Triathlon

Manufactured by Stryker

Sourced in United States

The Triathlon is a piece of lab equipment designed for conducting various types of scientific research and analysis. It is a versatile and high-performance instrument that can be utilized in a wide range of laboratory applications.

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Lab products found in correlation

Pfc sigma, by DePuy (3 mentions) Attune, by DePuy (2 mentions) Nexgen, by Zimmer Biomet (2 mentions) Persona partial knee, by Zimmer Biomet (1 mentions) Navigation system 2, by Stryker (1 mentions) Orthopilot, by B. Braun (1 mentions) Trident cup, by Stryker (1 mentions) Vanguard, by Zimmer Biomet (1 mentions) Polyglactin 910, by Johnson & Johnson (1 mentions) Persona, by Zimmer Biomet (1 mentions)

20 protocols using triathlon

Surgical Approaches and Techniques in UKA and TKA

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All procedures were performed by a single surgeon in a suburban academic center designated for hip and knee arthroplasty. Identical perioperative and pain management protocols were used for all cases. Tranexamic acid was used for all cases and all procedures were performed without robotic assistance.
The UKA procedures were performed using an identical surgical technique, via a mini-midvastus approach and a spacer block technique with conventional instrumentation. Minimal medial release was performed to allow limb alignment to remain in slight residual varus and to avoid overcorrecting into deleterious valgus, as is the optimal standard practice in medial UKA procedures. All UKAs involved the medial compartment, with use of a cemented, fixed-bearing design (ZUK; Smith & Nephew; or Persona Partial Knee; Zimmer Biomet).
TKA procedures utilized a medial parapatellar approach and computer-assisted navigation (Stryker Navigation) for the distal bone cut. The remainder of the bone cuts were made with traditional instrumentation using a measured resection technique. All TKAs involved the use of a cemented or cementless design from 1 of 2 manufacturers (Triathlon; Stryker Orthopaedics; or EMPOWR; DJO Surgical).

Jansen K., Beckert M., Deckard E.R., Ziemba-Davis M, & Meneghini R.M. (2020). Satisfaction and Functional Outcomes in Unicompartmental Compared with Total Knee Arthroplasty: Radiographically Matched Cohort Analysis. JBJS Open Access, 5(3), e20.00051.

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Robotic-Assisted Total Knee Arthroplasty for Varus Osteoarthritis

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In this analysis, 129 varus knees that underwent TKA for primary osteoarthritis between November 2019 and February 2023 were included. Patients with a history of femoral or tibial fractures, valgus knee deformity, osteotomy, rheumatoid arthritis, post-traumatic arthritis, or pyogenic arthritis of the knee joints were excluded. For the TKA procedures, posterior-stabilising prostheses (Triathlon^®; Stryker, Kalamazoo, MI, USA) were implanted using the MAKO Robotic Arm Interactive Orthopaedic System (Stryker, Kalamazoo, MI, USA). The robotic system enabled the precise measurement of the medial and lateral gaps in flexion and extension before and after femoral bone cutting. The study protocol was approved by the institutional review board.

Lee J.H., Jung H.J., Lee J.K., Hwang J.H, & Kim J.I. (2023). Large Osteophytes over 10 mm at Posterior Medial Femoral Condyle Can Lead to Asymmetric Extension Gap Following Bony Resection in Robotic Arm–Assisted Total Knee Arthroplasty with Pre-Resection Gap Balancing. Journal of Clinical Medicine, 12(18), 5980.

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Comparison of Cemented TKA Stem Lengths

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This was a single-center study conducted at Hässleholm Hospital in southern Sweden between February 2008 and November 2010. 59 patients (31 women) with osteoarthritis of the knee were prospectively randomized to receive either a cemented cruciate retaining (CR) TKA with a tibial stem of standard length or a CR TKA with a short tibial stem (Triathlon; Stryker) (Figure 1).
Randomization was done using sealed envelopes drawn by the department’s study coordinator, with 30 patients allocated to the “standard stem” group and 29 patients allocated to the “short stem” group. 1 patient was lost from the study due to a misplaced envelope. This randomization technique meant that neither the study coordinator nor the surgeons were blinded.

Molt M, & Toksvig-Larsen S. (2015). 2-year follow-up report on micromotion of a short tibia stem: A prospective, randomized RSA study of 59 patients. Acta Orthopaedica, 86(5), 594-598.

