Total knee replacement (posterior stabilised): Visionaire Genesis II (Smith and Nephew)


Subscribe to get full access to this operation and the extensive Knee Surgery Atlas.


Learn the Total knee replacement (posterior stabilised): Visionaire Genesis II (Smith and Nephew) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Total knee replacement (posterior stabilised): Visionaire Genesis II (Smith and Nephew) surgical procedure.

This case illustrates the use of patient specific instrumentation to perform a total knee replacement. The Visionaire technology is from Smith & Nephew, being introduced in 2010. It utilises a single weight bearing AP alignment film of the patient’s leg and a focused MRI of their knee to provide the data for cutting jig and implant design. The information is relayed to technicians who are based in the United States of America who design the knee replacement for you within the parameters you have set for them.

The surgeon sets the sizing constraints for example to upsize unless medial-lateral overhang, the rotational axis, the varus/valgus alignment, the tibial slope and  tibial rotation. These usually correspond to the the typical component features used in a standard knee replacement, but can be varied.

Once the implant has been designed the plan is e-mailed to the surgeon and it is then checked and accepted. Printed 3-D printed nylon cutting blocks are manufactured for both the tibial and femoral sides of the knee replacement. The blocks are applied to the patient intra-operatively, cuts made and then the final preparation of the bone is performed using standard instrumentation and the total knee replacement is then implanted.

The use of Visionaire technology is associated with more reproducible implant placement, decreased operative times, fewer equipment trays in theatre, a reduced tourniquet time and reduced blood loss. Technically the Smith and Nephew Visionaire instrumentation is particularly useful in cases where there is difficulty passing standard instrumentation such as the intramedullary femoral rod in cases of femoral mal-union or  canal occlusion.

Author: Mr Richard Baker MD, MSc, MB.ChB, FRCS (Tr & Orth)

Institution : The Avon Orthopaedic Centre , Bristol ,UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
  • On successful completion of each quiz you will receive validated CPD points that add to the certificate in your CPD folder.
  • Your dashboard also will contain a record of the time you have spent logged onto and using the site.
  • The timer suspends after 5 minutes though if there is no activity.
  • When you restart you will resume at the same point in the module.
  • Once you have completed each quiz you will need to feedback on the module first then click “submit” and your paper will be marked.
    The pass mark is 75%.
  • If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
  • Once these have been read you can re-do just the questions you failed on.
  • Once you have passed the quiz you can return at a future stage & resit .

CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


  • Did you find this technique helpful?
  • YesNo

Lessons Status


Logo Logo Logo Logo Logo Logo Logo

Associates & Partners

Logo Logo Logo Logo Logo Logo