Complete System from Primary to Revision
Wide Range of Sizes
Streamlined Instruments
High-End Materials
Note: Combination with TrabecuLink Femoral and Tibial Cones only in USA cleared.
Fixed Bearing as cruciate ligament retaining (CR), posterior stabilized (PS and PS+) for cruciate ligament sacrificing and revision options (CCK) are available. The high compatibility between the components gives the system a high intraoperative flexibility.
Revision CCK:
The LinkSymphoKnee System is implanted by means of a streamlined, lightweight and ergonomic instrument set, allowing for straightforward workflow and high reproducibility. Multi-purpose instruments and elaborated trial components help to reduce the amount of instruments and number of trays, thus enhancing the intra-operative handling and flexibility.
The LINK Unicondylar Sled Prosthesis was first implanted in 1969. It was last modified in 1981, and ever since the successful implant design has remained unchanged:
Naturally shaped components - Polycentric femur design permits anatomically adapted reconstruction:
"Round-on-Flat" Design. This design allows excellent freedom of movement, leading to patient specific mobility.13:
Proven longevity
All-poly design
This version is available in four heights: 7, 9, 11 and 13 mm, and four diameters: 45, 50, 55, and 58 mm.
Metal-backed design
This version is available in four heights: 8, 9, 11, and 13 mm and three diameters: 45, 50, and 55 mm.
LINK PorEx Surface Modification
Femoral components
The femoral components are available in four sizes:
• Small (16 x 40 mm)
• Medium-small (17 x 46 mm)
• Medium (18 x 52 mm)
• Large (20 x 60 mm)
In the event of a revision, explantation is easier than with undercut stem structures.14
Tibial plateaus
The symmetrical shape of the tibial plateaus allows them to be used both medially and laterally. The dimensioning is adapted to the shape of the tibial head anatomy.
Successful long-term clinical outcomes4
Numerous different versions enable customization to suit different bone structures and possible sensitivity. The system permits cemented and cementless anchorage. Additional PorEx Surface Modification can reduce ion release, and can also reduce wear because the coefficient of friction is lower.14 Modular tibial components allow approximation of tibial stems, which can ensure stability when bone condition is poor.7
Fixed Bearing as cruciate ligament-conserving (CR) or cruciate ligament replacement (PS) and Mobile Bearing (CR/CS) are available. GEMINI SL Fixed Bearing consists of a single tibial metal casing, which enables both cruciate ligament preservation (CR) and cruciate ligament replacement (PS) options. This simplifies the choice of implant and gives intraoperative flexibility.
Features of GEMINI® SL® Fixed Bearing PS:
If the ligaments and capsule are intact and joint stability is good, the Fixed Bearing Cruciate Retaining (CR) version can be used for natural joint reconstruction.
The Fixed Bearing CR with moderate congruence reduces the bone loading by means of enhanced load distribution, and enables natural femoral rollback and femur rotation15.
If the posterior cruciate ligament is insufficient or has been removed,
the Fixed Bearing Posterior Stabilized (PS) version is used.
The freedom of rotation provided by GEMINI SL Mobile Bearing helps to preserve the alignment of the patellofemoral and also femorotibial articulations during knee flexion. Self-alignment by means of rotation of the polyethylene PE articulating surfaces improves the postoperative kinematics.11
At the same time, the polished tibial base plate improves the abrasion behavior.10, 11
GEMINI SL Mobile Bearing offers the advantage of a highly compliant joint geometry with reduced surface and substrate stress distribution, while the Mobile Bearing articulation reduces the development of boundary surface bone loads.9
Good mobility with an enlarged articulation surface.
The high degree of articulation congruence stabilizes the knee, also in cases of loss of the posterior cruciate ligament.8, 9, 12
In the production of Vit-E plateaus, vitamin E is used as an antioxidant in order to protect the material by neutralizing the free radicals created by highly crosslinking. The product's mechanical properties and biocompatibility are preserved 19,20,21,22,23
Visit our spar-k microsite for information about the new spar-k instrument set:
The LINK Endo-Model has been in use for over 30 years as a rotational or hinge knee prosthesis for both primary and revision arthroplasties. The Endo-Model Rotational Knee Prosthesis gives you a multiplicity of options.
The method for implanting the Endo-Model is simple and uncomplicated.2, 6 The prosthesis has an intracondylar and an intramedullary fixation, which provide a high degree of stability and protection against bacteria.1, 7 For patients with a hypersensitivity to metal, LINK also offers a special surface coating (LINK PorEx).13
The Endo-Model is an implant with intrinsic stability.1, 5, 12 The various options (Endo-Model Standard, Endo-Model Modular, Endo-Model SL, Endo-Model W) offer a high degree of flexibility.
