(Smith & Nephew), based in Great Britain, received its first major government order in 1914. And by the end of the 20th century, it became one of the largest suppliers of medical equipment and materials, and also became known for innovative developments in the field of orthopedics and endoscopy.
For hundreds of thousands of people around the world, endoprostheses from Smith & Nephew provide the opportunity to return to a full life, thanks to the constant improvement of technology and high-quality performance
Products from Smith & Nephew Orthopedics AG, Switzerland, Smith & Nephew Orthopedics AG
The following types of goods are produced:
- Tools for installing hip endoprostheses Tools for installing hip endoprostheses: Tools for installing hip endoprostheses, complete and separate: 1. Tools
- Hip joint endoprostheses Hip joint endoprostheses: Hip joint endoprostheses, complete and separately: 1. Uncemented implants: 1.1. Femoral components according to K. Zweimuller: – standard
- Tools for installing knee endoprostheses
- Endoprostheses of the knee joint Endoprostheses of the knee joint, complete and separately: 1. Endoprosthesis of the knee joint hinged RT-PLUS: 1.1. Femoral Component (type 128910). 1.2.Tibial
- Tools for installing knee endoprostheses
- Tools for installing hip endoprostheses
- Hip joint endoprostheses Hip joint endoprostheses, complete and separately: 1. Uncemented implants: 1.1. Femoral components according to K. Zweimuller: – standard SL-PLUS Standard; – lateralized
Characteristics of Smith Nephew endoprostheses
Designed for the following functions:
- relieve stress on the hip joint;
- speed up the process of traditional therapy;
- relieve pain syndrome;
- restore limb mobility;
- improve patient comfort;
- stop the deformation and development of the disease.
Smith Nephew hip endoprostheses are created by leading manufacturers in this field. With their systematic wearing, the load on the injured joint is reduced and mobility is restored to the patient. Made from materials certified by a safety certificate, we constantly improve manufacturing technologies. They are mobile, highly durable and lightweight.
Permitting documentation for the Russian Federation (Product Certification)
To import products into the Customs Union (CU), in particular Russia, it is necessary to obtain permits, in particular a declaration of conformity with the CU TR. The cost of the declaration is 9,000 rubles, you may need Test Reports. Also, for the legal sale of products from Smith & Nephew Orthopedics AG, Switzerland, Smith & Nephew Orthopedics AG, you will also need a declaration. ⁉️You will most likely need to obtain temporary import of products to provide product samples. Registration of permits by phone: +7 (499) 348-29-89
Customs clearance of goods
To quickly clear customs, you can contact specialized brokers or prepare the entire set of documents yourself for import into the territory of the Customs Union from Switzerland
- Foreign trade agreement with all annexes
- Invoice (original) + translation Proforma or Commercial
- Telex or invoice confirming the cost of transportation
- Insurance policy
- Transaction passport for a transaction over $50,000
- Packing list
Customs payments
Selection of HS code for goods Smith & Nephew Orthopedics AG, Switzerland, Smith & Nephew Orthopedics AG
| Products | HS CODE | Import duty/VAT |
| 0 / Various | ||
| 9021310000 | 0 / Various | |
| 9018908409 | 0 / Various |
The company imported goods under the following names: Smith & Nephew Orthopedics AG, Switzerland, Smith & Nephew Orthopedics AG. You can buy products through an official distributor or directly
Knee joint prostheses for total arthroplasty
Zimmer - The NexGen® LPS-Flex Mobile Zimmer - LPS-Mobile Bearing Knees
- With a movable platform.
- Both systems allow the artificial knee joint to flex and rotate freely.
- Metal components are used: attached to the end of the femur, replacing the upper part of the tibia.
- Endoprostheses include a plastic articular surface loosely attached to a base plate that acts as artificial cartilage.
- Provide 155⁰ active flexion and 25 degrees of unimpeded internal and external rotation.
- Bone cement is used for fixation.
The Zimmer Gender Solutions® Patello-Femoral Joint
- Knee joint prostheses with a movable platform.
- Designed for active patients, positioned as an early intervention option.
- Allows you to preserve large areas of bone, requiring a smaller incision.
- The use of this implant requires the surgeon to be able to handle special instruments and have knowledge of minimally invasive techniques.
- The endoprosthesis takes into account gender differences; the special shape of its components more accurately reflects the characteristics of female and male anatomy.
- Includes 35 different sizing options.
DePuy Sigma® Rotating Platform Knees
- With a movable platform.
- It involves installing a movable bearing supported on a rotating platform, which allows you to simulate the natural movements of the knee.
