One of the latest developments for improved accuracy and patient satisfaction in knee surgery is personalized knee resurfacing implants. These implants are designed uniquely for each patient's anatomy, which decreases the amount of bone resection and pain after the surgery.
"The basic idea is that if you look at traditional knee replacements, you have a finite number of implants that you have to fit to the patient's bone," says Raj Sinha, MD, PhD, surgeon at John F. Kennedy Memorial Hospital in Indio, Calif. "In 15-20 percent of the cases physicians have to compromise the size of the implant. When the implant is too big, it puts stress and strain on the surrounding soft tissues."
How the surgery works
ConforMIS has developed personalized implants for partial knee surgery, including the iUni G2. The implant is based on a three-dimensional model of the patient's bone. The physician takes a CT scan six weeks before the surgery and then ConforMIS converts the image into a 3D scan for the implant. Then, the implant is constructed for the patient's individual anatomy.
This technology also allows the physician to navigate the surgery preoperatively, identify where the bones are within the 3D space, and correct limb alignment prior to implantation of the prostheses.
"We've taken the procedure of surgical navigation out of the operating room and now we can pre-navigate the limb alignment," says Dr. Sinha. "The cutting devices are individually created for the patient fitting accurately on the patient's bone with the correct orientation and pre-calculated alignment."
With the pre-navigated plan, the physicians can create minimal bone resections by making sure the resections are accurate. Removing a small amount of bone is preferable for patients, especially young and active patients who may need a revision later in life.
"If you have a young patient who plays a lot of sports and the device has to be replaced, the revision looks like the first surgery because so little bone has been removed," says Dr. Sinha.
Future of personalized knee replacements
Personalized knee replacements are currently used in one and two compartment partial knee replacements. The total knee replacement version of the surgery is expected to come out later this year or early next year.
"Once the total knee replacement technology comes out, we'll be able to offer personalized knee resurfacing implants to most of our patients," says Dr. Sinha.
Dr. Sinha will be presenting the results of the surgeries he has done at the International Society for Technology in Arthoplasty meeting in Dubai later this year. He hopes the results of his procedures will spread awareness for personalized knee implants to other physicians.
“I think most surgeons wait for data before training on a new procedure. I think that data is now being generated and the potential advantages are quite significant," says Dr. Sinha.
Reimbursement
Dr. Sinha has been performing one and two compartment partial knee replacements using personalized implants for two years and has not experienced any change in reimbursement from surgeries using non-personalized implants. Additionally, the implants have been marketed at a competitive price for hospitals and he adds he has not experienced any push back from insurance companies for reimbursement because these implants are extensions of what has already been done with in terms of accuracy modifications.
Read other coverage on knee surgery solutions:
- Beyond Traditional Surgery: Options for Knee Surgery With Better Outcomes
- Computer-Assisted Knee Surgery: Using the PiGalileo System For Incision Accuracy
- Smith & Nephew Launches Improved FAST-FIX Meniscal Repair System
"The basic idea is that if you look at traditional knee replacements, you have a finite number of implants that you have to fit to the patient's bone," says Raj Sinha, MD, PhD, surgeon at John F. Kennedy Memorial Hospital in Indio, Calif. "In 15-20 percent of the cases physicians have to compromise the size of the implant. When the implant is too big, it puts stress and strain on the surrounding soft tissues."
How the surgery works
ConforMIS has developed personalized implants for partial knee surgery, including the iUni G2. The implant is based on a three-dimensional model of the patient's bone. The physician takes a CT scan six weeks before the surgery and then ConforMIS converts the image into a 3D scan for the implant. Then, the implant is constructed for the patient's individual anatomy.
This technology also allows the physician to navigate the surgery preoperatively, identify where the bones are within the 3D space, and correct limb alignment prior to implantation of the prostheses.
"We've taken the procedure of surgical navigation out of the operating room and now we can pre-navigate the limb alignment," says Dr. Sinha. "The cutting devices are individually created for the patient fitting accurately on the patient's bone with the correct orientation and pre-calculated alignment."
With the pre-navigated plan, the physicians can create minimal bone resections by making sure the resections are accurate. Removing a small amount of bone is preferable for patients, especially young and active patients who may need a revision later in life.
"If you have a young patient who plays a lot of sports and the device has to be replaced, the revision looks like the first surgery because so little bone has been removed," says Dr. Sinha.
Future of personalized knee replacements
Personalized knee replacements are currently used in one and two compartment partial knee replacements. The total knee replacement version of the surgery is expected to come out later this year or early next year.
"Once the total knee replacement technology comes out, we'll be able to offer personalized knee resurfacing implants to most of our patients," says Dr. Sinha.
Dr. Sinha will be presenting the results of the surgeries he has done at the International Society for Technology in Arthoplasty meeting in Dubai later this year. He hopes the results of his procedures will spread awareness for personalized knee implants to other physicians.
“I think most surgeons wait for data before training on a new procedure. I think that data is now being generated and the potential advantages are quite significant," says Dr. Sinha.
Reimbursement
Dr. Sinha has been performing one and two compartment partial knee replacements using personalized implants for two years and has not experienced any change in reimbursement from surgeries using non-personalized implants. Additionally, the implants have been marketed at a competitive price for hospitals and he adds he has not experienced any push back from insurance companies for reimbursement because these implants are extensions of what has already been done with in terms of accuracy modifications.
Read other coverage on knee surgery solutions:
- Beyond Traditional Surgery: Options for Knee Surgery With Better Outcomes
- Computer-Assisted Knee Surgery: Using the PiGalileo System For Incision Accuracy
- Smith & Nephew Launches Improved FAST-FIX Meniscal Repair System