Comments about the Smith & Nephew GENESIS II Total Knee System | Which Medical Device

I've been using this knee as my main option for knee Arthroplasty for the last 5 years, and have experience of about 350 implantations so far.
It is a good, straightforward implant procedure, and allows for easy teaching of technique to juniors.

On the femur side, anterior or posterior referencing is possible, and external rotation is built into the component, so rarely needs adjustment. Cutting blocks well machined, and implant always fits tightly. Jigs allow revision of cuts with minimal fuss. 8 implant sizes allows good implant/ patient anatomy matching. I don't routinely sacrifice the PCL, but the reamer and box chisel instruments for this are simple, and leave a good bone bridge anteriorly.

On the tibia, I use intramedullary jigging, which is robust and reproducible. The extra medullary jig is straightforward. A 3rd pin inserted tangentially keeps all in place whilst sawing.

Flexion and extension gap assessment is achieved using supplied spacer block and clip on shims. The flexion gap is asymmetrical (trapezoidal), so this is an important step. This will reliably give the poly thickness too.

Trial insertion can be done with tibial plate unfixed, allowing accurate rotional positioning, and laser marks on trials facilitate marking.
Implantation is straightforward. The poly insertion into the tibial tray can be a fiddle, and excessive forward translation of the tibia to do this bit, assisted by a hefty pull on the Homan's retractor, can foul the femoral implant surface on the back of the tibial tray. Consequently, it is easier to assemble tibial implants either before or at insertion, and before cementing on femur.

All in all, a good sound knee. Good post op function and implant survivorship locally so far, and good performance in the registers, as long as you ignore bad results from the Oxinium uncemented version (Australia).

Annoying bits: company keep " upgrading" the kit, so often get strange looking bits of kit when working in different hospitals.

With my procurement helmet on, it is very competitively priced currently, certainly in Scotland.

The Smith and Nephew Visionaire system works with this implant, providing patient specific cutting blocks. I have had some experience of this, and it works very well. It promises to reduce operating time and morbidity, and reduce kit and implant storage requirements. Watch this space.