- The design ensures a reduction in internal stress and wear, so it lasts longer than its analogues.
- According to statistics, about 1 million such endoprostheses have been implanted in the world, 97% of which have been used for more than 20 years.
DePuy Sigma® Fixed-Bearing Knees
- Fixed support.
- Wear-resistant polyethylene and advanced metal components are used, which do not cause rejection in 99.6% of cases after 5 years of operation.
Smith & Nephew OXINIUM®
- Fixed support.
- Prosthetic knee joint with a high level of wear resistance.
- Made from zirconium metal, which makes it more resistant to abrasion and scratching.
- During testing, an 85% reduction in wear of polyethylene was noted compared to cobalt-chromium materials used in other implants
Stryker Triathlon® Total Knee Replacement System
- Fixed support.
- This type of artificial joint is designed to work with the body.
- Gives good results in returning motor activity after surgery.
- The design of the device allows the implant to bend, expand, and rotate similar to a natural knee
Biomet Vanguard® Complete Knee System
- Fixed support.
- A device that adapts to the specific features of the patient's anatomy.
- Assumes a high degree of flexion (about 145⁰).
- Available in 90 sizes, 10 hip size options.
Product Features
All endoprostheses are created from our own patented materials using advanced technologies, as well as software developed by the company.
OXINIUM
The material from which the heads, stems and acetabular implants are made is an oxidized alloy of zirconium (97.5%) and niobium (2.5%). It is 2 times more wear-resistant and stronger than cobalt-chromium alloy, and is also 20% lighter. The coefficient of friction is significantly reduced. Suitable for patients sensitive to nickel.
Cross-link polyethylene. Obtained by irradiating standard polyethylene with a dose of 10 Mrad. The only one proven to produce fewer wear debris. For example, when testing a liner paired with cobalt chrome, the volume of wear particles decreased by 80% compared to conventional.
The combination of these materials used in the production of hip and knee implants is called VERILAST.
Knee prostheses for partial arthroplasty
BioMet Oxford® Knee
- A device intended for patients with limited (medial) arthritis.
- The prosthesis uses movable plastic bearings and is implanted on only one side.
- Allows you to remove 75% less bone and cartilage, so its installation procedure is less painful and the recovery rate is higher.
- Clinical trials show 98% success after 10 years of wear and 95% after 15 years
DuPuy Sigma® High Performance Partial Knee
- Intended for active patients who require a high degree of flexion but are not yet ready for total arthroplasty.
- Allows you to kneel, squat, and sit cross-legged.
- The surgeon uses any of its components individually to replace the desired knee compartment.
- Preserves the maximum intact area of the native knee.
Hip endoprostheses
ANTHOLOGY
Minimally invasive endoprosthetic system for total hip replacement. Includes tool kit, head and stem with cementless installation. Designed for implantation through natural muscle gaps without damaging the muscles.
POLARSTEM uncemented femoral stem
Successfully used since 2002. The three-fold narrowing of the distal end, a self-locking design with a reinforced center allows you to reliably stabilize the implant. The shortened leg and narrowed shaft make it easy to install the prosthesis.
useful links
PROSTHETIC KNEE JOINT
COT MESSINA cooperates with leading manufacturers of joint prostheses
PROSTHETIC KNEE JOINT
COT MESSINA guarantees its patients the high quality of all materials
ASSEMBLY KNEE PROSTHETIC
Surgeons at the COT MESSINA clinic are leading specialists in the field of joint replacement
Institute of Orthopedics and Traumatology Clinic Cot Messina
Joint Commission International
Representative office in the Russian Federation and the CIS
Moscow, st. Zemlyanoy Val, 27с2, office 411
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Knee replacement using artificial joints from Smith&Nephew
Knee replacement is one of the most common types of orthosurgical treatment. Degenerative destruction of the cartilaginous intra-articular layers most often develops in the knees, taking on a particularly severe and irreversible form. The increased amount of loads on the knee joints and the special duration of these loads have an effect (given that even stationary knees are often under static pressure). When conservative therapy for arthrosis (degenerative disorders of the cartilage layer) no longer brings results, and joint pain becomes unbearable, the only way out is knee replacement.
How to choose an endoprosthesis
Suppliers of endoprostheses in Russia
As of July 2021, the following suppliers of the most hip joint endoprostheses are represented in Russia:
- Zimmer (“Zimmer”);
- DePuy, Johnson & Johnson (“DePuy”, owned by the Johnson & Johnson concern);
- Stryker (“Stryker”);
- Smith & Nephew (“Smith & Nephew”);
- Biomet (“Bayomet”);
- Aesculap, B. Braun ("Aesculapius", department).
