ORTHO NEWS

SUNWAY Medical Centre, Sunway City reaffirms their advocacy to provide better mobility and healthcare options for senior citizens to ensure better quality of life in the near future.

To this end, Sunway Medical Centre, one of Malaysia’s leading smart hospitals, has succeeded in carrying out the country’s first robot-assisted joint replacement procedure. This milestone achievement comes as part of the hospital’s diligent investment in state-of-the-art smart hospital technology to improve patient care and precision medicine.

As with many ailments, the risk of developing arthritis increases with age. Our joints are pertinent in allowing us to carry out essential daily activities, and when they become injured or diseased, the resulting pain and stiffness can severely limit one’s ability to use their joints and move comfortably. Osteoarthritis patients do experience some degree of movement limitation in their daily lives.

The most effective solution to improve these conditions is total joint replacement surgery – especially so for areas such as the knees and hips. These types of procedures are some of the most cost-effective and consistently successful surgeries performed in orthopaedics in recent years. Undergoing total joint replacement surgery provides pain relief from arthritis, functional restoration of arthritic joints, as well as improving overall health and comfort in elderly patients.

Revolutionising total joint replacement surgery

To accurately operate and insert the artificial joints, assistive technologies such as navigation systems and robotic assistance have been in development in recent years. These navigation and robotic systems function in similar fashion to global positioning systems (GPS) in vehicles, guiding surgeons toward the best route when conducting the procedure.

In a future-forward step toward improving the way total joint replacement surgery is conducted at their hospital, Sunway Medical Centre is using two advanced robotic systems to assist in these procedures. Both systems enhance the process of joint replacement by providing a CT-derived, patient-specific 3D model that grants the surgeon the ability to pre-plan the procedure and thus enable accurate planning of implant size and alignment. These futuristic systems also allow surgeons to virtually conduct a hip or knee replacement before performing any resections.

‘With this technology, we are able to facilitate a higher accuracy of implant placement and conduct a successful operation with minimal invasiveness,’ said Dr Chua.

Sunway Medical Centre, Sunway City consultant orthopaedic and arthroplasty surgeon Dr Chua Hwa Sen explains that the new system is revolutionary in its unique ability to provide the patient with a personalised surgical experience that is specifically tailored to his individual needs and anatomy.

“With this technology, we are able to facilitate a higher accuracy of implant placement and conduct a successful operation with minimal invasiveness. This, in turn, allows the patient to experience less postoperative pain and a quicker recovery,” he said.

“This highly-intelligent and adaptive technology has allowed us to demonstrate an elevated level of accuracy and less alignment outliers in total knee arthroplasties compared to its conventional procedure. Its unique ability to analyse surgical decisions with quantifiable data gives me hope that we are truly providing our patients with the best possible smart hospital technology to improve their lives,” said Sunway Medical Centre, Sunway City consultant orthopaedic, arthroplasty and trauma surgeon Dr Suhail Suresh Abdullah.

Quick return to painless mobility

At its core, the purpose of carrying out total joint replacement surgery with robotic assistance is to ultimately ease the experience of patients. Among the many benefits seen in patients in recovery from robot-assisted surgery are less scarring, minimal blood loss, and a quicker return to their normal daily activities.

When compared to minimally invasive conventional surgery, a large portion of respondents mentioned they considered robot-assisted surgery to be safer, more efficient, less painful and provided better results post-operation.

With the integration of these state-of-the-art robotic systems, Sunway Medical Centre continues to solidify their position as one of the country’s pioneers in the healthcare industry.

The hospital intends to continue their stride toward strengthening investments in smart hospital technology for the foreseeable future, in line with their commitment to precision medicine and to expand their regional leadership in robotic surgery.

KKLIU: 1438/2022

ARVIS offers orthopedic surgeons a wearable AR headset used during surgery to help accurately place hip and knee implants

July 22, 2022

WILMINGTON, Del.–(BUSINESS WIRE)–Today, Enovis (NYSE: ENOV), an innovation-driven medical technology company, announced the commercial launch of ARVIS^® (Augmented Reality Visualization and Information System) with over 200 cases successfully completed in the U.S. This FDA-cleared system is the only proprietary, real-time, hands-free augmented reality (AR) technology precisely engineered for orthopedic surgeons, so they can visualize precision guidance when performing hip and knee surgery with the support of AR.

