The medial-pivot insert is designed to allow normal motion and natural function by replicating the native structure of the knee and providing a highly-conforming surface on the medial side.1

Home Healthcare Professionals - Our Products Orthopedics Knee Primary Medial-Pivot Knee Systems


The MicroPort Orthopedics' Advance® medial-pivot knee system was launched in 1998, making it the first medial-pivot knee system available on the market. A culmination of years of research and design by Wright Medical and Dr. J. David Blaha resulted in a truly unique knee replacement design. With over 20 years of documented usage, MicroPort Orthopedics line of Medial-Pivot products have been used in over 600,000 cases in 70 countries worldwide. Patient reported satisfaction with a Medial-Pivot prosthesis is 95%, while the Medial-Pivot design has achieved outstanding clinical success worldwide, with documented 98.8% survivorship at 17 years.2

A recent study also confirmed higher patient satisfaction when knees are balanced with a tighter medial compartment.3

MicroPort Orthopedics provides a full Evolution® medial-pivot continuum of care, offering a primary knee with both cemented and cementless options. A stemmed primary for both the femur and tibia, and a revision portfolio featuring a CCK with medial-pivot articulation.

Heart 1


Patient satisfaction


Survivorship at seventeen years


Implanted to date

Evolution® knee system

The Evolution® medial-pivot knee system delivers superior flexion stability, anatomic motion, and wear–limiting design.

Evolution Medial-Pivot Knee System
Primary Medial-Pivot Knee Systems Evolution mp knee exploded 1

Advance® knee system

With a stable, pivoting medial side, the Advance® medial-pivot knee is designed to feel and function like a natural knee.

Primary Medial-Pivot Knee Systems Micro Port Advance Medial Pivot 540x300 1
Blue star


Traditional knee replacements have been shown to exhibit anterior/posterior translation, which decreases stability and can cause early revisions4-5. Through medial ball-in-socket articulation, coupled with lateral mobility, the Evolution® medial-pivot knee system has been formulated to maximize stability throughout the range of motion.

Blue star


The Evolution® medial-pivot knee system enhances quadriceps efficiency and reduces the quadriceps avoidance found in traditional knee replacements. By enhancing quadriceps efficiency, the patient can have increased proprioception and a more normal feeling knee.6

Blue star


The Evolution® knee with NitrX™ coating features a titanium niobium nitride (TiNbN) coating that has been shown to reduce the release of cobalt (Co), chromium (Cr), nickel (Ni), and molybdenum (Mb) ions common in standard CoCr implants.9 The Evolution® knee with NitrX™ coating maintains the kinematic benefits of the Medial-Pivot design10, resulting in optimal stability.11

Blue star


The Evolution® medial-pivot insert features an anterior raised lip, to replicate the function of the PCL, and a posterior raised lip, to replicate the function of the ACL, acting like an ACL-PCL substituting knee.

Blue star


In-vivo long-term clinical studies have consistently shown that medial-pivot design achieves equal or higher degrees of flexion than traditional posterior stabilized (PS) knee design, with an average of 124°.1;7-8


  1. Blaha J. The rationale for a total knee implant that confers anteroposterior stability throughout range of motion.
  2. Macheras GA et al A long term clinical outcome of the Medial Pivot Knee Arthroplasty System. Knee. 2017 Mar;24(2):447-453
  3. Tsukiyama H et al “Medial rather than lateral knee instability correlates with inferior patient satisfaction and knee function after total knee arthroplasty” The Knee 24 (2017) 1478–1484
  4. Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB. Multicenter determination of in vivo kinematics after total knee arthroplasty. Clin Orthop Relat Res. 2003
  5. Schmidt R et al Fluoroscopic analyses of cruciate-retaining and medial pivot knee implants. Clin Orthop Relat Res. 2003 May;(410):139-47
  6. LaMontagne M, et al. Quadriceps and Hamstring Muscle Activation and Function Following Medial Pivot and Posterior Stabilized TKA: Pilot Study
  7. Karachalios Th et al. An 11- to 15- year clinical outcome study of advance medial pivot knee arthroplasty. Bone Joint J 2016
  8. Van Overschelde P, Parker A Preliminary Short-term Outcome of first 300 consecutive cases of second generation Medial-Pivot Total Knee replacement System EKS Arthroplasty Conference - eposter - London - April 20-21, 2017
  9. MPO Data on file
  10. Dennis DA, Komistek RD, Mahfouz MR, Haas BD, Stiehl JB. Multicenter determination of in vivo kinematics after total kneearthroplasty. Clin Orthop Relat Res. 2003
  11. Freeman MA, Pinskerova V. The movement of the knee studied by magnetic resonance imaging. Clin Orthop Relat Res. 2003;410:35-43