Medical Plastics News Group Editor Dave Gray sat down with Brian Lambton, Corin’s global professional education manager, to discuss Corin’s entrance in to the orthopaedic, robotic market following its acquisition of US surgical robotic firm OMNI.
Corin, a UK-based company that according to Lambton, has seen significant growth over the last four or five years, has recently begun working with global investment firm, Permira.
Henry Minello, principal in the healthcare team of Permira said, “The US market for robotics in orthopaedics is growing at a very rapid pace. We expect Corin to remain at the forefront of development in robotics and computer-assisted surgery.”
Lambton stated that, “in November last year, we bought an Australian company called Global Orthopaedic Technologies (GOT). This is how we began our relationship with OMNI Orthopaedics Inc.” OMNI’s proprietary robotic platform, OMNIBotics, allows surgeons to conduct patient-specific total knee surgery, and designs, engineers, manufactures and distributes a wide range of proprietary hip and knee implants.
Stefano Alonsi, Corin’s CEO expressed his delight at the combination of OMNIBotics for the knee and Corin’s Optimised Positioning System (OPS) for the hip, and said how he thought, “Corin is now uniquely positioned to address functional patient-specific joint replacement.”
“It is the perfect time to be part of a larger organisation that shares our dedication to improving the lives of individual patients through technological innovation.” Rick Epstein, OMNI’s CEO said. “We are thrilled to be joining Corin to maximise the potential of our robotic solutions, adding another unique technology to their ecosystem.”
This acquisition was not the first for the company, with them purchasing Australian company, Optimised Orthopaedics, the owners of OPS technology in 2013. This technology was, “designed to look at patients on an individual basis and look at how their bones moved within their bodies,” according to Lambton. “Everybody is very different and therefore the implant needs to be positioned not just with precision but also with accuracy for that individual patient.”
Lambton went on to mention how, “OMNI has this incredible technology which enables you to do part of the operation initially, and then during the operation, without any prior scan, you are able to use a computer and robotic solution to use live data to analyse that individual patient’s need. You can then make all of the cuts that you require via robot technology.” This is more preferential than using individual cutting blocks, as Lambton explains, “you can simply pin the robot to the patient’s leg, and it does all the cuts in one go from there.”
This imageless knee replacement combines a robotic cutting guide with the world’s first robotic tool to measure ligament function. There is less pain for the patient and faster rehabilitation due to the unique implant positioning for each individual patient.
Lambton explained that there is no doubt that materials play an enormous role in orthopaedics. He went on to state how, “over the years we have discovered a lot more about the designs of the implants and also the material itself.” Originally polyethylene was manufactured and stored in oxygen, which Lambton informed was very bad for polyethylene.
However, Lambton explained that the way in which we eliminate the free radicals that are left behind has changed. “Previously, the challenges were that either the material is somewhat weak, or you have a material that still has some free radicals in it which are able to oxidise. When this material is put in to the human body, oxygen is dissolved within tissues, and that oxygen can then get in to the polyethylene.
“If we can control the cross linking process, we can reduce the wear of polyethylene significantly. Following this revelation, joint replacement length is now expected to be much longer.”
He went on to refer to some data from the World Health Organisation which had suggested that if you were a female who had lived up to 50 years old and lived in the first world, you had a 50:50 chance of living to be 100 years old. Lambton raised the issue that, we are operating on some of these people in their 40s and 50s, and therefore what is the expected life expectancy for these people?
Addressing the above concern, Lambton mentioned that some incredible work has been conducted by scientists at Massachusetts General Hospital, with regards to developing polyethylenes that include vitamin E as an antioxidant.
The antioxidant when included in the polyethylene is able to provide oxidative stability in vivo, and therefore the life span of that polyethylene material will be extended even further.
Lambton mentioned how their vitamin E-enriched polyethylene was named ECiMa. In order to make this, “we mix the vitamin E in at the front before it’s consolidated, so it’s very homogenous. We then highly crosslink it with a large dose of radiation to ensure the same level across the material, and then we use a mechanical process to eliminate all the free radicals without eliminating the properties of polyethylene.” In Lambton’s words, “We hope this is the Holy grail of polyethylene.
“The key is if you don’t get the implants in the right place, then it doesn’t matter how good your materials are, they will still fail under poor mechanical positioning of the implant.
“This acquisition will allow us to very precisely place those implants accurately for the individual patient, so it will last longer. What you are looking for is a long length of clinical survivorship, but also high levels of patient satisfaction.”
Lambton concluded, “there is a lot of discussion going on at the moment about getting it right first time, because if we can get the procedure right the first time then the hope is, that we would be doing it once and the patient would not have to return to the operating theatre again.”
Everything Corin are doing is aimed at combining the very latest technology with the best in material science to achieve the best outcome. Their strategy is to revolutionise orthopaedics and OMNIBotics, combined with APEX knee replacement aims to do this.