AR technology is a form of orthopedic surgical guidance technology that helps surgeons place and align implants during surgery. Unlike other traditional robotic systems that require additional staff, ARVIS is a self-contained, wearable surgical guidance device controlled by the surgeon that can either be worn on an ARVIS headband or compatible with the helmets already worn in surgery. ARVIS is designed to ensure surgeons can focus on their patient – not a screen across the room – by empowering them with a hands-free view of the procedure.

“ARVIS was designed to provide surgeons with better information, more confidence and an enhanced surgical experience that integrates seamlessly into their procedural workflow without the need for obtrusive and unnecessary equipment,” said Louie Vogt, President and General Manager of Enovis Surgical. “ARVIS is significantly smaller, but powerful and precise, with a more economical price than large robotic systems.^1,2 In turn, it can be adopted and scaled by a wide array of ambulatory surgical centers and hospitals, meaning more access to more patients wishing to experience the benefits of a technology-assisted knee or hip replacement.”

ARVIS is the first system with proprietary hardware designed to assist surgeons in precisely placing hip and knee joint replacements, to help improve joint replacement recovery outcomes. ARVIS is more sustainable and environmentally friendly than other technologies as well, due to the elimination of single use plastic instruments and consumables requiring disposal. It is AR-supported surgery, through the eyes of the surgeon.

Hip or knee replacement is the standard treatment for osteoarthritis, the most common form of arthritis and the most common cause of disability in adults. Osteoarthritis involves degradation of the joint through the breakdown of cartilage, including articular cartilage and subchondral bone, according to the Mayo Clinic.³

“Having knee or hip replacement is a big decision for any patient. ARVIS provides me real-time feedback at the operative site and guides me as I make cuts and check measurements to ensure that the angles are correct for the best fit and alignment. The screens are located within my line of sight, so I never have to take my eyes off the patient,” said Dr. Michael Nett,⁴ Chair of Orthopedic Surgery, South Shore University Hospital in Bay Shore, NY. “ARVIS gives me further peace of mind as I’m placing small components that can make a big difference for the long and short-term arthritis relief my patients expect and deserve. It’s a game changer.”

ARVIS AR Technology was acquired by Enovis subsidiary, DJO, LLC, as part of its acquisition of Insight Medical Systems on July 5, 2022. ARVIS is compatible with Enovis’ innovative EMPOWR™ Hip and Knee product offerings including EMPOWR™ 3D, Porous and Partial Knee, EMPOWR Acetabular^® and Dual Mobility, along with compatible femoral stems.

For more information, visit enovis.com/arvis.

References:

1. Novak, Erik J., Marc D. Silverstein, and Kevin J. Bozic. “The cost-effectiveness of computer-assisted navigation in total knee arthroplasty.” JBJS 89.11 (2007): 2389-2397.
2. Macario, Alex. “What does one minute of operating room time cost?” Journal of clinical anesthesia 4.22 (2010): 233-236.
3. Osteoarthritis – Symptoms and causes, Mayo Clinic, 2022: Osteoarthritis – Symptoms and causes – Mayo Clinic
4. Dr. Michael Nett is a paid consultant for Enovis Surgical.

About Enovis

Enovis Corporation (NYSE: ENOV) is an innovation-driven, medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services, and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit www.enovis.com.

Contacts
Media contact:
Shay Smith
Health+Commerce
707.971.9779
shay@healthandcommerce.com

by: Keni Mac, Sponsored by Colorado Springs Orthopaedic Group

Posted: Jul 22, 2022 / 02:20 PM MDT

Updated: Jul 22, 2022 / 02:20 PM MDT

In today’s Medical Minute, Orthopedic Joint Replacement Surgeon, Dr. Ted Stringer, with Colorado Springs Orthopaedic Group, dives into the the innovation of joint replacement over time. He explains that today’s advanced technology has improved the medical world greatly. Stringer says “digital” is the future of medical procedures.

Visit CSOG’s website to learn how you can schedule your next appointment.
Click here: CSOG.net.

Richard Berger, MD, of Chicago-based Midwest Orthopaedics at Rush, created a telehealth program for total joint replacement patients.

