A Prospective, Clinical Investigation of the Vanguard 360 Revision Knee

This investigation is being conducted on a new complete revision knee system, Vanguard 360,
which incorporates:

- Fixed Bearing Knee - Vanguard SSK360 with PS Bearing and PSC Bearing

- Fixed Bearing Knee - Vanguard SSK360 TiNbN Femur with PS Bearing and PSC Bearing

- Mobile Bearing Knee - Vanguard DA360 (only being collected in Europe)

The purpose of this study is to evaluate performance of the Vanguard 360 revision knee system
utilizing offset on either the tibial component, femoral component, or both in terms of the
restoration of mechanical alignment, clinical outcomes and survivorship.

The efficacy and performance of the devices will be assessed by improvement of pain,
function, range of motion and patient satisfaction measured pre-operatively and
post-operatively. Secondary performance and safety will be determined by radiographic
investigation, incidence of complications and revision rates.

Surgical techniques and patient care are to be standard for the surgeon participating in the
protocol. There will be no experimental or investigational devices used. There will be no
experimental or investigational surgical techniques used. The devices and products will be
used in accordance with their instructions for use and/or approved labeling.

Inclusion Criteria:

- Painful and disabled knee joint resulting from osteoarthritis, rheumatoid arthritis,
traumatic arthritis where one or more compartments are involved.

- Correction of varus, valgus or post-traumatic deformity

- Correction or revision of unsuccessful osteotomy, arthrodesis, or failure of previous
joint replacement procedure

- Ability and willingness of the patient to attend follow-up visit.

- Willing to give written informed consent

- Patients are at least 18 years of age, no upper age limit, must have reached full
skeletal maturity.

Exclusion Criteria:

- infection

- sepsis

- osteomyelitis

Relative Contraindications:

- An uncooperative patient or a patient with neurologic disorders who is incapable of
following directions

- Osteoporosis

- Metabolic disorders which may impair brain function

- Osteomalacia

- Distant foci of infections which may spread to the implant site

- Rapid joint destruction, marked bone loss, or bone resorption apparent on
roentgenogram

- Vascular insufficiency, muscular atrophy, neuromuscular disease

- Incomplete or deficient soft tissue surrounding the knee

Additional research-related exclusion criteria: patients who have a history of or current
infection in the affected knee.