The hidden element of joint replacement

Patients have no inkling there are different knee implant designs, which can affect outcomes, or that there is a choice.

As demand for joint replacement continues to rise, it is time to highlight that patients do have a right to choose their implant and surgeon. Once diagnosed, you can research the different implants available, which may influence your outcome. The implant is going to be yours for what should be a very long time, so making the right decisions early is very important.

Financial and logistical dynamics mean the NHS and private health systems look for best prices over patient outcomes, with price often optimised by product bundling and one-stop supply with large companies, and the surgeon is increasingly bypassed during that process.  Any price differences are insignificant compared to the overall procedure cost.

This can push patients on to a conveyer belt of treatment that can do them a disservice.  Like cars, implants vary a lot and research can provide options that are not always made clear or available to patients.

What is not widely appreciated is that you can shop around for your implant and surgeon. By researching your options using resources such as the National Joint Registry (NJR) and the Orthopaedic Data Evaluation Panel (ODEP), you can identify the best-performing devices and surgeons. Only you have your best interests at heart.

Researching and exercising your choice should not delay surgery or cause bureaucratic friction, but it can ensure you get a procedure that is synchronised to your particular health condition and may lead to a more optimum outcome.


Total knee replacement

Most total knee replacement has poorer patient satisfaction compared to hip replacement and most of this is due to a feeling of knee instability.

The normal knee’s geometry of a partial ball-in-socket joint with supporting ligaments is highly stable, but almost all current knee implants have design limitations that do not provide stability, particularly within the normal walking range.

The Australian NJR now defines three different total knee types by stability. These are classed as: ‘minimally stabilised’ that speak for themselves; ‘posterior stabilised’ which provide extra stability, but only at deeper flexion – their results are the poorest in NJRs, yet they are regularly used; third is ‘medial pivot’, better named ‘medially stabilised’ (MS) due to their superior stabilising design. Hybrid cars are taking over our roads, MS knee replacement is doing the same in orthopaedics.

MatOrtho UK, formerly Finsbury Orthopaedics, created the medial ball-in-socket TKR design (Medial Rotation Knee™ or MRK™) in 1994 that has consistently gained some of the best outcomes in the NJRs and higher patient satisfaction. Like the normal knee, it has a matching ball-in-socket that is fully engaged throughout motion and provides full-time stability.

MatOrtho® has refined the same implant with the introduction of the SAIPH® Total Knee replacement. This was first used in 2009, it has impeccable results and is more forgotten during daily tasks compared to other knee types. It has an improved patella function and full mobilisation, which together make it a market leader.


MatOrtho has pioneered some of the most significant advances in replacement joints including the Medial Stable knee, Hip Resurfacing (Andy Murray hip), and large ball Ceramic Hips. These innovations have helped many thousands of patients recover function and independence, and return to work, home life and even sport.

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