Osteoarthritis is one of the biggest drivers of disability. At this time, this degenerative condition has no cure. The current best treatment for end-stage osteoarthritis in the knee is either a partial or total knee replacement. Knee replacements have become safer and more effective than ever in the last decade. They are easier to recover from and allow people to be active in ways they haven’t been able to be for years.
There is a problem, however. Everyone’s knees are different, which is something few knee prosthetics take into consideration.
The solution? Patient-specific, custom knee replacements.
Custom Knee Replacements vs. Off-the-Shelf
A total knee replacement involves three components:
- A femoral implant
- A tibial implant
- A polyethylene spacer
The surgeon first removes damaged bone from the femur and tibia, then these prostheses are inserted onto the bones and cemented into place. The underside of the kneecap is resurfaced with synthetic material, and a plastic spacer is put between the femur and tibia.
Currently there are more than 150 total knee implants available for off-the-shelf knee replacements. Even though they are not customized to fully meet a patient’s needs, off-the-shelf knee replacements can be very effective and satisfactory. A 2018 systematic review found that 83 percent of the studies included reported 8 out of 10 patients being satisfied with their total knee replacement.
Room for Improvement
An 80 percent satisfaction rate, while admirable, still leaves one out of every five people with a total knee replacement unsatisfied with their implant. Some of the top complaints from an off-the-shelf knee replacement include:
- Just doesn’t feel right
What can be done about this? One possible answer is a custom knee replacement. At Summit Medical Group Orthopedics we use ConforMIS.
Both the implants themselves and the cutting guides used to perform the surgery—called jigs—are custom-made to the patient’s anatomy. A computed tomography (CT) scan is made of the patient’s knee, which is then sent to the implant company. The company uses the CT scan and 3D printing to create customized knee replacement components, as well as the jigs that are printed to the specifications of the patient’s anatomy.
Custom-fitting knee implants can reduce many sources of pain. Overhang—where the implant juts out beyond the bone—is associated with more pain. Custom knee replacements eliminate overhang and instability.
Custom implants require the removal of less bone tissue, preserving more of the patient’s own bone and leading to easier recovery. A 2018 study suggests that custom knee replacements are more likely to have better alignment than off-the-shelf components, which can mean better functionality and less pain to the patient. Independent studies from around the world are now demonstrating the advantages of the patient-specific knee implant.
I have been at the forefront of knee replacements for more than 30 years. I was one of the first surgeons in the United States to use custom 3D-printed components in total knee replacements. I know how effective and well-tolerated they can be. If you’d like to learn more, request an appointment with me or one of the other excellent joint replacement specialists at Summit Medical Group Orthopedics.