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Retrospective Analysis of Primary Total Knee Replacements

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This is a retrospective analysis of prospectively collected data for all patients undergoing primary total knee replacement under the care of a single surgeon in a UK hospital between December 2007 and November 2009. No exclusions were made on the basis of pathology of joint disease or severity of deformity.
Pre-operative Oxford Knee Score (OKS) [13 (link)] and body mass index (BMI) were collected at pre-assessment clinic appointments by independent arthroplasty practitioners within 12 weeks prior to surgery (all OKSs in this paper refer to a scale from 12 to 60, with a higher score indicating poorer outcome). At this time, patients had a standing long leg AP radiograph, including hip, knee and ankle, taken to assess FTMA. All the TKAs were performed using computer navigation by a single surgeon or by his assistant in his presence. Two commercially available computer navigation systems were used: eNlite Navigation System, Navigation System II (Stryker, Mahwah, NJ) or OrthoPilot (BBraun Aesculap, Tuttlingen, Germany). Two implant designs were used: Triathlon (Stryker) (118 knees) and Columbus (BBraun) (105 knees), implanted with the Stryker and OrthoPilot navigation systems, respectively. All knees were cruciate retaining (CR) and cemented.

Goudie S, & Deep K. (2014). Collateral soft tissue release in primary total knee replacement. Computer Aided Surgery, 19(1-3), 29-33.

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Revision Knee Arthroplasty Protocols

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In the primary group, nine patients had a PFC Sigma (DePuy Synthes, West Chester, Pennsylvania, USA) and two had a Triathlon (Stryker, Kalamazoo, Michigan, USA). In the fibrosis cohort, the primary knee arthroplasties were PFC Sigma in four cases, Triathlon in two, and Kinemax (Stryker Howmedica Osteonics, Mahwah, New Jersey, USA) in two. Four of the eight cases in this group had had the patella resurfaced during the primary procedure. In the non-fibrotic revision cohort the primary knee arthroplasties were PFC Sigma in two, Triathlon in one, and Kinemax in two. Revisions were performed using the NexGen rotating hinge (ZimmerBiomet, Warsaw, Indiana, USA; five cases), LCCK (ZimmerBiomet; five cases), and TC3 (DePuy Synthes; three cases).
In all primary and revision TKA patients, local anaesthetic was administered intraoperatively under direct vision (to a maximum dose of 100 ml of 0.2% ropivacaine). All patients were given routine postoperative analgesia, including regular paracetamol and a patient-controlled analgesia device. Patients in the fibrotic revision group were routinely started on continuous passive movement for 48 to 72 hours postoperatively.

Attard V., Li C.Y., Self A., Mann D.A., Borthwick L.A., O’Connor P., Deehan D.J, & Kalson N.S. (2020). Quantification of intra-articular fibrosis in patients with stiff knee arthroplasties using metal-reduction MRI. The Bone & Joint Journal, 102-B(10), 1331-1340.

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Stryker Triathlon Cruciate Retaining Knee System

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The Stryker Triathlon (Stryker, Kalamazoo, MI, USA) cruciate retaining knee system with patellar resurfacing will be used in both groups. The femoral component will be un-cemented, and patella and tibial components will be cemented. This implant and its surgical instruments are already in routine use for TKA at St John of God Subiaco Hospital. The surgical team are fully trained and experienced with the use of the instruments and surgical equipment for these implants.

Steer R., Tippett B., Khan R.N., Collopy D, & Clark G. (2021). A prospective randomised control trial comparing functional with mechanical axis alignment in total knee arthroplasty: study protocol for an investigator initiated trial. Trials, 22, 523.

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Triathlon TKA Surgical Technique

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Tourniquet was routinely used. A midline medial parapatella approach was made with eversion of the patella. Intramedullary jig referencing was used for the femur, using the epicondylar axis and Whiteside’s line¹⁸ to set the rotation, and an extramedullary jig was used for the tibia. The specified bone cuts were: 5° to 7° of valgus and neutral flexion/extension for the femoral component and zero varus/valgus with 3° of posterior slope for the tibial component. Soft tissue releases were then made as appropriate once the trial components were in place and osteophytes had been removed to achieve a balanced knee. The Triathlon (Stryker) TKA was used in all cases.

