The GMK Primary product range, including mobile and fixed bearings, offers different levels of constraint:

• Cruciate retaining
• Ultracongruent
• Posterior-stabilised

ADAPTING TO YOUR  OWN SURGICAL TECHNIQUE
Every surgeon is unique. The GMK instrumentation is specifically designed to provide flexible solutions according to every single surgeon’s preferences: accuracy, ease of use and reproducibility are the guidelines followed  for GMK instrumentation development.
The GMK Primary can be implanted following different surgical techniques, according to the surgeon’s philosophy:

• Bone referencing
• Ligament balance
• iMNS Computer Assisted
• MyKnee patient matched cutting blocks

Each surgical technique also provides various options, each one designed to fit every surgical scenario :

• Standard or muscle sparing surgical approach
• Intramedullary or extramedullary tibia options
• Conventional ligament balance technique, based on LBS system or ligament tensor
• Computer Assisted surgery, both referring to measured resections and ligament balance with the ligament  tensor
• MyKnee patient matched cutting blocks: standard, minimally invasive and allowing intraoperative ligament balance

DESIGN RATIONALE
[1] Anderson MJ, Becker DL, Kieckbusch T. - Patellofemoral complications after posterior-stabilized total knee arthroplasty: a comparison of 2 different implant designs. - J Arthroplasty. 2002 Jun;17(4):422-6
[2] D'Lima DD, Chen PC, Kester MA, Colwell CW Jr. - Impact of patellofemoral design on patellofemoral forces and polyethylene stresses. - J Bone Joint Surg Am. 2003;85-A Suppl 4:85-93.
[3] Morra EA, Greenwald AS. - Patellofemoral replacement polymer stress during daily activities: a finite element study - J Bone Joint Surg Am. 2006 Dec;88 Suppl 4:213-6
[4] Sharma A, Komistek RD, Ranawat CS, Dennis DA, Mahfouz MR - In vivo contact pressures in total knee arthroplasty. - J Arthroplasty. 2007 Apr;22(3):404-16
[5] Baldwin JL, House CK. - Anatomic dimensions of the patella measured during total knee arthroplasty. - J Arthroplasty. 2005 Feb;20(2):250-7.
[6] Kulkarni SK, Freeman MA, Poal-Manresa JC, Asencio JI, Rodriguez JJ. - The patellofemoral joint in total knee arthroplasty: is the design of the trochlea the critical factor? - J Arthroplasty. 2000 Jun;15(4):424-9.
[7] Ranawatt et al, Design may be counterproductive for optimizing flexion after TKR – Clin Orthop Relat Res. 2003 Nov;(416):174-6
[8] Kim et al, Range of motion of standard and high-flexion posterior cruciate-retaining total knee prostheses a prospective randomized study. – J Bone Joint  Surg Am. 2009 Aug;91(8):1874-81
[9] Kondo et al. “Arthroscopy for evaluation of polyethylene wear after total knee arthroplasty”, J Orthop Sci, 13:433-437, 2008. Orthop Sci, 13:433-437, 2008
[10] White et al., “Effects of sterilization on wear in total knee arthroplasty”, Clin Orthop, 331:164-71, 1996.
[11] Ries M D, “Highly Cross-Linked Polyethylene. The Debate is Over-In Opposition”, The Journal of Arthroplasty, 20:59-62, 2005.
[12] Baker et al., “The effects of degree of Crosslinking on the fatigue crack initiation and propagation resistane of orthopedic-grade polyethylene”, J Biomed Mater Res A, 66(1):146-54, 2002.
[13] Muratoglu et al., “Unified wear model for highly crosslinked ultra-high molecular weight polyethylenes (UHMWPE)”, Biomaterials, 20:1463-70, 1999.
[14] Westrich, Insall, Resection specimen analysis of proximal tibial anatomy based on 100 total knee arthroplasty specimens – J Arth, 1995  Feb;(1);47-51
[15] Engh et al, In vivo deterioration of tibial baseplate locking mechanisms in contemporary modular total knee components. – JBJS Am. 2001 Nov; 83-A(11); 1660-5
[16] Onsten et alt. Hydroxypatite augmentation of the porous coating improves fixation of tibial components, J Bone Joint Surg [Br] 1998;80-B:417-25.
[17] Polyethylene in TKA: Do we really need cross-linked polyethylene?, MORE Journal Vol. 1 May 2011
[18] No differences in human knee morphometry and gender-specific clinical outcomes: a literature review, MORE Journal Vol. 1 May 2011

CLINICAL FOLLOW UP
[19] International Evaluation Group , GMK Primary   1 year clinical follow up – study report , MORE Journal Vol. 1 May 2011
[20] Prim Dr W Anderl, Dr S Dittrich, Mag B Laky, PhD, Dr P Viè, GMK Primary 3 year clinical follow up – study report
[21] Dr P Lambert, Dr V Leon, Dr R Mendelin, Dr E Rinciari, Mechanical Axis Alignment After Total Knee Replacement Performed Through A Navigation System (iMNS) – study report, MORE Journal Vol. 1 May 2011

SINERGY
[22] MyKnee Publication Review MORE Journal Vol. 2 Supplement  June 2012
[23] Schroer et al. Mini-subvastus approach for total knee arthroplasty. J of Arthroplasty. 2008 Jan; 23(1): 19-25.
[24] McAllister et al. of minimally invasive surgical techniques on early range of motion after primary totalMcAllister et al. The impact of minimally invasive surgical techniques on early range of motion after primary total knee arthroplasty. J of Arthroplasty. 2008 Jan; 23(1): 10-18.
[25] Bonutti et al. Minimally invasive total knee arthroplasty. JBJS Am. 2004; 86: 26-32.
[26] King et al. Minimally invasive total knee arthroplasty compared with traditional total knee arthroplasty. Assessment of the learning curve and the postoperative recuperative period. JBJS Am. 2007 Jul; 89(7): 1497-503.
[27] Schroer et alt. Isokinetic Strength Testing of Minimally Invasive Total Knee Arthroplasty Recovery.  Journal of Arthroplasty, 2010 Feb; 25(2); 274-279

Medacta offers you the opportunity to experience an anatomic knee replacement system with the enhanced accuracy and proven efficiency of a system specifically designed for each individual patient: this is the synergy between GMK system and MyKnee.
MyKnee is a patient-specific cutting block, allowing the surgeon to realize his pre-operative 3D planning, based on CT or MRI images of the patient’s knee.