Guide to choose Knee Implant: Top knee implant brands in India

Introduction

When it comes to knee replacements, making an informed decision is crucial for ensuring a successful outcome. With a myriad of options available in the market, understanding the components, materials, pricing, and top brands can help you navigate through the process with confidence. In this blog, we’ll delve into the intricacies of choosing the right  knee implant.

What is a Knee Implant and its Components?

A knee implant, also known as a knee prosthesis, is a medical device designed to replace damaged or diseased knee joints. It typically consists of three components: the femoral component (attached to the thigh bone), the tibial component (attached to the shin bone), and the patellar component (replaces the surface of the kneecap).

1. Femoral Component: This component is attached to the end of the thigh bone (femur). It consists of a metal piece that replaces the surface of the distal femur.
2. Tibial Component:  Attached to the top of the shin bone (tibia), the tibial component is made of metal and plastic (polyethylene). It serves as the replacement for the top of the tibia and may include a plastic spacer that acts as a cushion between the femoral and tibial components.
3. Patellar Component: This component replaces the surface of the kneecap (patella). It is typically made of plastic (polyethylene) and may be attached to the undersurface of the patella during the knee replacement surgery.

These components work together to restore the function and stability of the knee joint, allowing for improved mobility and reduced pain. 

Choosing the right material type of knee implant

The materials used in knee implants are chosen for their durability, compatibility with the body, and ability to withstand the forces exerted on the knee during daily activities. The major components - femoral and tibial are either made up of metallic, ceramic or plastic.  Knee implant components are commonly made from various materials, each with its own set of pros and cons and cost ranges:

1. Metalllic (Cobalt-Chromium vs Titanium Alloys):

Pros- 

• Durability: Metal implants are known for their strength and durability, making them suitable for active individuals.
• Stability: They provide excellent stability and support for the knee joint.
• Longevity: Metal implants have a long lifespan, reducing the need for frequent revisions.

Cons- 

• Metal Sensitivity: Some patients may experience allergic reactions or sensitivity to metal components, leading to inflammation or discomfort.
• Corrosion: In rare cases, metal implants may corrode over time, potentially causing complications.

Cost Range: Metal implants typically fall within a moderate to high price range such as a titanium alloy based femur component will costs around INR 50,000-55,000 and tibial component will cost around INR 30,000-34,000. The prices are 30-40% lower for Cobalt chromium range.

Cobalt chrome vs titanium alloy: Cobalt chrome is a hard-wearing material whilst titanium is softer and a little more flexible, with properties similar to that of bone. Both the implants are good to use. There is no consensus as to which material is more suitable. However, the patients who have allergy to nickel could use titanium alloy implant.

2. Ceramic (Oxidized Zirconium):

These implants are composed of a zirconium alloy with a hard ceramic surface formed by oxidization of the outer layer. This material has been shown to be an effective bearing surface for total joint arthroplasty and an alternative material for use in patients with metal hypersensitivity.

Pros-

• Smooth Surface: Ceramic implants have a smooth surface, reducing friction and wear on the surrounding tissues.
• Biocompatibility: They are highly biocompatible, minimizing the risk of adverse reactions or inflammation.
• Wear Resistance: Ceramic materials offer excellent wear resistance, leading to improved longevity and durability.

Cons-

• Brittleness:  Ceramic implants may be more prone to fracture or breakage compared to other materials, especially in high-stress situations.

Cost: Ceramic implants tend to be more expensive due to the manufacturing process and material properties. Oxidised Zirconium ceramic  based femur component will costs around INR 50,000-55,000 and tibial component will cost around INR 30,000-34,000.

3. Plastic (Polyethylene):

The tibial and patellar components in knee replacements are made of polyethylene. The use of Ultra Highly Cross Linked PolyEthylene (UHXLPE) or Ultra High Molecular Weight PolyEthylene (UHMWPE) reduces even the minimal wear enabling the knee implants to last for a much longer time.

Pros-

Low Friction:  Polyethylene implants offer low friction properties, reducing wear and tear on the surrounding tissues.

Shock Absorption: They provide excellent shock absorption, mimicking the natural movement of the knee joint.

Biocompatibility: Polyethylene is biocompatible, minimizing the risk of adverse reactions.

Cons-

Wear and Tear: Over time, polyethylene implants may wear out, leading to implant failure or the need for revision surgery.

Potential for Debris:  Wear particles from polyethylene implants can accumulate in the joint, potentially causing inflammation or osteolysis (bone loss).

Cost Range: Polyethylene implant components are generally more affordable compared to other materials, making them a cost-effective option for many patients.

The choice of material should be based on factors such as patient preferences, activity level, budget, and the recommendations of the orthopedic surgeon. Ultimately, the goal is to select an implant that provides optimal functionality, longevity, and compatibility with the patient's lifestyle.

Pricing of Knee Implants

In India, the National Pharmaceutical Pricing Authority (NPPA) regulates the maximum prices of knee implants, to ensure affordability and accessibility. The knee implant price caps were last revised in 2021. The maximum prices that can be charged by hospitals for knee implants are given below:

Can you buy individual knee implant components or have to buy as a whole set?

In most cases, knee implant components are available as part of a complete set. However, some manufacturers may offer individual components to accommodate specific patient needs or revisions. It’s essential to consult with your orthopedic surgeon to determine the most suitable option for your condition.

Top Knee Implant Brands in India in 2024

Several reputable knee implant brands are available in India, each with its own advantages and considerations:

1. Zimmer Biomet: Known for its innovative designs and high-quality materials, Zimmer Biomet offers a wide range of knee implant options. While it may come at a higher cost, the reliability and longevity of their implants are often praised by surgeons and patients alike.
2. Smith & Nephew: With a focus on advanced technology and patient-specific solutions, Smith & Nephew provides customizable knee implants tailored to individual anatomies. However, the premium features may result in a higher price point.
3. Stryker: Stryker’s knee implant systems are lauded for their precision and compatibility with minimally invasive techniques. While cost-effective options are available, some patients may prefer the added benefits of premium implants.
4. Johnson & Johnson: Johnson & Johnson’s DePuy Synthes, a leader in orthopedic implants, develops cutting-edge medical implants for orthopedics and neurosurgery. They are dedicated to customizing their services to meet the unique needs of both patients and surgeons.
5. Medtronic, a global leader in medical technology, specializes in orthopedic implants and devices with a focus on spine solutions. They offer advanced implants and navigation technologies designed to enhance surgical precision and accelerate patient recovery.

Conclusion

Choosing the best knee implant requires careful consideration of various factors, including material types, pricing, and brand reputation. By understanding the components, materials, pricing mechanisms, and top brands available in India, patients can make informed decisions in collaboration with their healthcare providers. Remember to prioritize functionality, durability, and compatibility with your lifestyle for the best possible outcome.