New report confirms Smith+Nephew’s OXINIUM™ Technology is the best performing bearing surface at 20 years for total hip arthroplasty

Rhea-AI Summary

Smith+Nephew (NYSE:SNN) announces exceptional performance of their proprietary OXINIUM™ Technology in total hip arthroplasty, as confirmed by the Australian Orthopaedic Association National Joint Replacement Registry's latest annual report. The data shows OXINIUM on highly cross-linked polyethylene achieved the highest survivorship rate of 94.1% over 20 years among all bearing combinations.

Four global registries, including those from Australia, UK, Italy, and Netherlands, demonstrate that OXINIUM/XLPE had a 35% lower risk of revision at 10-years compared to other modular acetabular implants. The technology features unique benefits including metal durability, ceramic wear resistance, and superior corrosion resistance, with virtually no nickel, cobalt, or chromium content.

Positive

• Highest 20-year survivorship rate (94.1%) among all bearing combinations
• 35% lower revision risk at 10-years vs competitors
• Validation from four major global registries
• Superior material properties with virtually no harmful metals

Negative

• None.

Insights

Medical Device Analyst

The latest AOANJRR report delivers significant validation for Smith+Nephew's OXINIUM technology, confirming its 94.1% survivorship rate over 20 years - the highest among all bearing combinations for hip replacements. This exceptional longevity data represents a substantial competitive advantage in the orthopedic implant market.

What makes this particularly compelling is the consistency across four major registries (Australian, UK, Italian, and Dutch), all showing OXINIUM/XLPE has a 35% lower revision risk at 10 years versus competing products. In the orthopedic space, where clinical evidence drives adoption and pricing power, this multi-registry validation provides Smith+Nephew with powerful differentiation.

The OXINIUM technology's unique material transformation (not merely a coating) offers a rare combination of metal durability with ceramic wear resistance. Additionally, the reduced inflammatory markers and absence of certain metals exempts these implants from CMR substance labeling requirements - a regulatory advantage as medical device regulations tighten globally.

For Smith+Nephew, this strong clinical validation should strengthen its position in contract negotiations with hospitals and influence surgeon preference, potentially supporting premium pricing and market share growth in the competitive hip replacement segment.

Orthopedic Surgeon

From a clinical perspective, this 20-year data on OXINIUM represents a landmark achievement in orthopedic implant durability. The 94.1% survivorship rate addresses one of the most critical concerns in arthroplasty - long-term implant longevity and reduced revision burden.

The statement from Prof. Walter highlighting that "bearing wear has been virtually eliminated as a cause of failure" is particularly noteworthy. Historically, osteolysis from bearing wear was a leading cause of revision surgeries, creating significant patient morbidity and healthcare costs. OXINIUM's performance effectively removes this failure mode from clinical consideration.

The material science advantages - combining metal durability with ceramic wear resistance while avoiding nickel, cobalt, and chromium - addresses multiple clinical priorities: longevity, mechanical strength, and reduced potential for adverse tissue reactions. The 30x reduction in pro-inflammatory markers suggests improved biocompatibility, potentially reducing long-term complications.

For clinical practice, registry data of this caliber influences surgical decision-making far more than company marketing. Having consistent findings across four international registries provides the highest level of evidence short of randomized trials, giving surgeons confidence in choosing this bearing surface for patients requiring long-term implant performance.

Smith+Nephew (LSE:SN, NYSE:SNN), the global medical technology company, is pleased to announce that the latest annual report from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) highlights the exceptional performance of Smith+Nephew’s proprietary OXINIUM on highly cross-linked polyethylene. The data indicates that this combination has the highest survivorship rate (94.1%) among all bearing combinations over a 20-year period for total hip arthroplasty (THA).¹

The report on 20-year outcomes corroborates similar findings and peer-reviewed publications from the National Joint Registry for England, Wales, Northern Ireland and the Isle of Man (NJR).² Whitehouse et al. found that hip implants combining delta ceramic or OXINIUM (Oxidized Zirconium) heads with XLPE (highly cross-linked polyethylene) liners or cups had the lowest risk of needing revision surgery over a 15-year period.³ 

