Hip Prostheses

LUBINUS SP II

  • The design is adapted to the anatomical shape of the femur
     
  • Successfully used for 40 years1
     
  • Proven by a wealth of clinical data.1, 5
     
  • Minimal occurrence of periprosthetic fractures11
     
  • Minimally invasive implantation

Neutralizes torsional forces

The curved shape of the stem enables it to finds its way into the femoral canal, where it adapts perfectly to the anatomy.6 This means that stress peaks, as occur with three-point locking of straight shafts, are avoided and the stem has greater rotational stability.2
 

Developed in 1978, and available with a modular prosthesis head since 1984, this femoral stem was a great success and had a major influence on the principle of the anatomical hip prosthesis.1 The S‑shaped curvature, which follows the natural anatomy of the femur, has proved highly successful in this system. This has been repeatedly confirmed over the last 40 years in numerous publications, including the Swedish Hip Arthroplasty Register.1, 3 The outstanding clinical history was the reason for developing the SP-CL, based on the same principle.

Anatomical design

The anatomical shape of the stem enables it to fit centrally in the medullary canal. This helps to ensure a uniform cement coating, which can envelop the implant optimally.7 At the same time, anteroposterior and mediolateral ribs contribute to rotational stability.2, 8, 9, 10

Optimal anatomical reconstruction

The SP II offers a system with great modularity. The multiplicity of possible variations in CCD angle, neck length, and stem length gives maximum flexibility for reconstruction of the anatomical structures in primary and revision arthroplasties. The stem tip is curved on the lateral side in order to prevent impacts when it is introduced into the medullary canal. The slender stem design meets all the requirements for minimally invasive, soft tissue, and bone-conserving implantation.

Successful long-term outcomes

Many long-term outcomes with survival rates of up to 92.3 percent after 23 years emphasize the success and great reliability of the SP II Stem.1

 * www.odep.org.uk; Orthopaedic Data Evaluation Panel

Clinically proven system

For over 40 years, the LUBINUS SP II Hip System has held the distinction of being one of the most reliable cemented hip prosthesis systems.1 Its design and diverse sizes allow to provide the best possible cemented prosthesis for virtually every patient.1

SP II - OP, Impl., Instr.

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6110_SP_II_Long_Stems_OP-Impl-Instr_us_2020-09_002.pdf

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  1. Kärrholm, Lindahl, Malchau, Mohaddes, Rogmark, Rolfson, ANNUAL REPORT 2015; The Swedish Hip Arthroplasty Register  
  2. W.T. Stillwell. The Art of the Total Arthroplasty. Grune & Stratton, Inc. 1987; pp. 296
  3. H. Malchau et al; Prognosis of Total Hip Replacement, Orthopädie, Universität Göteborg, Schweden, 2002
  4. Malchau H, Herberts P, Ahnfelt L. Prognosis of total hip replacement in Sweden. Follow-up of 92.675 operations performed 1978-1990. Acta Orthop Scand 1993;64 (5): 497-506
  5. Garellick, Kärrholm, Rogmark, Rolfson, Herberts, ANNUAL REPORT 2014; The Swedish National Hip Arthroplasty Register.; p. 75
  6. Annaratone, Giovanni; Surace, Filippo Maria; Survival analysis of the cemented SPII stem; J Orthopaed Traumato (2000) 1:41-45. Springer Verlag
  7. LINK News Orthopädie aktuell, Spinger-Verlag GmbH & Co. KG, SPII® Modell Lubinus® - Stellenwert der SPII® Modell Lubinus® Hüftprothese im aktuellen Bericht des Nationalen Schwedischen Hüft-TEP-Registers von 1979 - 2002 
  8. Langhans, M., Hofman, D., Ecke, H., & Nietert, M. (1992). Der Einfluß der Formgebung des Prothesenschaftes auf die Beanspruchung des proximalen Femurs. Unfallchirurgie, 18(5), pp. 266-273.
  9. Noble, P., Alexander, J., Lindahl, L., Yew, D., Granberry, W., & Tullos, H. (1988). The anatomic basis of femoral component design. Clinical Orthopaedics and Related Research(235), pp. 148-165.
  10. Denaro, V., & Fornasier, V. (2000). Fill, fit and conformation - an anatomical and morphometric study of a hip component in total hip arthroplasty (Rippen-Link). European Journal of Orthopaedic Surgery & Traumatology, 10(4), pp. 239-247.
  11. High risk of early periprosthetic fracture after primary hip arthoplasty in elderly patients using a cemented, tapered, polished stem: An observational, prospective cohort o study on 1,403 hips with 47 fractures after a mean follow-up time of 4 years· Broden C, Mukka S, Muren O, Eisler Stark A, Skoldenberg O, Acta Orthopaedica 2015; 86 (1):x-x  

