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NAVIO

Surgical System

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About NAVIO◊

NAVIO Handheld Robotics

The freedom of robotics in your hands

The NAVIO Surgical System is designed to offer accuracy1-9, value5 and freedom at the cutting edge of robotics-assisted surgery; helping surgeons improve outcomes6 and patient satisfaction6-8 in total and partial knee arthroplasty.*

Now featuring version 7.0 software for a more streamlined surgical workflow, shorter learning curve and real-time access to intraoperative case information**.

Grow your practice, with the latest step in robotics technology

Currently the only handheld robotics system for knee arthroplasty

 Freedom: Handheld technology and a compact footprint for full portability across your OR and surgical centers. Find out why surgeons choose NAVIO 

 Accuracy: Clinically proven to deliver the accuracy patients deserve1-4 for implant placement9, alignment9 and bone resection*1-9, and to help reduce procedural variation10.

 Value and efficiency: Image-free preoperative mapping, eliminating the cost and implications of CT scans11, with potential to expand your robotics portfolio with additional handpieces. Shown to have a lower cost of ownership compared to other solutions.5

  Patient satisfaction: With 25% of knee arthroplasty patients showing dissatisfaction12-15, NAVIO Handheld Robotics improves alignment, stability and proprioception,16,17 which may help implant survivorship18- factors commonly associated with patient satisfaction.19,20

Give patients the confidence to get the surgery they need.

Find out more on how NAVIO Handheld Robotics works

 What’s new?

The next step - NAVIO 7.0 operating system upgrade

The NAVIO 7.0 software upgrade provides the next evolutionary step in robotic-assisted in joint surgery, delivering a surgical workflow designed to improve efficiency and usability, and further decrease the learning curve**:

Fewer registration steps

  • 72% reduction in required data point collection, with automatic landmark capture**
  • 40% reduction in workflow stages, with improved usability**21 and faster, image-free mapping
  • 2.5x larger data point collection area, with faster surface model generation**22
  • Single stage, patient-specific planning

Find out more about software version 7.0

The largest portfolio of implants for robotic-assisted knee arthroplasty

The NAVIO Surgical System is currently the only handheld robotics system for knee surgery and features the largest portfolio of compatible implants for total and partial knee arthroplasty.

Total knee implants


JOURNEY II BCS

JOURNEY II CR

JOURNEY II XR

LEGION Total Knee System Portfolio

GENESIS II Total Knee System Portfolio

Partial knee implants

JOURNEY UNI Unicompartmental Knee System

JOURNEY PFJ Patellofemoral Joint System

 

For guidance on knee implant selection, please contact us.

 *compared with conventional techniques
**compared to NAVIO software version 6.0 / 6.1

