales representative or call Customer Service at 1-800-238-7538.

*Based on in-vitro wear simulation testing, the LEGION^◊ CR Primary Knee System with VERILAST technology is expected to provide wear performance sufficient for 30 years of actual use under typical conditions. The results of in-vitro wear simulation testing have not been proven to quantitatively predict clinical wear performance. Also, a reduction in total polyethylene wear volume or wear rate alone may not result in an improved clinical outcome as wear particle size and morphology are also critical factors in the evaluation of the potential for wear mediated osteolysis and associated aseptic implant loosening. Particle size and morphology were not evaluated as part of the testing.

Living Proof - VERILAST^◊

This includes Smith & Nephew clinical history studies for LEGION^◊ Total Knee System including GENESIS^◊ II.

1. Smith and Nephew (2009). The Genesis II Total Knee. Available at: http://global.smith-nephew.com/us/GENESIS_II_TOTAL_KNEE_2968.htm Accessed, November 30, 2009.
2. Smith and Nephew Wins Gender Knee System Clearance (2009). Available at: www.allbusiness.com Accessed, December 7, 2009.
3. Bourne RB, Laskin RS, Guerin JS (2007). Ten-year results of the first 100 Genesis II total knee replacement procedures.
4. Orthopedics; 30:83-85.
5. Haas SB, Cook S, Beksac B (2004). Minimally invasive total knee replacement through a mini-midvastus approach: a comparative study. Clin Orthop Relat Res; 428:68-73.
6. Harato K, Bourne RB, Victor J, et al (2008). Midterm comparison of posterior cruciate-retaining versus -substituting total knee arthroplasty using the Genesis II prosthesis. A multicenter prospective randomized clinical trial. Knee; 15:217-221.
7. Karachalios T, Giotikas D, Roidis N, et al (2008). Total knee replacement performed with either a mini-midvastus or a standard approach: a prospective randomized clinical and radiological trial. J Bone Joint Surg Br; 90:584-591.
8. Laskin RS, Maruyama Y, Villaneuva M, et al (2000). Deep-dish congruent tibial component use in total knee arthroplasty: a randomized prospective study. Clin Orthop Relat Res; 36-44.
9. Laskin RS (2003). An oxidized Zr ceramic surfaced femoral component for total knee arthroplasty. Clin Orthop Relat Res; 191-196.
10. Laskin RS, Davis J (2005). Total knee replacement using the Genesis II prosthesis: a 5-year follow-up study of the first 100 consecutive cases. Knee; 12:163-167.
11. Laskin RS (2006). Reduced-incision total knee replacement through a mini-midvastus technique. J Knee Surg; 19:52-57.
12. Laskin RS (2007). The effect of a high-flex implant on postoperative flexion after primary total knee arthroplasty. Orthopedics;30:86-88.
13. McCalden RW, MacDonald SJ, Bourne RB, et al (2009). A randomized controlled trial comparing „high-flex“ vs „standard“ posterior cruciate substituting polyethylene tibial inserts in total knee arthroplasty. J Arthroplasty; 24:33-38.
14. Rothwell A, Taylor J, Wright M, et al (2009). New Zealand Orthopaedic Association: New Zealand Joint Registry Ten Year Report. October 2009. http://www.cdhb.govt.nz/njr/reports/A2D65CA3.pdf Accessed June 6, 2010
15. Emsley D, Newell C, Pickford M, et al (2009). National Joint Registry for England and Wales: 6th Annual Report. http://www.njrcentre.org.uk/ Accessed June 6, 2010