SP-CL

  • The S curvature follows the natural anatomical shape of the femur
     
  • Rib profile for high primary stability and structural elasticity1-3,7
     
  • Bone preserving
     
  • Minimally invasive implantation
     
  • LINK HX coating

Proven design

The SP-CL Hip Prosthesis System, with its anatomical, cementless design and its different versions, is aimed at the treatment of a wide range of patients. In order to meet the heavy demands put on the implants in a special way, the femoral components consistently follow the principle of the anatomical stem shape4, which has been in successful use for decades.

The anatomical S-shape helps to reduce stress peaks, which are a familiar problem with three-point fixation of straight stems. At the same time, it gives the implant greater rotational stability.1,5, 6
 

Developed for physiological force transmission

Metaphyseal fixation of the SP-CL is assisted by the HX coating (CaP).8 At the same time, the polished distal stem region protects against thigh pain.9,10 Medially the SP-CL rests along the length of the calcar (Shenton’s line) and is intended to promote a physiological distribution of forces.
 

Reduced stress shielding

The successful ribbed structure provides initial fixation in the compressed cancellous bone. This makes it possible to achieve a design elasticity in spite of the proven “fit and fill” principle in the proximal femur. Thus the ribs not only provide high primary stability,7 but in combination with the LINK Tilastan- S alloy, they also achieve double elasticity. This can lead to a reduction in “stress shielding”.1

Bone preserving

Anatomically shaped stems necessitate anatomically shaped instruments. The compressors in the SP-CL System follow exactly the anatomical design of the stems and prepare the bone bed for the SP-CL stem according to the natural contours of the intramedullary canal in the proximal femur.

While the flat, lateral implant profile is designed to protect the greater trochanter during implantation, cancellous bone compressors help to preserve valuable bone substance during resection.11
 

The compact, ergonomically designed instrument set permits effective, smooth intraoperative working.12

SP-CL HX Lat-Plus - OP, Impl. & Instr.

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SP-CL PoroLink - OP, Impl. & Instr.

