One question for sales personnel

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anonymous said:
What are the reasons I should choose DePuy Synthes knees or hips over Stryker or ZB?
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I have had the privilege to work regularly with design, regulatory and quality teams across the ortho landscape; I would say that J&J has one of the most robust verification and validation process in the industry. This is not to say that others have an inferior process but rather my opinion is that J&J goes another level to prove claims and maintain reliability/ conformity of supply. Take that for what it’s worth from an anonymous reply...

All that said. The best implant for you is the one your care provider is most proficient at. You should share your expectations for the procedure and you should seek multiple opinions. Shop for the best complete care in your area with the end goal in mind and find a practice that can help coordinate your post op treatment so that you can concentrate on healing and enjoying life.
 












After 36 years in this biz, I'd get a Microport or Medacta medial pivot knee, but really just about any other knee from any other company will last just as well.

For hips, all xlpe seems to work and every company has stems and cups that work pretty much equal.

After 20 years of computer assisted surgery, there is no evidence that it works better and that stands for robots as well.

It is all about your surgeon and his support staff and care pathway and of course the patient and their attitude.
 






20 years in industry here also. I’d get a Conformis knee. Only knee that mimics my individual knee geometry. More stable than a medical pivot. Not symmetric with artificial, poly-driven kinematics (like Journey too).
Who wouldn’t want an implant made just for them?
 






anonymous said:
20 years in industry here also. I’d get a Conformis knee. Only knee that mimics my individual knee geometry. More stable than a medical pivot. Not symmetric with artificial, poly-driven kinematics (like Journey too).
Who wouldn’t want an implant made just for them?
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Ahhh. No real evidence other than short term data to suggest that a knee made just for you is any better than a standard knee. Conformis is smoke an mirrors.
 






anonymous said:
Ahhh. No real evidence other than short term data to suggest that a knee made just for you is any better than a standard knee. Conformis is smoke an mirrors.
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What type of data is there for the Medacta knee? When do most knees fail in today’s world? 15 years? No. Short term failures are more common than poly failure. Mid flexion instability, fixation, and infection. Does Persona or Attune have long term data? I’d rather have my own implant than be made to fit the next size up in AP dimensions, or worse, the next size down. Conformis has been out for 10 years. I think we would have seen some issues by now.
 






anonymous said:
What type of data is there for the Medacta knee? When do most knees fail in today’s world? 15 years? No. Short term failures are more common than poly failure. Mid flexion instability, fixation, and infection. Does Persona or Attune have long term data? I’d rather have my own implant than be made to fit the next size up in AP dimensions, or worse, the next size down. Conformis has been out for 10 years. I think we would have seen some issues by now.
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nice... but so wrong. i can see your red cool-aid mustache from here.

lets talk about some long standing devices. sigma, genesis 2, logic, nexgen. Or lets discuss the merits of a patient specific cut block for the under skilled surgeons who should be sending their patients to higher volume facilities and not getting cases under their belt to improve their proficiency.

Go to a practice that has a high success rate and great post op coordination and execution of care. Ask your surgeon why they use the device the intend to put in your body. If they are honest they will tell you that is it the device they are most familiar with. After that they may give you a few merits of the device that they picked up at a case controversy meeting.
 






anonymous said:
What type of data is there for the Medacta knee? When do most knees fail in today’s world? 15 years? No. Short term failures are more common than poly failure. Mid flexion instability, fixation, and infection. Does Persona or Attune have long term data? I’d rather have my own implant than be made to fit the next size up in AP dimensions, or worse, the next size down. Conformis has been out for 10 years. I think we would have seen some issues by now.
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There have been some negative studies out on conformis. There have also been very few positive studies out supporting it. A lot can go wrong in a OR and there really aren’t any bail out options with Conformis. What happens if you need to do a poly swap? Does an infected patient have to wait a few weeks for poly?
 






anonymous said:
There have been some negative studies out on conformis. There have also been very few positive studies out supporting it. A lot can go wrong in a OR and there really aren’t any bail out options with Conformis. What happens if you need to do a poly swap? Does an infected patient have to wait a few weeks for poly?
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Show me the negative studies. Haven’t seen any. Plenty of positive studies...head to head against the big boys. Why do you need a bailout when it’s made for you? Oops, I cut 20 mm of tibia instead of the planned 5? If you think it takes weeks to make poly for a swap, you are drinking the off the shelf kool aid. You sound like the Stryker consultant in my town who spews falsehoods to patients because he has no answer to a custom knee.

