I am an orthopedic surgeon with over 25 years of experience on knee implants.
I have followed the evolution of knee prostheses and the surgical techniques, design and materials used that have allowed the incredible affirmation of this technique for the treatment of degenerative and inflammatory knee diseases. In Italy, the number of implants carried out per year have now reached more than 80000.
My personal experience is of more than 2000 implants of different brands and I can surely affirm that knee prosthesis is a surgical procedure that has solved most of the problems of patients suffering from gonarthrosis.
However, patients follow up have highlighted a ratio of 15/20% of “only partially” satisfied or “totally dissatisfied” patients, as per international bibliography. These patients, despite a perfect surgical intervention with no technical errors of application of the prosthesis, could not reach the ideal quality of life they thought could be achieved following a knee implant (poor joint stability, painful movements, etc.).
For this reason, I was excited when I discovered a new type of prosthesis: CONFORMIS.
After a learning and evaluation process, performed in Conformis implant centres carried out in various hospitals throughout the UK, I started implantingthis new device.
So, how does CONFORMIS differ from other prosthesis?
CONFORMIS is the patient’s prosthesis, completely built and modeled specifically for him/her.
CONFIRMS is the only fully customised device, built for the patient and specifically modeled on his/her knee.
Since it is a bespoke prosthesis, the implant fully adapts to the patient’s anatomy, therefore own ligaments are retained allowing a better proprioception, sensitivity and kinematic (specific movement) of that specific articulation.
The other prostheses have a standard design (shape) the same for everybody, changing only in dimensions. This obviously implies that it is the knee having to adapt to the implant and not vice versa.
CONFORMIS can give better performance because:
The surgical cut is smaller (minimally invasive).
Reduced bone sectioning (less blood loss) no transfusions required in most cases.
Reduced pain thanks to the above-mentioned reasons. During the post-operative, less use of opioids and anti-inflammatory medications meaning reduced side effects due to drugs.
Quick recovery and physiological attitude to move and start to walk.
Quick discharge from hospital and prompt return to daily activities (driving, biking, climbing stairs, etc.).
Patients’ examination and routine follow-ups at 4 and 10 weeks after surgical intervention with Conformis implants, have evidenced their complete satisfaction, compared with those on whom I also carried out a surgical procedure but with standard implants. I am thus able to ascertain the almost total absence of problems and dissatisfaction following a standard implant procedure.
CONFORMIS is suitable, in most cases, for any degenerative and inflammatory knee disorders. It should be excluded only in case of severe joint deformity in association with severe ligament injury and laxity.
A KNEE REPLACEMENT PATIENT JOURNEY WITH CONFORMIS IMPLANTS
Each patient is unique, so is his/her knee and so will be their journey.
First, after the initial examination the specialist will consider, together with the patient, if there is the need for surgery. If surgery is the option, then a CAT (computed axial tomography) with a dedicated software will be carried out. This is required to allow the reconstruction of the original anatomy before degenerative deformation took place.
The data is collected and sent to the Company’s headquarter, in the USA, for the manufacture and 3D construction of the implant, its component being made of metal and polyethylene parts.
The intervention is planned at about 30 to 35 days from the acquisition of the data.
AFTER THE SURGICAL PROCEDURE
The mobilization of the knee takes place within the first 12 hours. In the following 24 hours the patient will be invited to use crutches.
Normally this procedure allows for a “Short Track Discharge” approach and the patient is sent home after 5/6 days from actual surgery.