The program, Berger’s Elective Surgical and Telemedicine Experience, allows patients to have virtual pre- and post-surgical visits along with educational classes, according to a July 21 news release. It aims to eliminate the time, inconvenience and expense of traveling for in-office visits.

“With the rapid growth of telehealth, we want to foster an environment where patients feel like they are cared for more than ever,” Dr. Berger said in the release. “Now they can do telehealth conferences from the comfort of their own homes without taking time off work, sacrificing vacation days, or finding a caretaker for loved ones.”

Dr. Berger is an assistant professor at Rush University Medical Center and has performed more than 23,000 hip and knee replacements.

WILMINGTON, Del.–(BUSINESS WIRE)–Today, Enovis (NYSE: ENOV), an innovation-driven medical technology company, announced the commercial launch of ARVIS^® (Augmented Reality Visualization and Information System) with over 200 cases successfully completed in the U.S. This FDA-cleared system is the only proprietary, real-time, hands-free augmented reality (AR) technology precisely engineered for orthopedic surgeons, so they can visualize precision guidance when performing hip and knee surgery with the support of AR.

AR technology is a form of orthopedic surgical guidance technology that helps surgeons place and align implants during surgery. Unlike other traditional robotic systems that require additional staff, ARVIS is a self-contained, wearable surgical guidance device controlled by the surgeon that can either be worn on an ARVIS headband or compatible with the helmets already worn in surgery. ARVIS is designed to ensure surgeons can focus on their patient – not a screen across the room – by empowering them with a hands-free view of the procedure.

“ARVIS was designed to provide surgeons with better information, more confidence and an enhanced surgical experience that integrates seamlessly into their procedural workflow without the need for obtrusive and unnecessary equipment,” said Louie Vogt, President and General Manager of Enovis Surgical. “ARVIS is significantly smaller, but powerful and precise, with a more economical price than large robotic systems.^1,2 In turn, it can be adopted and scaled by a wide array of ambulatory surgical centers and hospitals, meaning more access to more patients wishing to experience the benefits of a technology-assisted knee or hip replacement.”

ARVIS is the first system with proprietary hardware designed to assist surgeons in precisely placing hip and knee joint replacements, to help improve joint replacement recovery outcomes. ARVIS is more sustainable and environmentally friendly than other technologies as well, due to the elimination of single use plastic instruments and consumables requiring disposal. It is AR-supported surgery, through the eyes of the surgeon.

Hip or knee replacement is the standard treatment for osteoarthritis, the most common form of arthritis and the most common cause of disability in adults. Osteoarthritis involves degradation of the joint through the breakdown of cartilage, including articular cartilage and subchondral bone, according to the Mayo Clinic.³

“Having knee or hip replacement is a big decision for any patient. ARVIS provides me real-time feedback at the operative site and guides me as I make cuts and check measurements to ensure that the angles are correct for the best fit and alignment. The screens are located within my line of sight, so I never have to take my eyes off the patient,” said Dr. Michael Nett,⁴ Chair of Orthopedic Surgery, South Shore University Hospital in Bay Shore, NY. “ARVIS gives me further peace of mind as I’m placing small components that can make a big difference for the long and short-term arthritis relief my patients expect and deserve. It’s a game changer.”

ARVIS AR Technology was acquired by Enovis subsidiary, DJO, LLC, as part of its acquisition of Insight Medical Systems on July 5, 2022. ARVIS is compatible with Enovis’ innovative EMPOWR™ Hip and Knee product offerings including EMPOWR™ 3D, Porous and Partial Knee, EMPOWR Acetabular^® and Dual Mobility, along with compatible femoral stems.

For more information, visit enovis.com/arvis.

References:

1. Novak, Erik J., Marc D. Silverstein, and Kevin J. Bozic. “The cost-effectiveness of computer-assisted navigation in total knee arthroplasty.” JBJS 89.11 (2007): 2389-2397.
2. Macario, Alex. “What does one minute of operating room time cost?” Journal of clinical anesthesia 4.22 (2010): 233-236.
3. Osteoarthritis – Symptoms and causes, Mayo Clinic, 2022: Osteoarthritis – Symptoms and causes – Mayo Clinic
4. Dr. Michael Nett is a paid consultant for Enovis Surgical.