The Endo-Model has been used successfully for over 30 years now, and can boast an unparalleled clinical history with excellent clinical results.1, 2, 5, 8 Even after 15 years, the Endo-Model has a survival rate of 98.5%.9
The Endo-Model enables speedy and uncomplicated implantation, while the design of the implant ensures good postoperative function.10, 11 Its excellent kinematics mean that the Endo-Model gives a high level of stability, especially in extension.3, 11 The implant allows flexion of the joint up to 142° and hyperextension of 2°.
Sizes:
4 different sizes for femoral and tibial components, for right and left in each case (XS, S, M, L).
Material:
CoCrMo, UHMWPE and LINK PorEx
Mechanism:
Available in rotational and hinge versions.
Type of fixation:
Cemented
Centralizers:
The shape of the centralizers enables a central position in the medullary canal. Furthermore, the centralizers prevent contact between the metal stem and the cortical bone, thus reducing stress peaks in the bone when bending forces are acting.3
LINK PorEx Technology:
For metal-sensitive patients, LINK offers a surface modification.13
The modular intracondylar total knee prosthesis, Endo-Model – M, is an addition to the Endo-Model Standard Knee Prosthesis.
Sizes:
4 different sizes for femoral and tibial components, for right and left in each case (XS, S, M, L).
Stem sizes:
Modular stem, cemented (EndoDur-S, LINK PorEx*): 50 mm-280 mm
Modular stem, cementless, tapered (Tilastan-S): 50 mm-280 mm
Modular stem, cementless, cylindrical (Tilastan-S): 60 mm (Ø 10-18 mm), 120 mm-280 mm (each size available in the following diameters: Ø 12-18 mm)
Mechanism:
Available in rotational and hinge versions.
Type of fixation:
Cemented and cementless
Centralizers:
The shape of the centralizers enables a central position in the medullary canal. Furthermore, the centralizers prevent contact between the metal stem and the cortical bone, thus also preventing stress peaks in the bone when bending forces are acting.3
LINK PorEx Technology:
The implant is also available with a coating for metal-sensitive patients.13
The modular intracondylar total knee prosthesis, Endo-Model – W, is an addition to the Endo-Model Knee Prosthesis.
Sizes:
3 different sizes for femoral and tibial components, for right and left in each case (S, M, L).
Stem sizes:
Modular stem, cemented (CoCrMo): 100 mm-160 mm (Ø 12-16 mm)
Modular stem, cementless (Tilastan): 100 mm-160 mm (Ø 12-24 mm)
Material:
CoCrMo, UHMWPE and LINK PorEx**
Mechanism:
Available in a rotational version.
Type of fixation:
Cemented and cementless
Centralizers:
The shape of the centralizers enables a central position in the medullary canal. Furthermore, the centralizers prevent contact between the metal stem and the cortical bone, thus also preventing stress peaks in the bone when bending forces are acting.3
Compatibility:
The Endo-Model-W is compatible with the MEGASYSTEM-C. All the stems from the MEGASYSTEM-C which have a male taper can be used.
The high degree of modularity of this system allows both, partial bone replacement in the proximal and distal femur regions in small increments and also total femur replacement.
You can find further information under MEGASYSTEM-C.
*Internal designation
**Only custom-made
Images from above:
Anatomically Adapted
Wide Range of Stems
Reproducible Surgical Technique
Flexible
Designed for Reliability and Stability
Coupling and Decoupling in the Joint Plane
Rotational Stability in Extension
Development based on the Endo-Model® Rotational and Hinge Knee Prosthesis, which has been used with great success for many years.
E. Engelbrecht, A. Siegel, J. Röttger, and Prof. H. W. Buchholz*
Statistics of Total Knee Replacement: Partial and Total Knee Replacement, Design St. Georg
Journal of Clinical Orthopaedics, 1976, No. 120, pp 54-64 (K3)
E. Engelbrecht, E. Nieder, E. Strickle, A. Keller
Intrakondyläre Kniegelenkendoprothese mit Rotationsmöglichkeit
- ENDO-MODELL®
CHIRURG 52: 368-375 (1981) (K1)
R. Dederich und L. Wolf
Kniegelenkprothesen-Nachuntersuchungsergebnisse
Unfallheilkunde (1982) 85:359-368 (K2)
J. Röttger, K. Heinert
Die Knieendoprothesensysteme (Schlitten- und Scharnierprinzip).
