Nexel® Total Elbow

A Choice for Elbow Replacement

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Zimmer Biomet’s Nexel® Total Elbow builds upon the original, Coonrad/Morrey Total Elbow and its 30+ year clinical heritage. It uses proprietary Vivacit-E® polyethylene bearings and advances in instrumentation to offer wear and durability properties.1-5 The bearing geometry has been redesigned to reflect advancements in contact stress engineering. The Nexel Total Elbow:

  • Available in sizes 4, 5, and 6
  • Available in left and right configurations
  • Has ulna and humeral components made from Tivanium® (Ti-6AI-4V) alloy
  • Includes Vivacit-E bearings to help prevent delamination, maximise oxidative stability, minimise wear, and improve mechanical properties-thereby having a 91% reduction in polyethylene wear compared to the Coonrad/Morrey elbow in laboratory testing6-10*.
  • Utilises a semi-conforming, thicker bearing design to reduce edge-loading and stress, and maximise contact area to distribute joint-reaction forces
  • Includes an innovative 3rd bearing in the humeral yoke for increased compressive contact area
  • Comes with a robust Co-Cr linkage system to enhance linkage durability without applying compressive loads to screws

With the Nexel Total Elbow, we offer an alternative to the Coonrad/Morrey Total Elbow.

Product Features

This device is a total elbow prosthesis designed for use with bone cement. It is available in sizes 4, 5 and 6, in left and right configurations. The ulna and humeral components are manufactured from Tivanium® (Ti-6Al-4V) alloy. The ulna component has a porous coating of Ti-6Al-4V plasma spray and is curved to facilitate implantation. The humeral component has a porous coating of Ti-6Al-4V plasma spray and has an anterior flange to accommodate a bone graft. The axle-pin and humeral screws are manufactured from Zimaloy® (Co-Cr-Mo) alloy. Vitamin E highly cross-linked ultra-high molecular weight polyethylene (Vivacit-E®) bearings are designed for optimal durability.

Stem Design

  • Intramedullary stem geometry and anterior humeral flange is maintained from the Coonrad/Morrey Total Elbow
  • Humeral component finished with Tiplasma spray, which improves for fixation and stem strength
  • Low profile A/P design minimises soft tissue interference

Modernised, Easy-to-Use Instrumentation

  • Improves efficiency and reproducibility
  • Humeral preparation system reduces stress risers through contained, circular resection and improves precision with enhanced cut-guide stability
  • Rasp tooth geometry with diamond cut pattern provides for a more efficient canal preparation
  • Includes specially designed, flexible ulna reamers for easier ulna canal preparation

Bearing Design Improves Contact Stress Distribution

  • Redesigned imagined elbow bearing geometry allows improvements in contact stress distribution11,12
  • Semi-conforming bearings engineered to eliminate reduce potential for edge loading
  • Bearings fixed to the humeral component to distribute joint reaction loads over more of the bearings surfaces
  • Design includes an innovative third bearing in the humeral yoke for increased compressive contact area when compared to the Coonrad/Morrey Total Elbow, which provides load sharing for enhanced mechanical integrity
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Surgical Techniques

References

  1. Zimmer ZRR_WA_2552_12Rev2*
  2. Zimmer ZRR_WA_2407_11Rev2*
  3. Zimmer ZRR_WA_2542_12Rev2*
  4. Zimmer ZRR_WA_2598_12*
  5. Zimmer ZRR_WA_2409_11*
  6. Popoola OO, Kincaid BL, Mimnaugh K, Marqueling M. In vitro wear of ultrahigh-molecular-weight polyethylene and vitamin E blended highly crosslinked polyethylene in linked, semiconstrained total elbow replacement prostheses. Journal of Shoulder and Elbow Surgery, 2013.
  7. Oral, E. et, al. Crosslinked Vitamin E Blended UHMWPE with Improved Grafting and Wear Resistance. Poster No. 1181. ORS 2011 Meeting.
  8. Oral, E. et, al.Trace amounts of grafted vitamin E protect UHMWPE against squalene-initiated oxidation. Poster No. 1295. ORS 2011 Meeting.
  9. Rowell, S. et, al. Detection of Vitamin E in Irradiated UHMWPE by UVVisible Spectroscopy. Poster No. 1186. ORS 2011 Meeting.
  10. Wolf, C. et, al. Radiation Grafting of Vitamin E to Ultra High Molecular Weight Polyethylene. Poster No. 1178. ORS 2011 Meeting.
  11. Aldridge, III, Lightdale NR, Mallon WJ, Coonrad RW. Total elbow arthroplasty with the Coonrad/Coonrad-Morrey prosthesis. A 10- to 31-year survival analysis. J Bone Joint Surg Br 2006; 88:509-514.
  12. Zimmer ZRR_WI_1222_12*

*Laboratory testing is not necessarily indicative of clinical performance.

 

Legal Manufacturer:

Zimmer, Inc.
1800 West Center Street
Warsaw, Indiana 46580 USA

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