Clement N.D., Bell A., Simpson P., Macpherson G., Patton J.T, & Hamilton D.F. (2020). Robotic-assisted unicompartmental knee arthroplasty has a greater early functional outcome when compared to manual total knee arthroplasty for isolated medial compartment arthritis. Bone & Joint Research, 9(1), 15-22.

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Comparative Outcomes of TKA and THA

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A tourniquet was used in every TKA procedure. A drain was used in every TKA and THA procedure. Three types of TKA prosthesis were used: Nexgen (Zimmer Biomet, Warsaw, IN), NRG (Stryker, Mahwah, NJ), and Triathlon (Stryker). All TKA components were fixed with cement. Trident cup (Stryker) with SecurFit femoral stem (Stryker) was the only type of THA implant used. The fixation method for all THA components was cementless. All the patients started ambulation within postoperative 24 hours, usually in the morning on POD1.

Chang W.L., Pai F.Y., Tsai S.W., Chen C.F., Wu P.K, & Chen W.M. (2024). Risk factors for venous thromboembolism after primary total joint arthroplasty: An analysis of 7511 Taiwanese patients. Journal of the Chinese Medical Association : JCMA, 87(5).

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Cementless vs Cemented TKA Implants

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This study was approved by the Regional Ethical Review Board in Lund, Sweden (entry no. 2015/8) and registered at ClinicalTrials.gov (NCT02578446). All of the patients gave informed consent prior to enrollment.
Patient selection and the surgical procedures that were used for this randomized RSA trial have been described previously^{19 (link)}. In short, 72 patients were randomized to a cementless Triathlon Tritanium (Stryker) cruciate-retaining (CR) fixed-bearing TKA implant or a cemented Triathlon (Stryker) CR fixed-bearing TKA implant. The prostheses were identical in geometrical shape except for the 3D-printed porous structure and 4 pegs on the undersurface of the tibial baseplate of the cementless implant. SMARTSET GHV bone cement (DePuy Synthes) was used for the cemented group, leaving the tibial keel cementless in all cases. Eight spherical tantalum beads (diameter, 0.8 mm; RSA Biomedical) were inserted into the tibia, and 5 were inserted into the polyethylene of the tibial insert. Patients remained blinded to the treatment; the surgery was performed by a single experienced surgeon (S.T.-L.). Both groups received the same intraoperative treatment and postoperative rehabilitation, including immediate full weight-bearing on the day of surgery.

van der Lelij T.J., Marang-van de Mheen P.J., Kaptein B.L., Toksvig-Larsen S, & Nelissen R.G. (2023). Continued Stabilization of a Cementless 3D-Printed Total Knee Arthroplasty: Five-Year Results of a Randomized Controlled Trial Using Radiostereometric Analysis. The Journal of Bone and Joint Surgery. American Volume, 105(21), 1686-1694.

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Additive Manufacturing of Tibial Tray Housing Prototype

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The housing prototype features an internal void intended to be fully occupied by the TEGs and frontend electronics (Figure 1). Cantilever beam structures along the housing periphery were tuned to achieve a vertical displacement of 0.2 mm when subjected to 2600 N, which approximates the maximum vertical load during a typical gait cycle, while not exceeding the fatigue strength of Ti6Al4V of 550 MPa [17 (link)]. Beam thickness varied nonuniformly around the periphery (Figure 2). The overall geometry of the housing prototype was based on the perimeter shape of a size 7 tibial tray (Triathlon, Stryker, Kalamazoo, MI) (Figure 3). In order to integrate the energy harvester system with the TKR, the interlocking mechanism of the tibial tray and UHMWPE bearing was reverse engineered on the superior and inferior surfaces, respectively, of the housing using CAD software (Solidworks, Dassault Systemes, Vélizy-Villacoublay, FR). The housing was manufactured using a Renishaw AM 400 (Wotton-under-Edge, UK) selective laser melting (SLM) machine. The printing and post-processing parameters are summarized in Table 1. The manufactured prototype is presented in Figure 4.

Yamomo G., Hossain N., Towfighian S, & Willing R. (2021). Design and Analysis of a Compliant 3D Printed Energy Harvester Housing for Knee Implants. Medical engineering & physics, 88, 59-68.

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