Comparing Knee Implants | Why Dr. Broome Choses Smith and Nephew Knee Implants

Dr. Broome: So not all knee replacements are the same, each company nowadays has a very good performing knee replacement implant system. But I think it's important to know what to ask as a patient and make sure that your doctor is using something that's going to last you the longest and had the least likelihood of failing or causing some adverse event. Traditional knees, the implants are this part that goes on the shin bone with this white polyethylene or plastic spacer there and then on the thigh bone, it's capped with this metal component here. So it's on the traditional knees this was the surface that works the best. Now years ago, when I was growing up, my granddad needed his knee replaced those the knees back then they would tell you, hey you need to wait until you're in your 70s or so because these are only going to last 12 to 15 years. That was in large part because this polyethylene spacer here would wear down in that time period. Along the road in the late 90s and early 2000s, these products have gotten much more durable. Their designs have gotten better. So these in large part have solved our wear problem. Now, most companies have a total knee that has this shiny metal, it looks like stainless steel, this is actually a blend of several different metal alloys, one of which is nickel. And when you put metal on this polyethylene, there's still some friction so there's still going to be some likelihood of wear. The other thing is there is a subset of population that's allergic to nickel and think about a lot of women that you may have seen or women would know this firsthand, when they wear certain forms of jewelry, especially cheaper jewelry, sometimes it'll cause a reaction on their skin or stain their skin. That's usually a nickel allergy. Well believe it or not, when you put an implant like this in the knee, some of those people have an allergic response and can quote unquote, reject the knee. So I prefer a knee that uses more of a this is called oxidizer zirconium which is more of a ceramic component and when you put ceramic on polyethylene, whether it's a knee or a hip or any other joint, the friction goes down so the wear is minimized even further. So this should be a bearing surface that's going to last much longer than the traditional metal on polyethylene. The other key advantage of this is oxidizer zirconium or oxinium is what we call bioinert, meaning the body can't reject this. So if someone comes to me with a knee that's been put in and they've rejected it due to metal allergy or nickel allergy, we remove those implants and we put this in so preferentially to me, you get you kill two birds with one stone with this implant. You got one that's going to last longer and one that the body is not not going to reject.

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