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  1. Langhans, M., Hofman, D., Ecke, H., & Nietert, M. (1992). Der Einfluß der Formgebung des Prothesenschaftes auf die Beanspruchung des proximalen Femurs. Unfallchirurgie, 18(5), pp. 266-273.
  2. Schill S, Thabe H. (2000). Long- and Mid-Term Results of the Cementless Link Prosthetic System in Combination with the Ribbed Stem and Screw-in Cup, Type "V". Orthopädische Praxis, 36, pp. 160-167.
  3. Thabe H, Wolfram U, Schill S. (1993). Medium-term results using the cement-free link endoprosthesis. Ribbed shaft V socket. Zeitschrift fur Orthopädie und ihre Grenzgebiete, 131(6), pp. 568-573.
  4. Annual Report 2016; Swedish Hip Arthroplasty Register; www.shpr.se
  5. Noble, P., Alexander, J., Lindahl, L., Yew, D., Granberry, W., & Tullos, H. (1988). The anatomic basis of femoral component design. Clinical Orthopaedics and Related Research(235), pp. 148-165.
  6. Denaro, V., & Fornasier, V. (2000). Fill, fit and conformation - an anatomical and morphometric study of a hip component in total hip arthroplasty (Rippen-Link). European Journal of Orthopaedic Surgery & Traumatology, 10(4), pp. 239-247.
  7. Pipino, F., Keller, A. (2006). Tissue-sparing surgery: 25 years’ experience with femoral neck preserving hip arthroplasty. Journal of Orthopaedics and Traumatology, 7(1), pp. 36-41.
  8. Palm, L., Jacobsson, S., & Ivarsson, I. (2002). Hydroxyapatite coating improves 8- to 10-year performance of the link RS cementless femoral stem. The Journal of Arthroplasty, 17(2), pp. 172-175.
  9. Petrou, G., Gavras, M., Diamantopoulos, M., Kapetsis, T., Kremmydas, N., & Kouzoupis, A. (1994). Uncemented total hip replacements and thigh pain. Archives of Orthopaedic and Trauma Surgery, 113(6), pp. 322-326.
  10. Khanuja, H., Vakil, J., Goddard, M., & Mont, M. (2011). Cementless femoral fixation in total hip arthroplasty. The Journal of Bone & Joint Surgery, 93(5), pp. 500-509.
  11. DiGiovanni, C.W., Garvin, K.L., Pellicci, P.M. (1999). Femoral preparation in cemented total hip arthroplasty: reaming or broaching? Journal of the American Academy of Orthopaedic Surgeons, 7(6), pp.349-357.
  12. Internal document W. Link (DOC-05042)

LCU

    • Successful stem design8
       
    • Intraoperative flexibility
       
    • High-end surface - LINK HX coating

    The hip prosthesis stems of the LCU System follow the concept of a straight stem with tapered lateral shoulder and an osteoconductive coating.4 The straight profile with rectangular cross-section provides the implant with proximal stability. The HX coating promotes bone integration.1 Two types of stem are available for the purpose of adaptation to the patient’s anatomy2:

    • Standard stem with 130º CCD angle
    • Lateralizing stem with 125º CCD angle


    The following materials and coatings are used for the hip prosthesis stems of the LCU System:

    • The stem is made from Ti6Al4V forged alloy.
    • The micro-roughness of the metal surface is created by corundum-blasting, which produces an even and uniform surface structure.2,3
    • The HX coating with a thickness of 20 +/- 10 µm is applied by LEP (LINK Electrochemical Process) to the entire length of the prosthesis.4

    A tapered distal end reduces distal bone contact and facilitates introduction of the stem into the medullary canal.1,5,6

    The self-anchoring shape of the stem is an optimization of the standard design in the proximal region in order to promote mechanical stability and favorable load transmission to the bone surface. The horizontal ribs in the proximal section of the stem serve to counteract subsidence of the stem and to promote primary stability. The distal region has vertical ribs to counteract the rotational forces.7

    Meta-diaphyseal support and fixation provided by a large medial curvature with a 100 mm radius of curvature for anatomical adaptation is the prerequisite for primary and secondary stability.

    The primary stability of the implant is additionally enhanced by the characteristic metaphyseal V-shape, while the rectangular cross-section neutralizes torsion forces.1,5
     

    The flat, tapering prosthesis neck allows a large scope of movement between prosthesis stem and acetabular cup.2 The 12/14 taper is designed for the use of modular LINK prosthesis heads made of ceramic or metal with various lengths and diameters.
    Furthermore, the highly polished neck region reduces abrasion in the event of unintentional contact with the acetabular cup9.
     

    LCU - OP, Impl. & Instr.

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    LCU PoroLink - OP, Impl. & Instr.

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    1. Khanuja H, Vakil J, Goddard M, Mont M. Current Concepts Review: Cementless Femoral Fixation in Total Hip Arthroplasty. J Bone Joint Surg Am. 2011;93:500-9.
       
    2. Internal documentation W. LINK
       
    3. Garcia-Rey E, Garcia-Cimbrelo E. Grit-Blasted Implant Bone Interface in Total Joint Arthroplasty. In: Karachalios T, editor. Bone-Implant Interface in Orthopedic Surgery: Basic Science to Clinical Applications. London: Springer; 2014. p. 83-9.
       