References:
1)   Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
2)   Batailler C, White N, Ranaldi F, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESS­KA) 2018.
3)    Jaramaz B, Nikou C, Casper M, Grosse S, Mitra R. Accuracy validation of semi-active robotic application for patellofemoral arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
4)   Jaramaz B, Mitra R, Nikou C, Kung C. Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for knee Arthroplasty in Bi-Cruiciate Retaining Total Knee Replacement. EPiC Series in Health Sciences. 2018;2:98-101. K.
5)   Data on file Smith & Nephew. Sg2 Healthcare Intelligence: Technology guide. 2014.
6)   Gregori A, Picard F, Bellemans J, Smith J, Simone A. Handheld precision sculpting tool for unicondylar knee arthroplasty. A clinical review. Abstract presented at: 15th EFORT Congress; June 4-6, 2014; London, UK.
7)   Smith JR, Picard F, Lonner J, Hamlin B, Rowe P, Riches P, Deakin A. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. 4-9 August, 2013. Natal, Brazil.
8)   Gustke K, Golladay G, Roche MW, Jerry G, Elson LC, Anderson CR. Increased Patient Satisfaction After Total Knee replacement using sensor-guided technology. Bone Joint J 2014;96-B:1333–8.
9)   Gregori A, Picard F, Lonner J, Smith J, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
10) Jacofsky DJ, Allen M. Robotics in arthroplasty: a comprehensive review. J Arthroplasty. 2016;31:2353-2363.
11) Ponzio DY, Lonner JH. Preoperative Mapping in Unicompartmental Knee Arthroplasty Using Computed Tomography Scans Is Associated with Radiation Exposure and Carries High Cost. J Arthroplasty. 2015;30(6):964-967.
12) Banerjee S, Cherian JJ, Elmallah RK, Jauregui JJ, Pierce TP, Mont MA. Robotic-assisted knee arthroplasty. Expert review of medical devices. 2015;12(6):727-735.
13) Urish KL, Conditt M, Roche M, Rubash HE. Robotic Total Knee Arthroplasty: Surgical Assistant for a Customized Normal Kinematic Knee. Orthopedics. 2016;39(5):e822-827.14) Nodzo SR, Carroll KM, Mayman DJ. Disposable Navigation for Total Knee Arthroplasty. Am J Orthop (Belle Mead NJ). 2016;45(4):240-245.
15) Abdel MP, Oussedik S, Parratte S, Lustig S, Haddad FS. Coronal alignment in total knee replacement: historical review, contemporary analysis, and future direction. Bone Joint J. 2014;96-B:857–62.
16) Roche M. Robotic-assisted unicompartmental knee arthroplasty. The MAKO experience. Orthop Clin North Am. 2015;46:125-131.
17) Lonner JH, Moretti VM. The evolution of image-free robotic assistance in unicompartmental knee arthroplasty. Am J Orthop. 2016;45:249-254
18) Sharkey PF, Hozack WJ, Rothman, RH, Shastri S, Jacoby SM. Why Are Total Knee Arthroplasties Failing Today? Clinical Orthopaedics and Related Research. 2002;404:7-13.
19) Stiehl JB, Komistek RD, Cloutier JM, Dennis DA. The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. J Arthroplasty. 2000;15:545-550.
20) Moro-oka TA, Muenchinger M, Canciani JP, Banks SA. Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2007;15:93-99.
21) 20375 V1 500197 REVA NAVIO 7 All Knees Surgical Technique 0619. 14529 V1 500095 REVC NAVIO TKA Surgical Technique 0718.
22) Data on file-SP0028 REVAB 199983 NAVIO 7.

How NAVIO Works

How NAVIO◊ Handheld Robotics works

Operational guidance, features and customizable options

The NAVIO Surgical System offers image-free data collection, surface mapping and bone resection- now with a shorter learning curve and a streamlined preoperative planning phase with our 7.0 operating system upgrade*.

How NAVIO works:

 Image-free registration: real-time characterizsation of bone and cartilage through landmark collection and point mapping, without preoperative imaging.

 Patient-specific planning: Visualise cuts and gap balancing prior to bone preparation, to help eliminate extensive ligament releases. Customise the plan for each patient using mechanical alignment and ligament data.

 Robotics-assisted bone preparation: Two control modes that automatically adjust to execute patient-specific plans with accuracy1-9:

  • Exposure control: the bur extends and retracts from the guard, based on proximity to the target cut surface.
  • Speed control: exposed bur speed adjusts according to proximity to the target cut surface.

 Confirmation: Upon completion, surgeons can assess the initial outcome of both long leg alignment and knee balance.

Watch how NAVIO works in total knee and partial knee arthroplasty. 

Multiple bone removal options – whatever your preference

The NAVIO Surgical System facilitates accurate bone removal1-9 with real-time feedback, according to surgeon preference:

Distal bur: An efficient, robotic-assisted hybrid technique using saws and burs to prepare the distal femur for an AP cutting guide (suitable for TKA and XR).

Bur-all – for robotics purists: a complete, bur-only robotics method (Suitable for UKA/XR and TKA).

Study: NAVIO shows high-level accuracy and few errors in tibial and femoral surface preparation for better mechanical axis alignment9.

Why use NAVIO Handheld Robotics?

How NAVIO compares to conventional instruments

Conventional
Manual instruments include alignment rods that are intra- or extra-modulary that centralise and align the components according to the
surgical plan.