Do your research before you bash technology. It’s the future, and the only reason the ortho cartel hasn’t gone this direction is the massive inventory of sets and trays they would have to scrap would cost more than Conformis would be to buy.
 






anonymous said:
Show me the negative studies. Haven’t seen any. Plenty of positive studies...head to head against the big boys. Why do you need a bailout when it’s made for you? Oops, I cut 20 mm of tibia instead of the planned 5? If you think it takes weeks to make poly for a swap, you are drinking the off the shelf kool aid. You sound like the Stryker consultant in my town who spews falsehoods to patients because he has no answer to a custom knee.

Do your research before you bash technology. It’s the future, and the only reason the ortho cartel hasn’t gone this direction is the massive inventory of sets and trays they would have to scrap would cost more than Conformis would be to buy.
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If conformis is the future, why is everyone buying robots? Wouldn’t it be cheaper to buy conformis?

You sound like a new hire not a 20 year vet. High manipulation rates don’t sound like the future
 






anonymous said:
If conformis is the future, why is everyone buying robots? Wouldn’t it be cheaper to buy conformis?

You sound like a new hire not a 20 year vet. High manipulation rates don’t sound like the future
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I’ve been around since before navigation and robots. They are one in the same. They get you closer to perfection. Your knee can only be so balanced when you remove various thicknesses of bone and replace that with a symmetric implant. You can externally rotate, flex the femoral component, use a medial pivot poly, etc., but in the end, the knee is balanced at 90 and 0, not mid flexion. Surgeons are used to cramming the thickest poly in to make up for this, and they sleep better. When switching to a custom knee, if they aren’t trained properly, they put in a thicker poly than the Conformis plan calls for, and are manipulating that knee. Once they realize they should leave it a little looser than their std knee implant, All is perfect. Robots are bought to keep up with the Jones’s. They take up more time, money and space, and I have yet to see a study on improved outcomes. That UK Haddad study is a joke, and spending a million bucks because patients have better bone cuts is a farce. You can dismiss Conformis, but it makes more sense than you box openers will ever know. Purchasing depts like the cheapest sticker price, and don’t look at the whole picture. Robots make for good billboards, and the hospital doesn’t have to worry about marketing a single surgeon using a different knee like Conformis, but they can advertise their hospital with technological advances. Domo Ari Gato.
 






Conformis has the worst MAUDE data of any knee I have ever seen. It is a joke every single month. Knee too lax or too tight, more “infections” than any other. More patient falls than any other. It is statistically even worse than Attune. Compare the rate of tibial loosening for Triathlon Tritanium on MAUDE with Conformis and Attune and it’s clear what you should have. Robots make no difference and the Haddad paper is from a guy paid over a million $ by Stryker and in the journal he edits. Bullshit on the robot, but kudos for Tritanium.
 






How many times are Stryker knees (or any other knee) reported on Maude for a poly swap? NONE. Because a new poly must be made, all Conformis swaps for anything are reported. I guarantee anyone reading this has not reported an infection and poly exchange, ever. Read through the bullshit, and come up with a better reason to think a 20 year old design is “modern”. 20 years ago, we didn’t have cell phones, gps in cars, and TVs weighed 100 pounds and had a tube.
 






I report every poly swap or revision of any of our parts for infection with every DePuy joint I attend. You should too.

I do wonder sometimes whether we really have more Attune loosenings than others or whether we are just over reporting compared with them.
 






anonymous said:
I report every poly swap or revision of any of our parts for infection with every DePuy joint I attend. You should too.

I do wonder sometimes whether we really have more Attune loosenings than others or whether we are just over reporting compared with them.
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Do you report swaps for non-infections? Or manipulations? How many times does your doc tell you to leave an extra poly for a potential swap and that you don’t need to come to the case. Are those reported?
I think you are in the minority. I can say with certainty that Zimmer reps doing swaps and revisions don’t take the time to report it.
 






Otherwise know as "adverse events". Reps are compelled by the FDA to report AE's to the FDA by way of their company's regulatory and compliance procedures. Good to know nobody bothers....
 






anonymous said:
Otherwise know as "adverse events". Reps are compelled by the FDA to report AE's to the FDA by way of their company's regulatory and compliance procedures. Good to know nobody bothers....
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I never reported once, my first month I had the pleasure of having my distributor come out to babysit a case I was in on and it was a simple vanilla poly swap. After the case I asked how I should fill out the paperwork and he just laughed and told me to grow up fast than walked away. Good times.
 






anonymous said:
I never reported once, my first month I had the pleasure of having my distributor come out to babysit a case I was in on and it was a simple vanilla poly swap. After the case I asked how I should fill out the paperwork and he just laughed and told me to grow up fast than walked away. Good times.
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You are not alone. Happens everywhere.
 






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