About Enovis

Enovis Corporation (NYSE: ENOV) is an innovation-driven, medical technology growth company dedicated to developing clinically differentiated solutions that generate measurably better patient outcomes and transform workflows. Powered by a culture of continuous improvement, global talent and innovation, the Company’s extensive range of products, services, and integrated technologies fuels active lifestyles in orthopedics and beyond. For more information about Enovis, please visit www.enovis.com.

Homewood, AL – When faced with a total joint replacement, people are now opting for alternative regenerative treatments, ideally minimally invasive ones. QC Kinetix (Homewood) has an arsenal of regenerative medicine treatment methods to help alleviate pain caused by degenerative joint pains in the knee.

For patients who are looking to avoid the long recovery after traditional total knee replacement surgery, QC Kinetix (Homewood) uses an innovative procedure that provides relief from joint pains of the knee without the need for replacement. QC Kinetix (Homewood) will also work with patients to develop an individualized treatment plan tailored to their condition.

“When patients come in for regenerative medicine treatments at QC Kinetix (Homewood), we take the time to talk with them about their specific needs. We have a team of professionals passionate about helping people live a healthier, more natural life and will work closely with our patients to find out what is causing them pain or discomfort to get back on the road to living an enjoyable life. Our goal is not only to provide relief through treatment but also to educate each patient on how they can achieve long-term relief by making some lifestyle changes,” said the clinic’s Jeff Cooke during the continuous medical education training.

QC Kinetix (Homewood) provides an innovative no-touch procedure for the stabilization of the knee, designed to stimulate new blood growth and bone formation at the joint surface. This process helps repair the torn or worn cartilage while also providing stabilization and restoring motion to the knee. QC Kinetix uses this treatment as a viable Birmingham knee replacement alternative for surgery. To facilitate the treatment, the company uses state-of-the-art technology and equipment to deliver a safe experience. These tools are paired with the training and experience of the professionals at the clinic.

Sports and musculoskeletal conditions are typically treated with surgery or rest, but regenerative medicine offers a cutting-edge treatment alternative. QC Kinetix (Homewood) has been performing replacement surgery alternatives for athletes with pain due to tendon injuries, foot pain, lower back pain, and Birmingham hip replacement alternatives for more than 20 years.

Patients can find QC Kinetix (Homewood) at 1 Independence Drive, Suite 800, Homewood, AL 35209. Contact the clinic via phone at (205) 686-1941 or visit their website for more information.

We recently sat down with Dave Kempfert, PT, Director of Rehabilitation Services at the Bone and Joint Institute of Tennessee to discuss new protocols in physical therapy and rehabilitation. Find out how patients are recovering from joint replacement surgery much faster than ever before.

Q: How have the rehab protocols for total joint replacement patients improved or changed in recent years?

Kempfert: Back in the day we used to see patients for months of rehab to regain range of motion and function. Today, many patients are coming in at 2 – 3 weeks of rehab looking like they used to after four months of therapy.

Surgical technology has also improved joint replacement outcomes significantly. Doctors can use CT scans and 3D planning with robotic assistance to make very precise decisions and cuts. More precise surgery leads to less soft tissue trauma, which we love on the rehab side. This means patients generally have more mobility and less swelling and pain post-op.

Because of this, we’re able to get patients started on a lot of things sooner. We often have to hold patients back from doing too much because they feel so much better.

Q: How does the Bone and Joint Institute of Tennessee excel in providing rehab after total joint replacement?

Kempfert: I think as a team the Bone and Joint Institute of Tennessee is blessed with a lot of great providers, both physicians and rehab clinical staff. We excel, in part, because of our ability to work as a team; we’re literally down the hallway from our doctors. Our physicians are very experienced; they do about 1,400 hip and knee joint replacements per year.

Much of our success comes from working together in providing preoperative education through our total joint education classes. It’s a collaborative effort between all departments: surgery, rehab, and the groups that provide the walkers and ice machines you go home with. We give education on nutrition, safety and fall risk, and preoperative exercises to prepare patients before the surgery. We all feel better if we can help our patients become knowledgeable about what to expect. This gives the patients and family members a lot of peace of mind going into surgery and also results in better compliance after surgery.

I think we do a good job between the anesthesiologists who do pain management during surgery and the doctors who do pain management after surgery.