Conventional alignment guides:

  • Lack precision10,11
  • Are not tailored to each patient's individual morphology
  • Can result in inadvertent deviations from the surgical plan2

Robotics
Robotic systems include passive, semi-active and active systems with a robotic arm, robotic guided cutting jigs and robotic milling systems.
For total and partial knee replacement, robotic systems may:

  • Help surgeons avoid surgical errors10,12
  • Decrease variability12
  • Increase accuracy in mechanical alignment for more natural kinematics12-15

As the latest step in robotics technology, NAVIO combines image-free planning, guidance and accurate execution to help optimise kinematics and gap balancing1-9.


The largest range of compatible implants

The NAVIO Surgical System is currently the only handheld robotics system for knee surgery and features the largest portfolio of compatible implants for total and partial knee arthroplasty.

Total knee implants


JOURNEY II BCS

JOURNEY II CR

JOURNEY II XR

LEGION Total Knee System Portfolio

GENESIS II Total Knee System Portfolio

Partial knee implants

 

 

JOURNEY UNI Unicompartmental Knee System

 

 

 

JOURNEY PFJ Patellofemoral Joint System

 

For guidance on knee implant selection, please contact us

*compared to NAVIO software version 6.0 / 6.1

 

References:
1)   Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
2)   Batailler C, White N, Ranaldi F, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESS­KA) 2018.
3)    Jaramaz B, Nikou C, Casper M, Grosse S, Mitra R. Accuracy validation of semi-active robotic application for patellofemoral arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
4)   Jaramaz B, Mitra R, Nikou C, Kung C. Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for knee Arthroplasty in Bi-Cruiciate Retaining Total Knee Replacement. EPiC Series in Health Sciences. 2018;2:98-101. K.
5)   Data on file Smith & Nephew. Sg2 Healthcare Intelligence: Technology guide. 2014.
6)   Gregori A, Picard F, Bellemans J, Smith J, Simone A. Handheld precision sculpting tool for unicondylar knee arthroplasty. A clinical review. Abstract presented at: 15th EFORT Congress; June 4-6, 2014; London, UK.
7)   Smith JR, Picard F, Lonner J, Hamlin B, Rowe P, Riches P, Deakin A. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. 4-9 August, 2013. Natal, Brazil.
8)   Gustke K, Golladay G, Roche MW, Jerry G, Elson LC, Anderson CR. Increased Patient Satisfaction After Total Knee replacement using sensor-guided technology. Bone Joint J 2014;96-B:1333–8.
9)   Gregori A, Picard F, Lonner J, Smith J, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
10) Pastides P, Nathwani D. The role of newer technologies in knee arthroplasty. Orthopaedics and Trauma. 2017;31:47-52.
11) Nair R, Tripathy G, Deysine GR. Computer navigation systems in unicompartmental knee arthroplasty: a systematic review. Am J Orthop. 2014;43:256-261.
12) Jacofsky DJ, Allen M. Robotics in arthroplasty: a comprehensive review. J Arthroplasty. 2016;31:2353-2363.
13) Lonner JH. Robotically assisted unicompartmental knee arthroplasty with a handheld image-free sculpting tool. Orthop Clin North Am. 2016;47:29-40.
14) Roche M. Robotic-assisted unicompartmental knee arthroplasty. The MAKO experience. Orthop Clin North Am. 2015;46:125-131.
15) Lonner JH, Moretti VM. The evolution of image-free robotic assistance in unicompartmental knee arthroplasty. Am J Orthop. 20 International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.

