ZBEdge is dynamic intelligence with the power to elevate and unlock the full potential of 911Թ’s cutting-edge suite of integrated digital technologies, robotics and implant solutions.
911Թ is committed to supporting the value of our technology with evidence. Read below for the latest on our ZBEdge products.
Key Takeaway:Sequential bilateral robotic-assisted TKA is a valid option for improving accuracy and early outcomes, without posing an additional risk of complications.
Key Takeaway :The learning curve associated with introducing the ROSA® Knee System…was relatively short and did not lead to increases in operative time or any additional complications or adverse events for case performed during the learning phase.
Key Takeaway:Robotic-assisted TKA with the ROSA® Knee System significantly decreases radiographic outliers and length of stay without affecting the rate of complications or early patient reported outcome measures in low-volume surgeons.
Key Takeaway:[The] results show a high repeatability of registration of anatomic landmarks and gap assessment among observers using this robotic system for both image-based and [imageless] software.
Key Takeaway: Robotic-assisted total knee arthroplasty [with the ROSA® Knee System] may be safely performed in the ambulatory surgery center setting.
Key Takeaway:Robotic-assisted total knee replacement is associated with a lower loss of aROM in the immediate post-operative period and higher odds of achieving 90° of flexion within one-month. Unlike manual total knee replacement patients, robotic-assisted total knee replacement patients also exceeded their pre-operative aROM by three-months post-operative.
Key Takeaway:Robotic-assisted TKA with the ROSA® Knee System may improve the surgeon's operative experience by reducing the physiologic and ergonomic strain associated with total knee arthroplasty, however more studies are needed to support this.
Key Takeaway:"…this new robotic system demonstrated high accuracy [for resection angle and implant placement] in 2D and 3D measurements…"
Key Takeaway: The results indicate that raTKA may help enhance the early functional recovery of TKA patients and promote a better satisfaction level in the early post-operative period.
Key Takeaway:Achieving a time neutral robotic procedure, compared to conventional TKA, is feasible and has been shown to require approximately 70 cases in this study.
Key Takeaway:[Imageless] robotic-assisted TKA with ROSA® Knee reduces pain and improves early functional recovery compared to conventional TKA at 4-6 weeks, but functional outcomes at one year are equivalent based on the MCID for KOOS-JR
Key Takeaway:Overall, the increased accuracy of implant size predictions from this 3D templating technology has the potential to improve intra-operative efficiency and minimize costs and surgical time.
Read Publication
Key Takeaway: Early literature regarding the ROSA® Knee System is promising as studies have shown precision of its bony resections, accuracy of overall limb alignment, and low early revision rates.
Key Takeaway:The potential of the confluence of the ROSA Knee System and analytics platforms to simplify the surgical procedure, improve accuracy, and provide a vehicle for mass customization and individualization of care for each patient is a noteworthy advance.
Dr. Lonner concludes that the value of contemporary knee robotics may not yet be fully appreciated, which is emphasized by the prospects of advancing AI with pre, intra, and post-operative data in order to further optimize outcomes for TKA. He feels that robotics in arthroplasty is on the verge of becoming “self-evident”.
Key Takeaway:The ROSA® Knee System produces more accurate and reproducible component position angles in the sagittal plane for both femoral and tibial components, and the coronal plane for the tibial component compared to navigated TKA.
Key Takeaway:Imageless rTKA was associated with longer surgical time, better pain perception and improved ROM at 12-month follow-up compared with nTKA. No significant differences were reported on other PROMs, complication rates and radiographic outcomes.
Key Takeaway:X-Atlas™ imaging technology could effectively predict implant sizing.
The X-Atlas™ imaging technology proved to be accurate to reconstruct a 3D bone model and results have shown that it might provide benefits to surgeons seeking improved planning and precision without the problems of obtaining 3D imaging.
Key Takeaway :The AFIP concept allowed the restoration of the native knee anatomy and alignment with a natural ligament pattern.
With a more physiological target for ligament balancing, [robotically assisted] AFIP technique had equivalent clinical outcomes at 12 months compared to aMA, with a faster recovery.
Key Takeaway:The ROSA® Knee System produces high precision and reproducibility of resection levels, angles, and post-operative limb angles in vitro.
Key Takeaway:Robotic-assisted total knee arthroplasty with the ROSA Knee System is highly accurate and provides comparable component positioning to the Mako Total Knee in both saggital and transverse planes.
Key Takeaway:The ROSA Knee System is showing a favorable gap balancing technique and the possibility to create individualized alignment.
