Surgical Robotics Technology

Smith+Nephew Introduces LEGION◊ CONCELOC◊ Cementless Total Knee System


Smith+Nephew announces the introduction of its LEGION CONCELOC Cementless Total Knee System (TKS) and first completed surgical procedures. 

CONCELOC Advanced Porous Titanium is a patented, proprietary, 3D printed porous structure technology first used in Smith+Nephew’s leading REDAPT Revision Hip System, launched in 2016. CONCELOC is created in a virtual environment and manufactured through 3D printing additive manufacturing to optimize its porous structure to promote bony ingrowth.1-4  

“LEGION CONCELOC addresses the critical elements of the cementless total knee through its unique design. The asymmetrical keel is designed to help achieve immediate bone fixation, while the patented 3D printed structure of CONCELOC encourages biological ingrowth,” said Dr. Mathias Bostrom, an orthopaedic surgeon at the Hospital for Special Surgery in New York City, and one of the system’s designing surgeons. “I’m excited for how this technology may lead to improved operating room efficiency while eliminating many of the past and current challenges of cementless knee designs.”

Combining CONCELOC 3D printing technology with LEGION’s clinical success5-8 * treating over two million patients creates a unique, modern cementless knee implant. It serves a resurgent segment9 driven by the potential for better long-term fixation through biologic integration10, shorter operating times11, and the shift to Ambulatory Surgery Centers.12

“The launch of LEGION CONCELOC enables Smith+Nephew to enter a rapidly growing market in cementless knees,” said Skip Kiil, President of Global Orthopaedics at Smith+Nephew. “This proven technology allows us to leverage great clinical results of LEGION, modern 3D printing technology, our Real Intelligence technology suite, and new streamlined SYNC Performance Instruments to provide an economic solution that removes cement costs and time to knee procedures.”

The LEGION CONCELOC Cementless Total Knee System is now available in North America and will be introduced in various European and Asia Pacific markets once regulatory approvals are finalised.


  1. Smith + Nephew 2019. Technical Memo TM-19-067.
  2. Kienapfel H, Sprey C, Wilke A, Griss P. Implant fixation by bone ingrowth. J Arthroplasty. 1999;14(3):355-368.
  3. Bobyn J, Pilliar R, Cameron H, Weatherly G. The optimum pore size for the fixation of porous-surfaced metal implants by the ingrowth of bone. Clin Orthop Relat Res. 1980(150):263-270.
  4. Biologic fixation of additive manufactured CONCELOC Advanced Porous Titanium in a load-bearing animal model. White paper, 04741v2 April 2020
  5. Victor J, Ghijselings S, Tajdar F, et al. Total knee arthroplasty at 15-17 years: does implant design affect outcome? Int Orthop. 2014;38(2):235-241.
  6. Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) 2021. Hip, Knee & Shoulder Arthroplasty Annual Report.
  7. National Joint Registry for England, Wales, Northern Ireland and the Isle of Man. Hertfordshire, UK 2021. 18th Annual Report.
  8. McCalden RW, Hart GP, MacDonald SJ, Naudie DD, Howard JH, Bourne RB. Clinical Results and Survivorship of the GENESIS II Total Knee Arthroplasty at a Minimum of 15 Years. J Arthroplasty. 2017;32(7):2161-2166
  9. [Accessed: 28th Oct 2021]
  10. 10.  Restrepo S, Smith EB, Hozack WJ. Excellent mid-term follow-up for a new 3D-printed cementless total knee arthroplasty. Bone Joint journal. 2021;103-B(6 Sup A):32-7
  11. 11.  Yayac M, Harrer S, Hozack WJ, Parvizi J, Courtney M. The use of cementless components does not significantly increase procedural costs in total knee arthroplasty. J Arthroplasty. 2020;35:407-712
  12. 12.  DeCook CA. Outpatient joint arthoplasty: transitioning to the Ambulatory Surgery Center. J Arthroplasty. 2019; 34: S48-S50

* We thank the patients and staff of all the hospitals in England, Wales and Northern Ireland who have contributed data to the National Joint Registry. We are grateful to the Healthcare Quality Improvement Partnership (HQIP), the NJR Steering Committee and staff at the NJR Centre for facilitating this work. The views expressed represent those of the authors and do not necessarily reflect those of the National Joint Registry Steering Committee or the Health Quality Improvement Partnership (HQIP) who do not vouch for how the information is presented.

Source: Smith+Nephew

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