Total Knee Arthroplasty

Using NAVIO in total knee arthroplasty

Total knee arthroplasty failures are mostly attributable to instability and malalignment1, with stability and proprioception shown to affect patient satisfaction- particularly for high-demand patients.2,3

NAVIO has demonstrated more accurate bone resection and alignment, through intraoperative planning, surface mapping and full range-of-motion data collection, for reduced wear and higher implant survivorship.*4-12

Watch how NAVIO works in total knee arthroplasty:

See below for guidance on:

  • Image-free registration
  • Customisable planning
  • Bone preparation
  • Postoperative assessment

Image-free registration

  • a 3D model of patient anatomy is created through direct mapping of articular bone surface
  • Full range-of-motion data collection, including soft-tissue laxity
  • No CT, MRI or preoperative imaging required

 

Customizable, surgeon-controlled planning

  • Intraoperative patient-specific planning for implant placement and soft-tissue balancing
  • Solid surface and cross sectional joint representation, with 3D views of transverse, saggital and coronal planes
  • Confirmation of cut guide size and placement on the bone surface

Robotics-assisted bone preparation

  • Multiple robotics-assisted bone removal options with fine-tuning adjustments.
  • Virtual tool for varus/valgus, flexion and rotation confirmation both before and after resection.
  • Handheld surgical resection tool delivers the latest cutting technology
  • Robotically-controlled precision milling for greater control and accuracy during resection

 

Postoperative assessment

  • Gap balancing comparisons throughout range-of-motion
  • Confirmation of final long leg alignment

 

Measured resection Gap balancing


The largest portfolio of compatible implants

The NAVIO Surgical System is currently the only handheld robotics system for knee surgery and features the largest portfolio of compatible implants for total and partial knee arthroplasty.

Total knee implants


JOURNEY II BCS

JOURNEY II CR

JOURNEY II XR

LEGION Total Knee System Portfolio

GENESIS II Total Knee System Portfolio

For guidance on knee implant selection, please contact us

*compared with conventional techniques

 

References:
1)   Sharkey PF, Hozack WJ, Rothman, RH, Shastri S, Jacoby SM. Why Are Total Knee Arthroplasties Failing Today? Clinical Orthopaedics and Related Research. 2002;404:7-13.
2)   Stiehl JB, Komistek RD, Cloutier JM, Dennis DA. The cruciate ligaments in total knee arthroplasty: a kinematic analysis of 2 total knee arthroplasties. J Arthroplasty. 2000;15:545-550.
3)   Moro-oka TA, Muenchinger M, Canciani JP, Banks SA. Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2007;15:93-99.
4)   Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
5)   Batailler C, White N, Ranaldi F, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESS­KA) 2018.
6)    Jaramaz B, Nikou C, Casper M, Grosse S, Mitra R. Accuracy validation of semi-active robotic application for patellofemoral arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
7)   Jaramaz B, Mitra R, Nikou C, Kung C. Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for knee Arthroplasty in Bi-Cruiciate Retaining Total Knee Replacement. EPiC Series in Health Sciences. 2018;2:98-101. K.
8)   Data on file Smith & Nephew. Sg2 Healthcare Intelligence: Technology guide. 2014.
9)   Gregori A, Picard F, Bellemans J, Smith J, Simone A. Handheld precision sculpting tool for unicondylar knee arthroplasty. A clinical review. Abstract presented at: 15th EFORT Congress; June 4-6, 2014; London, UK.
10) Smith JR, Picard F, Lonner J, Hamlin B, Rowe P, Riches P, Deakin A. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. 4-9 August, 2013. Natal, Brazil.
11) Gustke K, Golladay G, Roche MW, Jerry G, Elson LC, Anderson CR. Increased Patient Satisfaction After Total Knee replacement using sensor-guided technology. Bone Joint J 2014;96-B:1333–8.
12) Gregori A, Picard F, Lonner J, Smith J, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.

Partial Knee Arthroplasty

Using NAVIO in partial knee arthroplasty

The NAVIO Surgical System has proven effective in unicompartmental knee arthroplasty, showing significant improvements to limb alignment1, component positioning1 and restitution of the joint-line height.2

Designed to help surgeons achieve more accuracy in bone resection and alignment through intraoperative planning, surface mapping and full range-of-motion data collection, for reduced wear and higher implant survivorship.*2-10

Watch how NAVIO works in unicompartmental knee arthroplasty:

See below for guidance on:

  • Image-free registration
  • Customisable planning
  • Robotically-assisted execution 

Image-free registration

  • Patient-specific anatomic and kinematic data collection
  • Provides a 3D model of patient anatomy
  • No CT, MRI or preoperative imaging