Physical therapy teaches people the appropriate ways to use heat and ice, electrical stimulation to block pain, proper positioning, and use of assistive devices like canes and walkers. It’s a team effort. All of us work together, and this includes the patient actively taking responsibility for their care.That really makes a difference in the great outcomes that we get here.

Q: What’s the rehab process like for total hip replacement surgery?

Kempfert: Oftentimes, we don’t see total hip patients in physical therapy. We will do physical therapy if someone is getting back to a high level of activity or has a fairly active lifestyle and the doctor and rehab team agree the patient needs it. The majority of total hip patients can often get back to a good quality of life without physical therapy.

Q: What’s the rehab process like for total knee replacement (TKR) surgery?

Kempfert: Now that’s different! You will not do well after total knee replacement – no matter how skilled your surgeon – without quality rehab services. It starts with education. A lot of times patients feel strange things after TKR. We can help them know what’s normal and how the healing process is going to work. We can help them achieve a positive mindset and motivate them to work hard and improve.

We also do a lot for pain and swelling control through ice, electrical stimulation, manual techniques, manual mobilizations to the kneecap and joint, and even help control pain through breathing techniques. Getting that thigh muscle to activate again is important. Swelling and discomfort and the apprehension after surgery can lead you to not being able to fire your thigh muscle properly. We also work on full knee extension and a good knee bend immediately after surgery.

These things aren’t worked in isolation. And there’s no “cookbook.” Some people may have a great bend, but they can’t get their knee straight, or vice versa. We can’t just give them a handout on TKR rehab; you need a skilled interventionist.

Progressively getting the patient back to weight-bearing and normalizing their gait/walking pattern is important. Then we start doing small, but progressive training steps so they get back to daily living: getting out of bed, out of chairs, negotiating stairs, etc. We teach safe ways to get up and down and make sure they’re stable.

Along with that comes balance control and balance training. You lose a sense of where your body is in space sometimes after joint replacement surgery. So you have to retrain people on what normal motion looks and feels like. We want to make sure people get a safe transition home and not fall, which we all know can lead to injury and setbacks with progress.

Finally, we get to multitasking drills. People need to train in real life situations, so we may simulate going downstairs while carrying your little dog or a laundry basket. Before we discharge a patient, we might add extra weight or challenges that throw them off balance. This helps ensure patients will be safe and not be at risk. Multitasking is an important part of getting back to a task in the real world.

We continue to change protocols as the times change. It all depends on the individual. While we’ll always push to get you to the standardized goal, there’s no exact “recipe” for recovering from a joint replacement. One person’s great function may be to walk their dog; for another, it may mean hiking hills on unstable surfaces. We try to become a true coach and partner with our patients to achieve optimal outcomes.

Schedule An Appointment for Rehabilitation Services

For more information about Rehabilitation Services, visit their website at https://bit.ly/3d5M1DY or to schedule an appointment, call (615) 791-2640.

Have a question for the Bone and Joint Institute? Fill out the form below:

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Bone and Joint Institute of Tennessee is seeking qualified professionals for a variety of open positions in Williamson County. Openings include clinical administrative assistants, cast technicians, clinical positions including MAs, LPNs and RNs, occupational and physical therapists and more.

“The mission at Bone and Joint Institute is to improve the lives of those we serve through superior, patient-centered orthopaedic care,” said Darren Harris, CEO of Bone and Joint Institute. “We’re proud of the existing team we’ve built to serve the community and are excited to add new employees to our organization.”

Bone and Joint Institute of Tennessee is a high-tech, fast-paced orthopaedic care clinic that has a rich legacy in Williamson County’s healthcare community. In any role, team members can expect to provide the highest quality care through innovation, compassion and commitment to patients.

Employees can expect a fun and dynamic environment with excellent benefits including medical, dental, vision and retirement. For a complete list of open positions, click here.

ABOUT BONE AND JOINT INSTITUTE OF TENNESSEE
Bone and Joint Institute of Tennessee is a destination for comprehensive orthopaedic care. The state-of-the-art flagship facility in Franklin, Tennessee, is led by nationally recognized physicians with expertise in orthopaedic surgery, arthroscopic surgery, joint replacement, sports medicine and spinal surgery. The facility also includes an onsite ambulatory surgery center and a Rehabilitation Services department, a team of physical and occupational therapists working alongside physicians to offer personalized care. Bone and Joint Institute also operates orthopaedic urgent care and physical therapy clinics in Thompson’s Station (Tollgate) and Nolensville. For more information visit BoneAndJointTN.org.

