Nexel® Total Elbow – An excellent Choice for Elbow Replacement


Zimmer Biomet’s Nexel Total Elbow builds upon the original, market-leading Coonrad/Morrey Total Elbow and its 30+ year clinical heritage. It uses proprietary Vivacit-E® polyethylene bearings and advances in instrumentation to offer an excellent wear and durability properties.1-5 The bearing geometry has been redesigned to provide advancements in contact stress engineering. The Nexel Total Elbow:

  • Is available in sizes 4, 5, and 6
  • Is available in left and right configurations
  • Has ulnar and humeral components made from Tivanium® (Ti-6AI-4V) alloy
  • Includes Vivacit-E bearings to help prevent delamination, maximize oxidative stability, minimize wear, and improve mechanical properties-thereby having a 91% reduction in polyethylene wear compared to the Coonrad/Morrey elbow in laboratory testing6-10*.
  • Utilizes a semi-conforming, thicker bearing design to reduce edge-loading and stress, and maximize contact area to distribute joint-reaction forces.
  • Includes an innovative 3rd bearing in the humeral yoke for increased compressive contact area
  • Comes with a robust Co-Cr linkage system to enhance linkage durability without applying compressive loads to screws

With the Nexel Total Elbow, we’ve upgraded to we offer an excellent alternative to the Coonrad / Morrey Total Elbow. 

This device is a total elbow prosthesis designed for use with bone cement. It is available in sizes 4, 5 and 6, in left and right configurations. The Ulnar and Humeral Components are manufactured from Tivanium® (Ti-6Al-4V) alloy. The Ulnar Component has a porous coating of Ti-6Al-4V plasma spray and is curved to facilitate implantation. The Humeral Component has a porous coating of Ti-6Al-4V plasma spray and has an  anterior flange to accommodate a bone graft. The Axle-Pin and Humeral Screws are manufactured from Zimaloy® (Co-Cr-Mo) alloy. Vitamin E highly cross-linked ultra-high molecular weight polyethylene (Vivacit-E®) bearings are designed for optimal durability.

Clinically Proven Stem Design

  • Intramedullary stem geometry and anterior humeral flange is maintained from the C/M Total Elbow.
  • Humeral component finished with Tiplasma spray, which improves for fixation and stem strength
  • Low profile A/P design minimizes soft tissue interference

Modernized, Easy-to-Use Instrumentation

  • Improves efficiency and reproducibility
  • Humeral preparation system reduces stress risers through contained, circular resection and improves precision with enhanced cut-guide stability
  • Rasp tooth geometry with diamond cut pattern provides for a more efficient canal preparation
  • Includes specially designed, flexible ulnar reamers for easier ulnar canal preparation

Bearing Design Improves Contact Stress Distribution

  • Redesignedimagined elbow bearing geometry allows improvements in contact stress distribution11, 12
  • Semi-conforming bearings engineered to eliminate reduce potential for edge loading
  • Bearings fixed to the humeral component to distribute joint reaction loads over more of the bearings surfaces
  • Design includes an innovative 3rd bearing in the humeral yoke for increased compressive contact area when compared to the C/M Total Elbow, which provides load sharing for enhanced mechanical integrity
  1. Zimmer ZRR_WA_2552_12Rev2*
  2. Zimmer ZRR_WA_2407_11Rev2*
  3. Zimmer ZRR_WA_2542_12Rev2*
  4. Zimmer ZRR_WA_2598_12*
  5. Zimmer ZRR_WA_2409_11*
  6. Popoola OO, Kincaid BL, Mimnaugh K, Marqueling M. In vitro wear of ultrahigh-molecular-weight polyethylene and vitamin E blended highly crosslinked polyethylene in linked, semiconstrained total elbow replacement prostheses. Journal of Shoulder and Elbow Surgery, 2013.
  7. Oral, E. et, al. Crosslinked Vitamin E Blended UHMWPE with Improved Grafting and Wear Resistance. Poster No. 1181. ORS 2011 Meeting.
  8. Oral, E. et, al.Trace amounts of grafted vitamin E protect UHMWPE against squalene-initiated oxidation. Poster No. 1295. ORS 2011 Meeting.
  9. Rowell, S. et, al. Detection of Vitamin E in Irradiated UHMWPE by UVVisible Spectroscopy. Poster No. 1186. ORS 2011 Meeting.
  10. Wolf, C. et, al. Radiation Grafting of Vitamin E to Ultra High Molecular Weight Polyethylene. Poster No. 1178. ORS 2011 Meeting.
  11. Aldridge, III, Lightdale NR, Mallon WJ, Coonrad RW. Total elbow arthroplasty with the Coonrad/Coonrad-Morrey prosthesis. A 10- to 31-year survival analysis. J Bone Joint Surg Br 2006; 88:509-514.
  12. Zimmer ZRR_WI_1222_12*

*Laboratory testing is not necessarily indicative of clinical performance.


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