Four registries in total - including the Italian Registry (RIPO; Register of Orthopaedic Prosthetic Implants) and the Dutch Arthroplasty Register (LROI) - have now demonstrated that OXINIUM/XLPE had a 35% lower risk of revision at 10-years versus other modular acetabular implants^1-5

These findings offer valuable guidance for surgeons and patients in selecting the most reliable implant materials for long-term outcomes. “When I started in practice more than 20 years ago bearing wear was the leading cause of failure of hip replacements,” said Prof. Bill Walter of The University of Sydney and Royal North Shore Hospital. “We used to see osteolysis as the main reason for revision. The AOANJRR now shows that bearing wear has been virtually eliminated as a cause of failure. The bearing combination of OXINIUM on highly cross-linked polyethylene leads the pack with revision rates at 20 years significantly lower than even metal on XLPE.” 

Through a unique manufacturing process, the OXINIUM alloy becomes a ceramicised metal - a true material transformation - rather than an applied coating.⁶ It is this material transformation that provides OXINIUM with its ground-breaking performance benefits which include:

• Unrivalled Material Science: The durability of metal, the wear resistance of ceramic and corrosion resistance better than both metal and ceramic.^6-16
• Differentiated Composition: Virtually no nickel, cobalt and chromium,¹⁶ with a 30x reduction in pro-inflammatory markers for OXINIUM.^*17  As such, OXINIUM implants do not require declaration of the presence of CMR (carcinogenic, mutagenic, reprotoxic) substances on the labeling.

“Registries throughout the world have highlighted the performance of OXINIUM for total hip arthroplasty. The AOANJRR report showing 20-year outcomes provides powerful evidence for payers, hospitals, surgeons, and patients of our truly differentiated and proven technology,” said Craig Gaffin, President of Global Orthopaedics at Smith+Nephew. “OXINIUM/XLPE continues to demonstrate superior revision rates across multiple global joint replacement registries.”

To learn more about Smith+Nephew’s OXINIUM Technology and hip reconstruction portfolio, please visit our booth (#3729) at the American Academy of Orthopaedic Surgeons Annual Meeting in San Diego March 11-13, 2025 or visit https://www.smith-nephew.com/en-us/health-care-professionals/products/orthopaedics/oxinium. 

- ends –

 

Media Enquiries

Dave Snyder          +1 (978) 749-1440 

Smith+Nephew      david.snyder@smith-nephew.com

 

*     ASTM International Standard Specification for Wrought Zirconium-2.5 Niobium Alloy for Surgical Implant Applications (UNS R60901) Designation: F 2384 – 10.

 