    4. Yang C., Effect of calcium phosphate surface coating on bone ingrowth onto porous-surfaced titanium alloy implants in rabbit tibiae, J Oral Maxillofac Surg. 2002 Apr;60(4):422-5.
       
    5. Hwang KT, Kim YH, Kim YS, Choi IY. Total hip arthroplasty using cementless grit-blasted femoral component: a minimum 10-year follow-up study. The Journal of arthroplasty. 2012;27(8):1554-61.
       
    6. Jones DL, Westby MD, Greidanus N, Johanson NA, Krebs DE, Robins L, et al. Update on Hip and Knee Arthroplasty: Current State of Evidence. Arthritis care & research. 2005;53:772-80.
       
    7. Vidalain, Jean-Pierre. Twenty-year results of the cementless Corail stem. International orthopaedics, 2011, 35. year, No. 2, p. 189-194.
       
    8. General information on Corail-type femoral stems: Hallan, G., et al. "Medium-and long-term performance of 11 516 uncemented primary femoral stems from the Norwegian arthroplasty register." Bone & Joint Journal 89.12 (2007): 1574-1580."
       
    9. International Orthopedics, Volume 41, Number 3, March 2017, Page 611-618  

    BiMobile Dual Mobility System

    • Reliable quality
       
    • Secure implantation
       
    • Solution for every patient

    The cementless BiMobile Acetabular Cup is available with a TiCaP double coating. The TiCaP double coating combines the properties of a highly porous layer of pure titanium for primary fixation and calcium phosphate coating, which together provide optimal primary and secondary implant stability.4, 5 A special macrostructure on the cup equator increases primary stability.9
     

    Highly wear-resistant acetabular cup1, 2, 6

    The BiMobile Dual Mobility System is available in two versions, either cemented or cementless. The metal casings in both versions are fabricated from biocompatible, sturdy EndoDur CoCrMo material.1, 2 The inner surface is highly polished in order to minimize wear.

    Use of known anchoring techniques

    The cemented BiMobile Acetabular Cup has a finely matt-finished SatinLink surface, which is also a feature of the SP II stems. Latitudinal and longitudinal groove-like structures reinforce the fixation and allow air to escape when the implant is pressed into the cement bed.
     

    Features and advantages

    • Highly abrasion-resistant, biocompatible EndoDur CoCrMo Material1, 2, 6
    • Secure implantation by means of a fixed implant-instrument connection and free view of the acetabular cup rim11, 12
    • Cementless and cemented anchorage
    • 28 mm prosthesis head from an acetabular cup size of 48 mm for a large range of motion
    • Wide choice of sizes (42-70 mm)
    • Clinically proven, very rough TiCaP double coating2, 3
    • Self-centering inlays for uniform load distribution and increased protection against luxation7
    • Anatomical medioventral recess for a large range of motion and to protect the femoral nerve and iliopsoas
    • Size-adapted clearance between liner and metal casing for constant articulation11
    • Intraoperative flexibility11, 12

    Self-centering inlay11

    The UHWMPE inlay can be combined with LINK prosthesis heads made of CoCrMo or ceramic with a 22 mm or 28 mm diameter.

    Reliable - Safe - Solution

    The concept of double mobility was developed by Prof. Gilles Bousquet in 1975 with the aim of treating habitual hip luxation.13 The system consists of a metal casing with a highly polished internal surface and a movable polyethylene inlay, in which a press-fitted prosthesis head moves. This provides a greater range of motion with less abrasion14, 15, 16 and reduced risk of luxation.15, 17, 18 It was on the basis of this principle that the BiMobile Acetabular Cup System came about.

    The development of the bimobile acetabular cup system drew on many years of experience with successful implant systems and fixation concepts plus state-of-the-art material and coating technologies. The result is the versatile  BiMobile Acetabular Cup System.
     