Almost all of them have factories in different countries, and their headquarters are usually located in the United States. In large Russian cities there are usually representatives of all of the listed companies.
As of mid-2021, endoprostheses from leading Western manufacturers practically do not differ from each other in terms of price and quality, so it is reasonable to leave the choice of the manufacturer of the hip joint endoprosthesis to the surgeon.
As of mid-2021, in the arsenal of modern and high-tech endoprosthetics, more expensive and cheaper models of endoprostheses are presented “for every taste and color” around the world. But this does not mean that expensive models are better. Of course, when releasing a new model of an endoprosthesis, the manufacturing company is forced to make it more expensive than previous models, because the development, clinical and laboratory studies of a new implant require significant financial costs. New models of endoprostheses take into account the shortcomings of previous generations, and, probably, modern models will prove to be more durable and reliable.
On the other hand, innovations in endoprosthetic designs are not always a good thing. Here it is appropriate to mention the DePuy company, owned by the Johnson & Johnson concern. This world-renowned company, which has been in existence for over 100 years, released a new cup (acetabular component) for hip replacement called ASR in July 2003.
However, according to the UK Arthroplasty Registry, this cup was found to have an unacceptably high rate of unsatisfactory outcomes (about 4% of installed endoprostheses required replacement within 2 years). Similar results (3-8%) were observed in other countries. In this regard, in August 2010, DePuy decided to recall ASR cups and stopped selling them. By this time, about 93 thousand of these cups had already been installed around the world [1].
So new is not always the best. Another example: since 1986, DePuy has been producing the Corail hip replacement stem with hydroxyapatite coating. Since then, more than 700 thousand of these legs have been installed in 75 countries, and in 2021 they are popular among doctors involved in endoprosthetics.
The patient’s attempts to independently find an endoprosthesis “better and cheaper” are obviously pointless, since endoprosthesis replacement requires not only the endoprosthesis itself, but also a set of special instruments, which are often placed in 3-8 drawers.
A set of tools for installing a hip joint endoprosthesis.
For endoprosthesis replacement, you need not just a few “boxes” of implants, but a full set of implants of various sizes, high-quality tools for installing the endoprosthesis, medical drills and a number of consumables, which should be easily supplied by a representative of the company that produces endoprostheses.
The surgeon and proper rehabilitation are more important than the endoprosthesis
Much more important is not how “cool” or “expensive” the endoprosthesis is chosen, but the quality of the operation. As practice and life show, incorrect installation (the notorious human factor) will not save the “best” endoprosthesis, but a “mediocre generic endoprosthesis” correctly installed during an operation can confidently and without problems last for many decades.
An unshakable rule: the key to success is the surgeon, not the endoprosthesis. There is no need to search for the best endoprosthesis - start searching for the best surgeon! Older surgeons are considered experienced, and rightly so, but the age of a surgeon does not always indicate great experience in a particular operation. In our country there are many thirty-year-old surgeons who operate on 3-5 hip joints every day, accumulating several hundred endoprosthetics per year.
This is an excellent indicator by world standards: a surgeon who performs more than 50 hip replacements per year is considered an experienced surgeon. If the annual number of operations is less, then such a surgeon will be considered “forever learning” no matter how old he is: 30, 40, 50, 60 or even 70.
There is one more important nuance. The result of endoprosthetics is determined not only by the quality of the operation itself, but also by compliance with the rules and methods of rehabilitation.
Chronicle
In Russia they began to install a voice prosthesis that has no analogues in the world
In October 2021, it became known that Leonid Kozhanov, a doctor at City Clinical Oncology Hospital No. 1, had created a voice prosthesis that has no analogues in the world, which has already begun to be installed in patients.
One of them was diagnosed with laryngeal sarcoma and underwent laryngectomy, an operation to remove the larynx. parts of the vocal apparatus. After this, doctors performed tracheoesophageal bypass and endoprosthetics. Thanks to the new invention, the patient's voice was completely restored. By the end of October 2021, he is living a normal life, there is no relapse of the disease.
It is noted that the voice prosthesis is a very complex and thin structure. The creation of the device began with drawings and a mold. Then the specialists conducted an acoustic analysis of the voice and measured the pressure in the vocal apparatus during operation of the prosthesis. This is necessary to create normal pressure in the trachea and larynx. The mechanism allows you to bring the sound of your voice as close as possible to a real, non-robotic one.
The patient takes a deep breath and, as he exhales, pumps about two liters of air into the prosthesis and esophagus. Thanks to this, the voice comes as close to normal in sound as possible.
