Intraoperative guidance, personalized alignment technologies, and rapid patient recovery remain at the forefront of hip and knee replacement advancements — areas where Exactech continues to set itself apart with its differentiated portfolio.
Widely regarded as the world’s premier annual conference for large joint arthroplasty, the 2024 American Association of Hip and Knee Surgeons Annual Meeting (AAHKS) delivered another exceptional event. The yearly meeting showcased significant advances in total joint replacement surgery, with a myriad of technologies focused on robotic or intraoperative guidance, personalized alignment and rapid patient recovery. Exactech stood out with its contributions in these areas and beyond, most notably with Exactech’s next-generation vitamin E-infused, crosslinked hip and knee bearings, representing a remarkable advancement in implant materials.
Other key themes from the meeting included the evolving, sometimes challenging economic and reimbursement trends in hip and knee arthroplasty, and the continued shift of procedures to the ambulatory surgery center (ASC) setting. Additionally, the role of GLP-1 drugs in the hip and knee arthritis continuum of care was a hot topic, alongside the growing emphasis on multimodal strategies to avoid the dreaded complication of periprosthetic joint infection.
Exactech distinguished itself at the meeting in three primary areas. We sat down with Exactech’s Chief Strategy and Medical Officer Sharat Kusuma, M.D., to discuss his key takeaways:
The top key takeaways:
Emerging Technologies: Flexible, downsized, intraoperative guidance technologies that achieve precise bone cut and angular alignment accuracy1—without requiring preoperative knee CT scans.
In the realm of intraoperative guidance technologies, ExactechGPS®, along with its proprietary Newton® and FLEX ligament-driven balancing solutions, are empowering surgeons to achieve their desired knee alignment philosophy. These innovations stand out for their ASC-friendly design, compact physical footprint and cost-effective pricing structure.
As explained by kinematic knee alignment pioneer Thomas Meade, M.D., of Allentown, Pennsylvania, at the AAHKS 2024 meeting, GPS delivers superior accuracy compared to robotic systems from his experience – all without the requirement for preoperative CT imaging. Most current robotic systems are unable to provide accurate intraoperative guidance without the patient first undergoing a cumbersome preoperative CT scan. GPS uses proprietary active, powered trackers to enable sub-millimeter accuracy1 without the preoperative CT scan. Additionally, GPS is the only guidance system on the market that supports knee, shoulder and ankle arthroplasty procedures.
Advanced Polyethylene Materials: Designs Built for Implant Longevity
While many companies chose to focus on their surgical technology solutions, Exactech took a broader approach, showcasing innovative materials designed for implant durability and longevity. The company is one of the few manufacturers offering vitamin E-enhanced technology for both hip and knee applications.
Exactech’s Alteon® XLE polyethylene for hips and Activit-E® for knees are both highly crosslinked and vitamin E-infused bearing technologies that were developed by the experts at Massachusetts General Hospital, designed to minimize wear, while maintaining long-term oxidative stability. In bench testing, Activit-E inserts have been shown to deliver superior wear resistance compared to conventional polyethylene, while maintaining desirable mechanical properties such as ductility and fracture toughness2-3. Both advanced materials use 3rd-generation vitamin E blending and crosslinking processes to achieve this elusive balance of polyethylene properties, designed to result in bearings that patients can count on for longevity and performance.
New Surgical Approaches: Patient-specific solutions that enable multiple surgeon philosophies and personalized patient alignment stole the spotlight
Exactech’s surgical innovations are transforming the orthopedic landscape, particularly in anatomic knee ligament balancing. ExactechGPS and the Newton Knee balancing system represent advancements in knee arthroplasty by allowing surgeons to execute either or both kinematic alignment and unique, full arc-of-motion ligament. The system offers pre-bone resection soft tissue analytics, designed to enable predictive postoperative stability. This approach delivers real-time, quantifiable ligament laxity data and integrates with Exactech’s GPS technology for enhanced precision, allowing surgeons to personalize the flexion and extension gaps for each patient.
Within hip arthroplasty, Exactech is revolutionizing the arena of hip resurfacing by collaborating with JointMedica Limited on the Polymotion® Hip Resurfacing System, which is based on a metal-on-polyethylene bearing surface. This next-generation hip resurfacing solution received a Breakthrough Device Designation from the FDA in 2023.
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References:
- Dai Y et al. Accuracy and precision in resection alignment: Insights from 10,144 clinical cases using a contemporary computer-assisted total knee arthroplasty system. The Knee. 2020 Jun;27(3):1010-1017.
- Oral E et al. An antioxidant stabilized, chemically cross‐linked UHMWPE with superior toughness. J. Biomed. Mater. Res., vol. 107, no. 6, Art. no. 6, Aug. 2019, doi: 10.1002/jbm.b.34287
- Alvarez L et al. Wear Resistance Of A Chemically Crosslinked Uhmwpe/vitamin-e Blend For Total Joint Arthroplasty Implants. ORS 2024 Annual Meeting Poster no. 2433.
- Watanabe R et al. Vitamin E-blending suppresses the lipid-induced reduction of impact strength of UHMWPE. p. 1.
*In vitro (bench) test results may not necessarily be indicative of clinical performance.