    BiMobile - OP, Impl, & Instr

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    1. Internal document W. LINK (DOC-08614)
    2. Internal document W. LINK (DOC-08725)
    3. Ullmark G et al.: "Analysis of bone formation on porous and calcium phosphate-coated acetabular cups: a randomised clinical [18F] fluoride PET study." Hip International 22.2 (2012).
    4. Cunningham B W et al.: “General Principles of Total Disc Replacement Arthroplasty”, Spine, Vol. 28, No. 20 Suppl., 2003
    5. Bobyn, J. D., et al. „The optimum pore size for the fixation of porous-surfaced metal implants by the ingrowth of bone.“ Clinical orthopaedics and related research 150 (1980): 263-270.
    6. Long, M., & Rack, H. (1998). Titanium alloys in total joint replacement—a materials science perspective. Biomaterials, 19(18), 1621-1639.
    7. Fabry C, Kaehler M, Hermann S, Woernle C, Bader R. 2014. Dynamic behavior of tripolar hip endoprostheses under physiological conditions and their effect on stability. Medical Engineering & Physics 36:65- 71.
    8. Internal document W. LINK (DOC-08553)
    9. Internal document W. LINK (DOC-08695)
    10. Loving L, Herrera L, Banerjee S, Heffernan C, Nevelos J, Markel DC, Mont MA. 2015. Dual mobility bearings withstand loading from steeper cup-inclinations without substantial wear. J Orthop Res. 33(3):398-404.
    11. Internal document W. LINK (DOC-08847)
    12. Internal document W. LINK (DOC-07974)
    13. Noyer, D., Canton, J. H. (2016). Once upon a time… Dual mobility: hi story. International Orthopaedics Vol. 41 - No. 3 (March 2017): 611-618
    14. Charnley, John. „The long-term results of low-friction arthroplasty of the hip performed as a primary intervention.“ Bone & Joint Journal 54.1 (1972): 61-76.
    15. Philippot, R., Camilleri, J. P., Boyer, B., et al. (2009). The use of a dual-articulation acetabular cup system to prevent dislocation after primary total hip arthroplasty : analysis of 384 cases at a mean follow-up of 15 years . SICOT 33: 927-932.
    16. Wroblewski, B., Siney, P., Flemin, P. (2009). The principle of low frictional torque in the Charnley total hip replacement. JBJS (Br) Vol. 91-B(7): 855-858.
    17. Stroh, D. Alex, et al. "Dual-mobility bearings: a review of the literature." Expert review of medical devices 9.1 (2012): 23-31.
    18. Nevelos, J., Bhimji, S., Macintyre, J., et al. (2010). Acetabular Bearing Design Has a Greater Influence on Jump Distance than Head Size. 56th Annual ORS Meeting: Poster #2028.

    IP Polyethylene Acetabular Cup

    • Cemented implant for rapid postoperative mobilization1
       
    • Uniform cement coating by means of integral spacers
       
    • Increased mobility by means of optimized cup design5
       
    • High UHMWPE quality means low abrasion2, 3, 6, 7

    The IP Polyethylene Acetabular Cup is a cemented acetabular cup made of UHMWPE. The direct stability of the cup in the cement coating permits rapid postoperative mobilization of the patient. This, in turn, means shorter recovery times and shorter hospitalization for the patient.1

    LINK has decades of experience in the use of UHMWPE, and this was particularly valuable in the design of the cemented acetabular cups. The high quality of the polyethylene demonstrably minimizes abrasion suffered by the components, and thereby reduces the risk of osteolysis. Consequently, the incidence of component loosening is very low. 2, 3, 6, 7

    In addition to the material properties, the external shape of the acetabular cups helps to prevent loosening. Radial notches in the surface create a high degree of cement contact and allow air to escape when the implant is pressed into the cement bed.4 Furthermore, spacers on the rear surface of the acetabular cup permit a uniform cement coating. This surface design increases the stability of the cup in the acetabulum, thereby largely eliminating the risk of loosening.8

    Another feature of the cemented polyethylene acetabular cups is the high cup rim, which projects beyond the spherical shape. This gives the patient a wider range of mobility because the neck of the prosthesis strikes the cup rim later5. In combination with the Lubinus SP II Stem, this system offers an outstanding, anatomically adapted cemented hip implant.