Work on creating the prosthesis began back in 2006, and after many years of clinical research, the device was patented.
The uniqueness of the solution of Russian specialists lies in its long service life. The prosthesis serves patients for a total of 12 years, while foreign analogues barely survive to six months. Moreover, their replacement is impossible without surgery.
According to Kozhanov, by the end of October 2021, two patients are under the supervision of doctors whose service life of this prosthesis is 11 and 12 years. [2]
Johnson & Johnson introduced a cementless knee replacement
In mid-September 2021, Johnson & Johnson's DePuy Synthes division announced the launch of the Attune cementless knee replacement. The new product will go on sale in several countries at once. Read more here.
2016: Medtronic buys the developer of low-cost endoprostheses Responsive Orthopedics
At the beginning of June 2021, Medtronic announced the purchase of the developer of prostheses for knee and hip joints, Responsive Orthopedics. The cost of the deal was not disclosed. With this acquisition, Medtronic expects to enter the low-cost joint replacement market in 2021. Read more here.
2014: 400 thousand operations with prostheses for knee and hip joints in the USA for the amount of $7 billion
According to The Star Tribune, knee and hip replacements are the most common surgical procedures performed under Medicare for the elderly in the United States. In 2014 alone, about 400 thousand such operations were performed throughout the country worth more than $7 billion. The average cost of treatment and recovery of one such patient ranges from $17 thousand to $33 thousand [3]
How to use a prosthesis
After the operation, within the first 24 hours, a physical therapy specialist begins working with the patient so that recovery occurs with minimal risk of complications.
First, the patient is taught to get out of bed and get into it correctly so that rehabilitation proceeds correctly. Then the patient learns to walk again by performing special exercises under the supervision of an instructor.
The first exercise the patient performs is walking up the stairs. The descent from the stairs begins with the operated leg, and the ascent with the healthy one. There are several options for this exercise: walking with crutches without assistance and moving with the help of handrails.
Types of Smith and Nephew prostheses
Oxinium dentures
- Increased load is permissible; the metal alloy is not afraid of vigorous physical activity.
- Contains a minimal amount of nickel (less than 1%).
- Does not cause allergies due to the use of biologically compatible elements - niobium and zirconium.
- It has structural elasticity, which eliminates the possibility of breakage.
- The prosthesis can be used for a long time (from 15 years).
- It is resistant to corrosion.
POLARSTEM
Metal hip rod without cement fastening. The big advantage of the prosthesis is the huge selection of sizes, which allows minimally invasive surgery for patients of different ages. The design has a reinforced center, a self-fastening system, and a tapered end.
System R3
The design includes a cup for the acetabulum and a protective plate for the femoral head. The same layer of protection ensures the mobility of the system. R3 has a ceramic and polyethylene design, both materials are resistant to heavy loads and biochemical processes in the patient’s body. Stability is ensured by the porous surface of the outer side of the bowl. The prosthesis can be used for up to 20 years.
Birmingham Hip
The femoral head endoprosthesis, created by Smith and Nephew, is used for superficial surgery of the hip joint. The implant only envelops the bone, preserving the maximum amount of natural bone structures. Birmingham Hip is suitable for people aged or with a sedentary lifestyle, since the design eliminates overexertion and active movements. The prosthesis consists of a cementless acetabular cup, a cemented femoral head and a stem. The outer surface is smoothly polished.
The manufactured hip replacements are of high quality. This applies to all manufacturers operating in Europe or the USA. Therefore, it is incorrect to talk about which prosthesis is better or worse.
The main difference between endoprostheses is the friction pair formed due to the materials from which the head and the artificial acetabulum (or liner) are made.
- Metal-polyethylene. The metal head is not resistant to wear, and the complex polymer of the liner inserted into the acetabulum reduces friction. This is an economical option, since the price in Moscow is low.
- Metal-metal. A frequent combination of materials, which is used less and less due to frequent complications due to metal shadowing products.
- Ceramics-ceramics. The most expensive option, as it is technically difficult to produce. Has minimal friction with rare complications after installation. Ceramics have a high price, since the price is approximately 2 times higher than analogues.
Types of friction pairs.
Fixation methods
There are several ways to fix the endoprosthesis. The choice of a particular one is influenced by the age of the person being operated on, his gender, and the peculiarities of the bends of the bone.
Cement
Cement fixation is performed from specialized bone cement, which is supplied to medical institutions not as a ready-made mixture, but separately as a polymer powder with an initiator and an ampoule with a monomer. Immediately before the operation, they are mixed, and additional materials are added if necessary.