References

1. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) Hip, Knee & Shoulder Arthroplasty: 2024 Annual Report Adelaide; AOA, 2024:1–629. Available at: https://aoanjrr.sahmri.com/annual-reports-2024. Accessed December 11, 2024
2. National Joint Registry for England, Wales and Northern Ireland: 21st Annual Report. 2024. Available at: NJR 21st Annual Report 2024_Hips.pdf. Accessed January 06, 2025.
3. Whitehouse MR, Patel R, French JMR, et al. The association of bearing surface materials with the risk of revision following primary total hip replacement: A cohort analysis of 1,026,481 hip replacements from the National Joint Registry. PLoS Med 2024;21(11): e1004478.
4. Peters RM, Van Steenbergen LN, Stevens M, Rijk PC, Bulstra SK, Zijlstra WP. The effect of bearing type on the outcome of total hip arthroplasty. Acta Orthop. 2018:89;163–169. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5901513/. Accessed November 9, 2023.
5. Atrey A, Ancarani C, Fitch D, Bordini B. Impact of bearing couple on long-term component survivorship for primary cementless total hip replacement in a large arthroplasty registry. Poster presented at: Canadian Orthopedic Association; June 20–23, 2018; Victoria, British Columbia, Canada.
6. Hunter G, Dickinson J, Herb B, et al. Creation of oxidized zirconium orthopaedic implants. Journal of ASTM International. 2005;2:1-14.
7. Long M, Riester L, Hunter G. Nano-hardness Measurements of Oxidized Zr-2.5Nb and Various Orthopaedic Materials. Abstract presented at: 24th Annual Meeting of the Society for Biomaterials. April 22-26, 1998, San Diego, California.
8. Parikh A, Hill P, Hines G, Pawar V. Wear of conventional and highly crosslinked polyethylene liners during simulated fast walking/jogging. Poster presented at: Orthopaedic Research Society Annual Meeting; 2009; Las Vegas; NV.
9. Parikh A, Hill P, Pawar V, Sprague J. Long-term Simulator Wear Performance of an Advanced Bearing Technology for THA. Poster presented at: 2013 Annual Meeting of the Orthopaedic Research Society. Poster no. 1028.
10. Papannagari R, Hines G, Sprague J, Morrison M. Long-term wear performance of an advanced bearing technology for TKA. Poster presented at: Orthopaedic Research Society Annual Meeting; 2011; Long Beach, CA.
11. Smith+Nephew 2010. OR-10-155.
12. Aldinger P, Williams T, Woodard E. Accelerated fretting corrosion testing of zirconia toughened alumina composite ceramic and a new composition of ceramicised metal femoral heads. Poster presented at: Orthopaedic Research Society Annual Meeting; 2017; San Diego, CA.
13. Smith+Nephew 2016. OR-16-127.
14. 2005 ASM International Engineering Materials Achievement Award.
15. Dalal A, Pawar V, McAllister K, Weaver C, Hallab NJ. Orthopedic implant cobalt-alloy particles produce greater toxicity and inflammatory cytokines than titanium alloy and zirconium alloy-based particles in vitro, in human osteoblasts, fibroblasts, and macrophages. J Biomed Mater Res Part A. 2012;100A:2147-2158.
16. ASTM F2384-24 (May 2024). Standard specification for wrought zirconium-2.5niobium alloy for surgical implant applications (UNS R60901). Available at: https://www.astm.org/f2384-10r16.html. Accessed February 27, 2025
17. Hallab NJ, McAllister K, Jacobs JJ, and Pawar, V. Zirconium-Alloy and Zirconium-Oxide Particles Produce less Toxicity and Inflammatory Cytokines than Cobalt-Alloy and Titanium-Alloy Particles In Vitro, in Human Osteoblasts, Fibroblasts and Macrophages. 2012 Annual Meeting of the Orthopaedic Research Society. Poster no. 0971.

About Smith+Nephew

Smith+Nephew is a portfolio medical technology business focused on the repair, regeneration and replacement of soft and hard tissue. We exist to restore people’s bodies and their self-belief by using technology to take the limits off living. We call this purpose ‘Life Unlimited’. Our 17,000 employees deliver this mission every day, making a difference to patients’ lives through the excellence of our product portfolio, and the invention and application of new technologies across our three global business units of Orthopaedics, Sports Medicine & ENT and Advanced Wound Management.

Founded in Hull, UK, in 1856, we now operate in around 100 countries, and generated annual sales of $5.8 billion in 2024. Smith+Nephew is a constituent of the FTSE100 (LSE:SN, NYSE:SNN). The terms ‘Group’ and ‘Smith+Nephew’ are used to refer to Smith & Nephew plc and its consolidated subsidiaries, unless the context requires otherwise.

For more information about Smith+Nephew, please visit www.smith-nephew.com and follow us on X, LinkedIn, Instagram or Facebook.

 

Forward-looking Statements

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^◊ Trademark of Smith+Nephew. Certain marks registered in US Patent and Trademark Office.

 

FAQ

What is the 20-year survivorship rate of Smith+Nephew's OXINIUM Technology (SNN) in hip replacements?

OXINIUM on highly cross-linked polyethylene showed a 94.1% survivorship rate over 20 years, the highest among all bearing combinations for total hip arthroplasty.

How much lower is the revision risk for SNN's OXINIUM/XLPE compared to other implants?

OXINIUM/XLPE demonstrated 35% lower risk of revision at 10-years versus other modular acetabular implants, as confirmed by four global registries.

Which registries have validated Smith+Nephew's OXINIUM Technology performance?

The Australian AOANJRR, UK's NJR, Italian RIPO, and Dutch LROI registries have all validated OXINIUM's superior performance.

What are the key material advantages of SNN's OXINIUM Technology for hip implants?

OXINIUM combines metal durability with ceramic wear resistance, superior corrosion resistance, and contains virtually no nickel, cobalt, or chromium.