    1. L. Claes, P. Kirschner, C. Perka und M. Rudert, AE-Manual der Endoprothetik - Hüfte und Hüftrevision, Heidelberg Dordrecht London New York: Springer, 2012.
    2. S. M. Kurtz, „Advances in the processing, sterilization, and crosslinking of ultra-high molecular weight polyethylene for total joint arthroplasty“, Biomaterials 1999; 20:1659-1687.
    3. E. M. Brach del Prever, „UHMWPE for arthroplasty: past or future?“, J Orthopaed Traumatol 2009;10:1-8.   
    4. H. W. Buchholz (1969), “Das künstliche Hüftgelenk”, Sonderdruck aus Materia Medica Nordmark, Nov. 1969, 21/11: 613-622   
    5. Internal Document - DOC-07919  
    6. Internal Document - DOC-07954
    7. Internal Document - DOC-08062
    8. Garellick, Kärrholm, Rogmark, Rolfson, Herberts, ANNUAL REPORT 2014; The Swedish National Hip Arthroplasty Register.; p. 75

    MP Reconstruction System

    • Simple implantation5
       
    • Flexible options
       
    • Successful outcomes1, 2

    The MP Reconstruction System gives the surgeon the intraoperative flexibility and certainty1 that is essential for a successful revision procedure with pronounced bone loss. The system’s unique design has produced outstanding outcomes for decades.2, 3, 4

    With just three instrument trays, the MP System enables a simple and fast surgery and a smooth process in five steps. The modular system gives the surgeon a high degree of flexibility in terms of adapting leg length, offset, and anteversion, independently of the distal cementless anchoring of the stem. This permits a quick and uncomplicated intraoperative response to the individual anatomy and defect.5

    The stems in all six lengths have a 3° angulation, which facilitates following the anatomical curvature of the femur. The 2° tapered stem with peripheral longitudinal ribs gives outstanding stability in the femur, even with large proximal defects.2
     

    The PowerLock toothed connection allows the stem length to be adjusted intraoperatively by means of spacers in 10 mm increments up to 30 mm for revision arthroplasties. The absence of a taper connection means that the stem length and also the anteversion and offset can be adjusted retrospectively without endangering the distal fixation of the stem.

     

    Neck segments with varying offsets, CCD angles, and volumes, with and without suture holes, allow reconstruction of the proximal femur to be adapted according to the particular defect and anatomy.
     

    Cementless

    MP - Product Rationale

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    MP - OP, Impl. & Instr.

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    MP Monoblock - OP, Impl. & Instr.

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    LinkBio_MP_Monoblock_Advert_6_2020.pdf

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    LinkBio_MP_Monoblock_PostCard_6_2020.pdf

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    1. Postak PD, Greenwald AS: The Influence of Modularity on the Endurance Performance of the LINK® MP® Hip Stem. Orthopaedic Research Laboratories, Cleveland, OH, 2001
       
    2. Rodriguez, J. A., et al., et al. Reproducible fixation with tapered, fluted, modular, titanium stem in revision hip arthroplasty at 8-15 years follow-up. The Journal of Arthroplasty. 2014, 29.;
       
    3. Kwong LM, Miller JA, Lubinus P: A Modular Distal Fixation Option for Proximal Bone Loss in Revision Total Hip Arthroplasty. J Arthroplasty Vol. 18 No. 3 Suppl. 1 2003
       
    4. Klauser et al. - Medium-term Follow-Up of a Modular Tapered Noncemented Titanium Stem in Revision Total Hip Arthroplasty, The Journal of Arthroplasty Vol 28 No. 1, 2013, 84-89)
       
    5. Internal documents (Complaint Reports and Competitors Comparison)

    Waldemar Link GmbH & Co. KG

    Endoprostheses "Made in Germany"

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