The ROSA® robotic system has been recently introduced in the market and presents specific and peculiar features to optimize ligament balancing and an individualized alignment of the implant in a three dimensional prospective.
Key Takeaway:Robotic-assisted total knee arthroplasty with the ROSA® Knee System is successful in restoring a neutral alignment and improving clinical outcomes even in severely deformed knees.
Key Takeaway: The ROSA® Knee System produces high precision and reproducibility of resection levels, angles, and post-operative limb angles in vivo. Robotic-assisted total knee arthroplasty [with the ROSA® Knee System] may be safely performed in the ambulatory surgery center setting.
Key Takeaway:The ROSA® Knee System produces more accurate and reproducible bone resection angles and levels compared to conventional instrumentation.
Key Takeaway:Robotic-assisted total knee arthroplasty with the ROSA® Knee System may reduce the need for unnecessary soft tissue releases to achieve coronal alignment to the mechanical axis in total knee arthroplasty.
Key Takeaway:The [ROSA Knee System] is accurate in terms of the coronal alignment and bone resections. [This study] …shows that the accuracy previously reported only in cadavers can also be achieved in patients.
Key Takeaway:The ROSA® Knee System can be adopted rather quickly regarding the initial learning curve. This was measured as the initial cut point for reducing surgical time back to the mean surgical time. Improvements in accuracy compared to manual TKA were seen in the mastered robotic-assisted TKA cases.
Key Takeaway:The ROSA® Knee System improved reproducibility of post-operative alignment in valgus deformities and improved tibial component positioning compared to conventional TKA, suggesting that the ROSA Knee System may be more effective in challenging cases requiring precise alignment and component positioning.
Key Takeaway:The ROSA Hip® System is associated with a brief initial learning curve of 12 cases, with the most significant improvements in surgical efficiency realized during acetabular cup placement.
Key Takeaway:The ROSA Hip® System shows no clinically significant increase in radiation exposure to the patient compared to manual approaches. In addition, when compared to the literature, the radiation exposure is less than that of CT-based robotic approaches.
Key Takeaway:The ROSA Hip® System demonstrated more accurate acetabular cup positioning and resulted in fewer outliers compared to manual THA.
Key Takeaway:The ROSA Hip® System increases the accuracy of acetabular cup placement and the percentage of cups within the safe zone with no increase in overall case time.
Key Takeaway: The ROSA Hip® System leads to time savings compared to a robotic CT-based robotic system. The reduction in variance for surgical and total OR time allows for more efficient management of hospital resources.
Key Takeaway: The ROSA Hip® System leads to an earlier reduction in pain levels and a decrease in length of stay by 34.2%, allowing a greater proportion of outpatient cases with no increase in complication rate or inpatient rehabilitation compared to a manual technique.
Key Takeaway:Similar pain, but less opioid use, suggests that patients receiving cTHA required more opioids to manage the pain. The ROSA Hip® System may play a role in rapid recovery protocols and mitigation of post-operative opioid burden.
Key Takeaway: The ROSA Hip® System allows for accurate cup placement independent of obesity status, minimizing the risk of over-abducted “open” cups when using a minimally invasive direct anterior approach for THA.
Key Takeaway:The ROSA Hip® System standardizes the THA procedure by reducing differences in placement of left or right acetabular cups, which may lead to more homogenous outcomes across different surgical scenarios.
Key Takeaway:Robotic-assisted total hip arthroplasty with the ROSA Hip® System leads to lower treatment costs and improved utility through at least 5-years post-operative.
Key Takeaway:ONE Planner® Hip has a similar high level of accuracy as the predicate software supporting its use for preoperative planning with fluoroscopy-based robotic-assisted THA.
Key Takeaway:Signature ONE planner and patient-specific guides were significantly more accurate (P=.01) for the combined vectors of version and inclination compared to conventional instruments.
Key Takeaway:Signature preoperative planning and patient-specific instrumentation improves the accuracy of glenoid implant placement in TSA.
Key Takeaway:This study provides a unique and valuable visual aid to assist with patient counseling and setting perioperative expectations.
Patients can be counseled that the greatest proportional improvement in PROMs is within one month after THA, while function surpasses pre-operative baselines by three-months, and gait quality may not improve until after one-year. This can help set realistic expectations and target interventions toward patients deviating from the norm.
Key Takeaway:This study demonstrates that the use of a smartphone-based care platform after primary knee arthroplasty resulted in significantly less visits to physiotherapy and the ED when compared to the control group.