Beobachtungen und Ergebnisse nach 10 Jahren Erfahrung mit
über 3700 Operationen.
Z. Orthop. 122(1984) 818-826 (K17)
E. Nieder, E. Engelbrecht, A. Keller
Totale intrakondyläre Scharniergelenkendoprothese mit
Rotationsmöglichkeit - Endo-Modell®
Reprint from Issue 5: Orthopädische Praxis, 1987, 23. Jahresgang,
Seite 402-412 (K34)
K. Heinert, E. Engelbrecht
Total Knee Replacement - Experience with a Surface and
Total Knee Replacement: Further Development of the Model St. Georg®. 2400 Sledges and Hinges
Proceedings of the International Symposium on Total Knee Replacement, May 19-20, 1987, Nagoya, Japan Springer Verlag:, Berlin Heidelberg, New York Tokyo (1987),
pp 257-273 (K53)
E. Engelbrecht, M.D.
The Tibial Rotating Knee Prosthesis “Endo” Model: Surg. Technique
The Journal of Orthopaedic Surgical Techniques, Volume 3,
Number 2, 1987 (K36)
K. Heinert, E. Engelbrecht
Langzeitvergleich der Knie-Endoprothesensysteme St. Georg®
10-Jahres-Überlebensraten von 2236 Schlitten- und Scharnier Endoprothesen
Der Chirurg (1988) 59:755-762 (K38)
F. Madsen, P. Kjarsgaard-Andersen, M. Juhl, O. Sneppen
A Custom-Made Prosthesis for the Treatment of Supracondylar
Femoral Fractures after Total Knee Arthroplasty: Report of Four Cases
Journal of Orthopaedic Trauma, Vol. 3, No. 4, pp. 333-337,1989 (K42)
E. Nieder
Schlittenprothese, Rotationsknie und Scharnierprothese Modell
St. Georg® und Endo-Modell®. Differentialtherapie in der primären
Kniegelenkalloarthroplastik
Orthopäde (1991) 20:170-180 (K45)
G. von Förster, D. Klüber und U. Käbler
Mittel- bis langfristige Ergebnisse nach Behandlung von 118 periprothetischen
Infektionen nach Kniegelenkersatz durch einzeitige Austauschoperationen
Orthopäde(1991) 20: 244-252 (K46)
Adolph V. Lombardi, Jr, Thomas H. Mallory, Robert W. Eberle, and Joanne B. Adams
Results of Revision Total Knee Arthroplasty Using Constrained Prostheses
Seminars in Arthroplasty, Vol 7, No. 4 (October), 1996: pp 349-355
E. Engelbrecht, E. Nieder, D. Klüber
Reconstruction of the Knee - Ten to Twenty Years of Knee Arthroplasty at
the Endo-Klinik: A Report on the Long-term Follow-up of the St. Georg®
Hinge and the Medium-term Follow-up of the Rotating Knee Endo-Model®
Springer Verlag: Tokyo, Berlin, Heidelberg, New York (1997) (K57)
E. Nieder
Revisionsalloarthroplastik des Kniegelenks
Sonderausgabe aus: Orthopädische Operationslehre, Band II/1: Becken und untere Extremität
Herausgegeben von R. Bauer, F. Kerschbaumer und S. Poisel
F. Alt, U. Sonnekalb, N. Walker
Unikondyläre Schlittenprothese versus scharniergeführte
Totalendoprothesen des Kniegelenkes
Orthopädische Praxis 1/98, 34. Jahresgang, Seite 20-24, 1998 (K61)
A. V. Lombardi, T. H. Mallory, R. E. Eberle, J. B. Adams
Rotating Hinge Prosthesis in Revision Total Knee Arthroplasty:
Indications and Results
A Reprint from Surgical Technology International VI, 1998 (K55)
E. Nieder, G.W. Baars, A. Keller
Totaler Tibia-Ersatz Endo-Modell®
Orthopädie Aktuell: Nr. 5/1998, LINK News (K60)
S. Schill, H. Thabe
Die periprothetische Knieinfektion - Therapiekonzept, Wertigkeit
und mittelfristige Ergebnisse
Aktuelle Rheumatologie, Heft 5, 24. Jahrgang, 1999, pp 153-160 (K70)
G.W. Baars
Knieendoprothetik: Das optimale Implantat für jeweilige Indikation finden
Orthopäde 2000 (Suppl1) 29: S1-2
M. Zinck, R, Sellkau
Rotationsknieprothese Endo-Modell®- Geführter Oberflächenersatz mit Sti(e)l
Orthopäde 2000 (Suppl1) 29: S 38-42
M. Crowa, E. Cenna, C. Olivero
Rotating knee prosthesis - Surface or hinge replacement?
