Zimmer Biomet Holdings, Inc.’s new Vanguard Individualized Design (ID) knee implant will “revolutionize total knee replacement, ” by “respecting” soft tissue.
Zimmer Biomet’s New Vanguard Knee Will “Revolutionize” TKA
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Todd Davis, the company’s vice president and general manager of global knee business, made the bold prediction in a September 20, 2016 press release announcing the introduction of the implant.
Davis says the device has the ability to fine tune the knee’s balance through the use of independent medial and lateral bearing thickness and constraint options. “We will arm the surgeon with the ultimate soft tissue respecting capability.”
The device does this by incorporating two individual polyethylene bearings with different articulations on the medial and lateral sides. Traditional total knee implants feature a one-piece bearing constructed of polyethylene which is placed between the metal portions of the implant. The Vanguard ID’s flexible design allows surgeons to mix and match bearings of differing thickness and geometry, “ensuring they can personalize their approach to accommodate and preserve natural soft tissue, ” stated the announcement.
The original Vanguard Knee system, which Biomet, Inc. introduced in 2003, pioneered personalization in knee replacement by offering the broadest range of available sizes, says the company. “By equipping surgeons to combine a vast number of bearings of varying thickness (up to 2 mm) and articulations to ensure a personalized feel, the Vanguard ID builds on the Vanguard knee’s legacy of enabling surgeons to create a personalized fit, while maintaining surgical simplicity and intraoperative flexibility.”
Tom Aleto, M.D., of the Missouri Orthopedic Institute in Columbia, Missouri, said he believes he is achieving higher patient satisfaction with the Vanguard ID. “Maintaining natural ligament tension while preserving healthy soft tissue is critical not only to restore normal range of motion but to achieve patient satisfaction. In traditional knee design, surgeons typically release healthy soft tissues in an attempt to balance the knee and maintain feasible kinematics. Because the Vanguard ID allows me to mix and match components, I am able to individually treat each compartment while maintaining healthy soft tissues.”
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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