Implementation of this smartphone/smart watch care platform showed similar outcomes to traditional care models at 1 year postoperative. Traditional physiotherapy and ED visits were seen at much lower rates in this cohort, demonstrating a lower usage of health care resources. This application could assist in alleviating the need for health care dollars by reducing postoperative costs, enhancing communication across the health care team, and permitting such resources to be more properly distributed.
Key Takeaway:Patients found remote monitoring with mymobility easy to use, increased motivation, and recommend it to other patients undergoing lower extremity arthroplasty.
Remote monitoring technologies for THA, TKA, and UKA provide patients motivation to conduct their rehabilitation programs, and patients would recommend it to other patients undergoing similar procedures. The THA patients felt that these technologies could eventually even completely replace in-person rehabilitation programs, but all patients recommend a combination of technology and in-person rehabilitation postoperatively. This study showed an overwhelmingly positive experience of patients utilizing remote monitoring rehabilitation technologies.
Key Takeaway:Equivalent outcomes and significantly fewer PT visits with mymobility for TKA/PKA
The purpose of this study was to determine the non-inferiority of a smartphone-based exercise educational care management system after primary knee arthroplasty compared with a traditional in-person physiotherapy rehabilitation model. The data found that mymobility is clinically non-inferior to the standard of care for all outcomes. mymobility users demonstrated a significant reduction of physical therapy utilization post-operatively. Further, mymobility users trended lower on ED visits than control group, though not statistically significant. This platform could aid in decreasing post-operative costs, while improving patient engagement and communication with the healthcare team.
Key Takeaway:Equivalent outcomes and significantly fewer PT visits with mymobility for THA
The purpose of this study was to determine the non-inferiority of a smartphone-based exercise educational care management system after primary total hip arthroplasty compared with a traditional in-person physiotherapy rehabilitation model. The data found that mymobility is clinically non-inferior to the standard of care for all outcomes. mymobility users demonstrated a significant reduction of physical therapy utilization post-operatively. Further, mymobility users trended lower on ED visits than the control group and hospital readmissions, though not statistically significant. This platform could aid in decreasing post-operative costs, while improving patient engagement and communication with the healthcare team.
Key Takeaway:mymobility enables remote gait quality measurements
The purpose of this study was to assess the recovery of gait quality following primary total hip and knee arthroplasty using a smart-phone based care management platform. The recovery curves reflect previous curves captured by traditional gait analysis methods as well as functional and patient reported outcome scores. Capturing real-world gait quality metrics through the phone may provide further insights into objective recovery data not captured by traditional in-clinic assessments.
Key Takeaway:Objective and reliable data with mymobility
The purpose of this study was to characterize the recovery of physical activity following knee arthroplasty by means of step counts and flight counts (flights of stairs) measured using a smart-phone based care platform. This data demonstrated a recovery curve similar to previously reported curves for patient reported outcome measures in the arthroplasty arena. Patients and surgeons may use this information to help set goals for recovery following total and partial knee arthroplasty using objective activity measures.
Key Takeaway:mymobility can be integrated with ROSA Knee to passively collect data throughout the episode-of-care. Associations between intra-operative decisions regarding laxity and post-operative outcomes were identified.
There were higher step counts at six-weeks post-operatively in knees with >2mm increased laxity in both the lateral compartment in extension and medial compartment in flexion (p<0.05). Knees balanced in flexion within <0.5mm had higher KOOS JR scores at six-weeks post-operative (p=0.034) compared to knees balanced within 0.5 – 1.5mm. Knees with laxity balanced between 0.5 and 1.5 mm and those with more than 1.5 mm of laxity between medial and lateral compartments in extension had significantly greater step counts at six-weeks. The study has a relatively small sample size (n=131).
The focus of this paper was on the feasibility of data collection throughout the episode of care. These associations are intriguing, and the clinical relevance needs further investigation.
Key Takeaway:The current study demonstrates that the HipXpert system with the HipXpert 3D Display and Anchoring Application can be used to successfully achieve accurate implant orientation in the acetabulum.
The study tested the clinical accuracy of the HipXpert system with the HipXpert 3D Display and Anchoring Application in a cadaveric study. It demonstrates that the HipXpert system with the HipXpert 3D Display and Anchoring Application resulted in implant orientation accuracy of less than 5 degrees error for both anteversion and inclination for all 47 screw implantations using both the anterior and lateral tools.
Key Takeaway: Microsoft HoloLens 2 was used for unplanned remote assistance for telesurgical support.
This case study demonstrates the ability to use the HoloLens 2 with Microsoft Dynamics 365 Remote Assist Software to provide immediate telesurgical support by an industry representative, the PM, to the operating surgeon approximately 100 km apart. The data is transferred via an encrypted and secured cloud-based program and provided the PM a real-time surgeon viewpoint of the operating theatre, including direct line of site to the operative knee, the operating instruments, and even the surgeon’s hands.