Orthopäde 2000 (Suppl1) 29: S 43-44
J-N. Argenson. J M. Aubaniac
Total Knee arthroplasty in femorotibial instability
Orthopäde 2000.29:S 45-47, Springer Verlag 2000 (K72)
M. von Knoch, R. Brocks, C. Siegmüller, G. Ribaric, L. Leupolt,
G. von Förster
Knieflexion nach Rotationsknieendoprothese
Z. Orthop 2000; 138: 66-68 (K71)
R.E. Windsor, K. Steinbrink
Controversies in Total Knee Replacement Two-stage exchange is the optimal treatment for an infected total knee replacement
Oxford University Press 2001 (K78)
A. Katzer, R. Sellckau, W. Siemssen, G. von Foerster
ENDO-Modell Rotating Knee Prosthesis: a functional analysis
J Orthopaed Traumatol (2002) 3:163-170, Springer Verlag 2002
Thomas Nau, MD, E. Pflegerl, MD, J. Erhart, MD, and V. Vecsei, MD
Primary Total Knee Arthroplasty for Periarticular Fractures
The Journal of Arthroplasty, Vol 18, No 8, 2003 (K82)
G. Petrou, H. Petrou, C. Tilkeridis, T. Stavrakis, T. Kapetsis, N.
Kremmidas, M. Gavras
Medium-term results with a primary cemented rotating-hinge total knee replacement
A 7-TO 15-YEAR FOLLOW-UP
J Bone Joint Surg (Br), 2004; 86-B :813-17 (K84)
M.R. Utting, J.H. Newman
Customised hinged knee replacement as a salvage procedure for failed total knee arthroplasty
The Knee 11 (2004) 475-479 (K86)
Nayana Joshi, Antonio Navarro-Quilis
Is There a Place for Rotating-Hinge Arthroplasty in Knee Revision Surgery for Aseptic Loosening?
The Journal of Arthroplasty 2008; 23(8):1204-1210 (K94)
M. Napp, M. Frank, M. Witt
Pathologische Fraktur des distalen Femurs bei Knie-TEP
Der Orthopäde, Band 38, Heft 10, Oktober 2009 (K96)
Dae Kyung Bae, Sang Jun Song, Kyoung Ho Yoon, Jung Ho Noh
Long-Term Outcome of Total Knee Arthroplasty in Charocot Joint:
A 10- to 22- Year Follow-Up
The Journal of Arthroplasty 2009; 24(8):1152-1156 (K98)
The dynamic TrabecuLink Femoral- and Tibial Cones are an attractive solution for cementless restoration of bone defects10 and to provide additional support for the prosthesis if there is bone loss in the proximal tibia. The combination of the dynamic design5,6 of the cones and the biocompatible material Tilastan– E11,12 is ideal for ensuring stable, long-lasting fixation and successful bone regeneration.
The 3-dimensional TrabecuLink structure, with its pore size, porosity and structure depth, also provides an excellent basis for promoting osteoconduction and microvascularization, taking into account the requirements for the structure-covering protein layer (fibronectin - vitronectin - fibrinogen).1,2 TrabecuLink Cones can be used in combination with the long-established LINK Endo-Model knee family in a wide range of sizes and versions. The choice of sizes corresponds to the dimensions of the hinged
knee prostheses.
Stable – in metaphyseal fixation9,13
Elastic – due to integral bending axes in the inner metal wall
Versatile – for a broad range of solutions7
Protective – due to inner metal wall
Environmentally friendly3,8
TrabecuLink
3-dimensional structure – for optimal bone ongrowth
Pore filling
The sequence of images shows a pore of the TrabecuLink structure being filled with tissue under in-vitro cell culture conditions. The fibronectin laid down by human fibroblasts and continually reorganized over a period of eight days is visible as green fibers. Fibronectin is a component of the extracellular matrix that is formed at an early stage of the healing process. It forms a basis for the embedding of collagen, which is essential for mineralization of the tissue and ingrowth of bone into the structure. Apart from the accumulation of fibronectin, which increases over time, a clear contraction of the matrix towards the center of the pore can be observed. This contraction mechanism, which is attributable to the cellular forces acting in the tissue, accelerates the rate at which the pore is filled with tissue, compared to a layer-by-layer tissue growth (Reference: Joly P et al., PLOS One 2013; https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0073545). Julius Wolff Institute, Charité - Universitätsmedizin Berlin
References (general)