Such fixation is more preferable for older people, for women after menopause and those who have a wide bone canal and thin bone walls.
Doctors also decide to use the cement method for infectious diseases, since an antibiotic can be added to the cement, which will suppress inflammation, and rehabilitation with this method of fixation is much faster.
Cementless
Cementless fixation involves the use of a prosthesis with a texture into which bone tissue can grow. In theory, this method increases the durability of the prosthesis, but has a large number of complications , since the bone may not grow properly, or the patient will not follow the doctor’s recommendations after surgery.
Also, the service life of the prosthesis is increased due to the fact that it is possible to select a specific friction pair.
Due to the fact that antibiotics cannot be used when using this technique, the risk of inflammation increases in patients with additional factors during healing.
In addition to the disadvantages of a high risk of complications, cementless fixation is more expensive than cement fixation and requires long-term rehabilitation.
Combined
Hybrid fixation involves the use of both methods. The stem is fixed into the femoral bone using cement, and the head is screwed into the cup. According to long-term observations of doctors, such fixation is optimal for patients of all categories.
Indications
Replacement of natural bone structures with a prosthesis is recommended if the following problems exist:
- arthrosis of 1-3 degrees with deformation on one or both sides;
- coxarthrosis;
- Bekhterev's disease;
- fractures in old age;
- pathogenic formations in the neck and head of the femur;
- joint necrosis grade 3-4;
- rheumatoid arthritis;
- damage to the pelvic area with the risk of loss of musculoskeletal functions;
- severe injury to the acetabulum.
Indications and contraindications
| Indications | Contraindications | |
| Tumor processes in the hip joint and femur | Absolute contraindications | Relative contraindications |
| Fractures of the femoral neck | Severe osteoporosis | Varicose veins of the legs |
| Bilateral ankylosis of the hip joints | HIV infection | Obesity 3 degrees |
| Hip fracture in patients over 75 years of age | Technical impossibility of installing an implant | Hormonal osteopathy |
| Mental illness | Diseases of internal organs | |
| Necrosis of the femoral head | Incurable diseases of the endocrine system | Haemorrhoids |
Hip joint: price of prosthesis
The pharmacy does not sell artificial implants for endoprosthetics. They are handled by several companies in large cities. The price will depend on several factors:
- dealer markup;
- brand;
- design features;
- purchase directly from an official representative or through an intermediary in a hospital;
- quality of workmanship and specific model of the prosthesis.
Endoprostheses from almost all companies are represented in Moscow. The cheapest implants are offered by the Taiwanese “UOC”, but doctors’ reviews of this manufacturer are quite wary. The essence of the low price is obvious - Chinese and Taiwanese companies simply clone models of European companies.
A titanium prosthesis from a well-known manufacturer in Moscow costs 99-120 thousand rubles. Asian designs are about 2 times cheaper. If the friction pair is ceramic-ceramic, then the price fluctuates around 200 thousand rubles. The average bill for a classic metal-polyethylene design does not exceed half that of a ceramic product. When purchasing in a hospital, additional markup is possible, masked by additional medical services.
Zimmer prostheses are the most popular, and the model range has all the necessary types of orthopedic implants. What are the best implants from the company? It depends on how the patient will use it. For normal everyday life at a slow pace, all design options are suitable. Price in Moscow.
- Classic bipolar implant. Equipped with a metal-polyethylene friction pair. Durability – up to lifelong with moderate use. The amount that the manufacturer asks for the product usually does not exceed 120 thousand rubles.
- Single-pole titanium prosthesis. The cheapest option. Only the head of the femur is prosthetic, and the acetabulum remains its own. It is impossible to select a friction pair; it always contains metal components. The starting price tag is from 75 thousand rubles.
- Ceramic. The most expensive type of construction. Has a minimal gradient of friction and wear. The price starts from 200 thousand rubles.
To summarize, the question of how much a design from Zimmer costs depends directly on the model. The price in Moscow starts from 75 thousand rubles.
How are dentures fixed?
The difference in design depends not only on the friction pair. In some patients, the acetabulum, to which the head of the femur is attached, is also affected. In this case, the doctor will have to replace both parts of the damaged joint. This operation is called total endoprosthetics.
Types of implant fixation in bone:
- Cementless prosthesis. Both unipolar and bipolar prosthetic devices can be inserted into the patient's own femur without the addition of fixation cement. It is used in young patients to increase the durability of the product.
- Cement. Necessary for elderly patients and those with autoimmune diseases. Due to the fragility of the own femur, the pin of the metal structure is additionally strengthened with cement. The effect on rehabilitation is insignificant, since the installation of any friction pair is possible.