Key Takeaway: 6-week post-operative recovery trends were associated with 12-week post-operative recovery trends for gait and range of motion (ROM) metrics.
Key Takeaway:Objective functional improvement is likely not captured in the patient’s perceived recovery. Thus, a holistic approach to monitoring recovery should include passively collected gait metrics such as what is offered by Persona IQ The Smart Knee.
Key Takeaway:Data from Persona IQ The Smart Knee shows high data collection compliance, providing baseline free-living gait metrics after total knee arthroplasty, which may be useful in comparisons of individual patients, cohort comparisons, and in determining minimally clinically important differences in future studies.
Key Takeaway:Kinematic data is intended as an adjunct to other physiologic measurement tools. Analysis of gait data may allow for better understanding of differences in recovery and the ability to set goals within different patient groups.
Key Takeaway:Objectively measured functional recovery can act as an excellent supplement to the Patient Report Outcome Measures (PROMs) typically collected for monitoring patient outcomes following Total Knee Arthroplasty.
Key Takeaway:Persona IQ post-operative data generated a concern for one patient recovering poorly despite positive 2-week clinical outcomes. These findings allowed early intervention prior to the routine follow up to allow the patient to return to their previous recovery trajectory.
Key Takeaway:Remote monitoring combining implantable sensors and wearables may be useful to assist in identifying patients in need of additional intervention beyond the 90-day episode of care.
Key Takeaway:Remote monitoring of functional ROM measured by implantable sensors may be useful in identifying patients at risk of limited ROM, determining MUA need, and monitoring ROM recovery following MUA.
Key Takeaway:Signals generated by an embedded sensor during total knee arthroplasty can transmit through bone and cement, providing accurate ROM data, which may be capable of detecting prosthesis fixation changes remotely.
Key Takeaway:“Patients were engaged and satisfied with use of remote monitoring technologies. Remote monitoring and virtual visits may have potential to reduce patient and provider cost burden, maintaining similar outcomes as the traditional care.”
Key Takeaway: "Post-operative Qualified Step Count, Walking Speed and ROM were used to analyze the recovery of three different cohorts of bilateral TKA patients. These metrics suggest that appropriately selected patients can successfully undergo staged bilateral TKA as early as three to six weeks following their first TKA, even if full ambulation has not yet been achieved."
Key Takeaway:Persona IQ® The Smart Knee® “represents a significant advancement in TKA technology and rehabilitation tracking.” Insights from smart implants can aid care teams in early identification of some patient recovery concerns.
Read Publication
Key Takeaway:OrthoGrid Hip AI® allows reproducible quantitative assessment of leg length and acetabular cup position on fluoroscopic images.
This material is intended for healthcare professionals. Distribution to any other recipient is prohibited. 911Թ does not practice medicine. For indications, contraindications, warnings, precautions, potential adverse effects and patient counselling information, see the package insert or contact your local representative; visit www.zimmerbiomet.com for additional product information. Not all patients are candidates for the use of this product and surgeons should evaluate individually to determine which patients are appropriate for therapy at home.
All names used in the mymobility app examples are fictitious. No identification with actual patients or health care professionals is intended or should be inferred. Apple, Apple Watch, iPhone, HealthKit and Mac are trademarks of Apple, Inc., registered in the U.S. and other countries. Patients must have compatible hardware and be clinically appropriate for remote care to use mymobility.WalkAI Exceptions are visible through the ⳾Dzٲ® clinician experience and are only for patients using the mymobility app with an iOS device.
NAVIO is a registered trademark of Smith and Nephew.
Mako is a registered trademark of Stryker Corporation.
Microsoft and HoloLens 2 are trademarks of the Microsoft Corporation.
Indications and contraindications can be found here.
Persona IQ: The objective kinematic data generated by the CTE with CHIRP System are not intended to support clinical decision-making and have not been shown to provide any clinical benefit.
For full prescribing information for the CANARYcanturio™te, refer to physician instructions for use.
canturio™ Legal Manufacturer
Canary Medical USA LLC
2710 Loker Ave. West
Suite 350
Carlsbad, CA 92010
Customer Service: 1-833-692-2627
canarymedical.com
canturio™ Exclusively Distributed By
911Թ, Inc.
1800 West Center St.
Warsaw, Indiana 46581-0587 USA
Persona® Knee Legal Manufacturer
911Թ, Inc.
1800 West Center St.
Warsaw, Indiana 46581-0587 USA