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MAHWAH, N.J., Aug. 27, 2021 /PRNewswire/ — This weekend, Stryker will appear at Coca-Cola Park with its “SmartRobotics™ Stadium” booth, where local orthopaedic surgeons will speak with IronPigs fans about joint health and treatment options, while putting the latest innovation in joint replacement technology, Mako SmartRobotics™, on full display. The activations held on Saturday, August 28 and Sunday, August 29, which will feature family-friendly, interactive games between innings, are part of Stryker’s cross-country tour in partnership with Minor League Baseball™ (MiLB™).

“I’m encouraged by all the baseball fans safely gathering outside at Coca-Cola Park, and Stryker looks forward to joining in on the fun,” said Don Payerle, president of Stryker’s Joint Replacement division. “I hope attendees will stop by our SmartRobotics™ Stadium and learn how Stryker can help them or their loved ones deal with knee and hip pain they may have been putting off.”

Throughout the games, videoboard commercials and promotions will help IronPigs fans learn more about Stryker, and one lucky fan will even get a seat upgrade. In addition to the game day events, local, Mako-certified orthopaedic surgeons will return to the ballpark on Thursday, September 9 for an educational seminar on joint health, the latest technologies for patients and surgical/nonsurgical treatment options.

Return to Healthy Hips and Knees

Many patients dealing with hip and knee pain may avoid seeking treatment options for some time. Putting off joint treatment may lead to an increased use of medications, a more difficult recovery and more complicated surgeries, according to a recent Lancet study.¹ It is important for those living with joint pain to speak with their healthcare professionals about treatment plans available to them. Getting educated on treatment options may help prevent further pain and complications.

Pennsylvanians are encouraged to visit Coca-Cola Park and learn about new advances in healthcare designed to treat joint pain and keep people active, including Mako SmartRobotics™ robotic-arm assisted surgery. Those in attendance can visit the SmartRobotics™ Stadium booth near TD Bank Plaza. To register for the seminar and learn more about joint health treatment options, please visit makosmartrobotics.com.

Lastly, as part of its “Own the Walk” charitable program, Stryker will donate $1 to K9s For Warriors – the nation’s largest provider of service dogs to American veterans living with military-related trauma – for every walk issued to a batter during the regular season. Stryker has been a committed partner of K9s For Warriors since 2015, having sponsored 31 service dogs to date — the largest number by any corporate partner.

All surgery carries risk. See your orthopaedic surgeon to discuss your potential benefits and risks. Not all patients will have the same postoperative recovery and activity level. Individual results vary.

About Stryker

Stryker is one of the world’s leading medical technology companies and, together with its customers, is driven to make healthcare better. The company offers innovative products and services in Orthopaedics, Medical and Surgical, and Neurotechnology and Spine that help improve patient and hospital outcomes. More information is available at stryker.com.

About Minor League Baseball

Minor League Baseball is the governing body for all professional baseball teams in the United States, Canada, and the Dominican Republic that are affiliated with Major League Baseball^® clubs through their farm systems. In 2019, Minor League Baseball attracted over 41.5 million fans to its ballparks to see baseball’s future stars and experience affordable family-friendly entertainment that has been a staple of Minor League Baseball since 1901. For more information, visit www.MiLB.com. Follow Minor League Baseball on Facebook, Instagram and Twitter.

About K9s For Warriors

Determined to end veteran suicide, K9s For Warriors is the nation’s largest provider of trained Service Dogs to military veterans suffering from PTSD, traumatic brain injury and/or military sexual trauma. With the majority of dogs coming from high-kill rescue shelters, this innovative program allows the K9/Warrior team to build an unwavering bond that facilitates their collective healing and recovery. This treatment method is backed by scientific research (from Purdue University’s OHAIRE Lab) demonstrating Service Dogs’ ability to help mitigate their veteran’s symptoms of PTSD while simultaneously restoring their confidence and independence.

¹ https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(21)00001-1/fulltext

SOURCE Stryker

Related Links

https://www.stryker.com