Customisable, surgeon-controlled planning

  • Size, orient and align components virtually on a 3D model
  • Confirm implant placement relative to the articulating surface
  • Adjust implant placement to balance soft-tissue throughout the full range-of-motion (UKR only)
     

Robotic-assisted bone preparation

  • Handheld surgical resection tool delivers the latest cutting technology 
  • Robotically-controlled precision milling for greater control and accuracy during resection

 

 

Achieving improved restitution of the joint-line height: Read study

The largest portfolio of compatible implants

The NAVIO Surgical System is currently the only handheld robotics system for knee surgery and features the largest portfolio of compatible implants for partial knee arthroplasty.

Partial knee implants

 

JOURNEY UNI Unicompartmental Knee System

 

 

JOURNEY PFJ Patellofemoral Joint System

 


For guidance on knee implant selection, please contact us

 

References:
1)        Nair R, Tripathy G, Deysine GR. Computer navigation systems in unicompartmental knee arthroplasty: a systematic review. Am J Orthop. 2014;43:256-261.
2)      Herry Y, Batailler C, Lording T, Servien E, Neyret P, Lustig S. Improved joint-line restitution in unicompartmental knee arthroplasty using a robotic-assisted surgical technique. Int Orthop. 2017;41:2265-2271.
3)      Batailler C, White N, Ranaldi F, Neyret P, Servien E, Lustig S. Improved implant position and lower revision rate with robotic-assisted unicompartmental knee arthroplasty. European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESS­KA) 2018.
4)       Jaramaz B, Nikou C, Casper M, Grosse S, Mitra R. Accuracy validation of semi-active robotic application for patellofemoral arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.
5)      Jaramaz B, Mitra R, Nikou C, Kung C. Technique and Accuracy Assessment of a Novel Image-Free Handheld Robot for knee Arthroplasty in Bi-Cruiciate Retaining Total Knee Replacement. EPiC Series in Health Sciences. 2018;2:98-101. K.
6)      Data on file Smith & Nephew. Sg2 Healthcare Intelligence: Technology guide. 2014.
7)       Gregori A, Picard F, Bellemans J, Smith J, Simone A. Handheld precision sculpting tool for unicondylar knee arthroplasty. A clinical review. Abstract presented at: 15th EFORT Congress; June 4-6, 2014; London, UK.
8)      Smith JR, Picard F, Lonner J, Hamlin B, Rowe P, Riches P, Deakin A. The accuracy of a robotically-controlled freehand sculpting tool for unicondylar knee arthroplasty. Congress of the International Society of Biomechanics. 4-9 August, 2013. Natal, Brazil.
9)      Gustke K, Golladay G, Roche MW, Jerry G, Elson LC, Anderson CR. Increased Patient Satisfaction After Total Knee replacement using sensor-guided technology. Bone Joint J 2014;96-B:1333–8.
10)    Gregori A, Picard F, Lonner J, Smith J, Jaramaz B. Accuracy of imageless robotically assisted unicondylar knee arthroplasty. Paper presented at: International Society for Computer Assisted Orthopaedic Surgery; June 17-20, 2015; Vancover, Canada.

Surgeon Resources

Surgeon resources

Video & resource library for NAVIO handheld robotics

This library of resources contains surgeon testimonial videos, product information, surgical demonstrations and downloadable documents for your reference.

Additional dedicated resources are available for total knee and partial knee arthroplasty.

Why surgeons choose NAVIO

Surgical demonstrations

The bur-all technique with NAVIO and JOURNEY II BCS:

Robotic-assisted TKA: accuracy, gap balancing and JOURNEY II for optimum performance:

JOURNEY II XR with NAVIO, presented by Dr Jimmy Chow:

Additional Resources

Product brochure

NAVIO design rationale

Blueprint marketing program

Total care program

Distal Burring Surgical Technique Addendum

NAVIO bone tracker set-up guide

Patient testimonial

For further information or guidance

We can arrange for a Smith & Nephew representative to contact you at your convenience.

Contact us