What is Conformis Custom Knee Replacement?
Conformis custom knee replacement is a type of knee replacement surgery where the implants are specifically designed and made for each patient. This approach aims to provide a better fit and alignment compared to standard off-the-shelf implants, potentially leading to improved outcomes and patient satisfaction. The process involves creating implants that match the patient's unique anatomy based on CT scans and other imaging techniques.
Knee replacement surgery, also referred to as total knee replacement or total knee arthroplasty, is a surgical procedure in which the worn-out or damaged parts of the knee joint are removed and replaced with artificial knee components called prostheses or implants made of metal, ceramic, or plastic.
Anatomy of the Knee
The knee is made up of the femur (thighbone), tibia (shinbone), and patella (kneecap). The lower end of the femur meets the upper end of the tibia at the knee joint. A small disc of bone called the patella rests on a groove on the front side of the femoral end. The fibula, another bone of the lower leg, forms a joint with the shinbone. The bones are held together by protective tissues, ligaments, tendons, and muscles. Synovial fluid within the joint aids in the smooth movement of the bones over one another. The meniscus, a soft crescent-shaped area of cartilage between the femur and tibia, serves as a cushion and helps absorb shock during motion.
Indications for Conformis Custom Knee Replacement
Conformis custom knee replacement is typically recommended for patients with osteoarthritis of the knee joint that is not responsive to conservative treatment. Osteoarthritis is a degenerative joint disease that causes breakdown and eventual loss of cartilage in the joint, causing a painful rubbing of bone surfaces with movement. Other knee conditions that may necessitate Conformis custom knee replacement include severe knee joint fracture or trauma and failed primary or prior knee replacement surgery.
How Does Conformis Custom Knee Replacement Differ from Traditional Knee Replacement Surgery?
In a traditional knee replacement surgery, an off-the-shelf implant is chosen from a selection of standard fixed sizes. The surgeon then makes the necessary adjustments to fit the implant to the patient during surgery. Because these traditional implants are not designed to your specific anatomy, surgeons often have to compromise on implant fit, rotation, and alignment, which can cause pain or discomfort after surgery.
The Conformis technology offers unique advantages not possible with traditional, standardized implants, such as:
- Individualized fit that virtually eliminates sizing compromises
- Design that follows the shape and contour of each patient’s knee to provide a more natural-feeling knee
- Maintenance of the patient’s natural joint lines to avoid instability
Preparation for Conformis Custom Knee Replacement
Preparation for Conformis custom knee replacement is similar to traditional knee replacement surgery but may involve additional steps due to the personalized nature of the implants. In general, common preparation may involve:
- A thorough consultation with your orthopedic surgeon who will evaluate your knee condition, medical history, and overall health to determine if Conformis custom knee replacement is suitable for you.
- Detailed imaging studies, such as CT scans or MRI scans to capture your knee anatomy in three dimensions. These images are used to design the custom implants that will be used during surgery.
- A review of your medications or supplements you are taking and any allergies you may have.
- Your surgeon may instruct you to avoid certain medications and supplements that can thin the blood and increase the risk of bleeding during surgery.
- You should not consume solids or liquids at least 8 hours prior to surgery.
- A signed informed consent form will be obtained from you after the pros and cons of the surgery have been explained.
Procedure for Conformis Custom Knee Replacement
In general, Conformis custom knee replacement surgery may involve the following steps:
- You will be given general or regional anesthesia to ensure you are comfortable and pain-free during the surgery.
- After sterilizing the surgical site with an antiseptic solution, the surgeon makes an incision over your knee to access the joint.
- Muscles and tissues are carefully moved aside to expose the knee joint.
- Specialized instruments, designed based on your custom implant, are used to prepare the bone surfaces of the femur (thigh bone) and tibia (shin bone). This step ensures proper fit and alignment of the custom implant.
- The custom implant is carefully placed and secured onto the prepared bone surfaces. The implant may be fixed using cement or press-fit techniques, depending on the specific surgical approach.
- The surgeon tests the stability and range of motion of the new knee joint to ensure proper function and alignment.
- Once the implants are securely in place, the incision is closed with sutures or staples. A sterile dressing is applied to the surgical site.
Postoperative Care and Recovery
After surgery, you will be taken to the recovery room where medical staff will monitor your vital signs and ensure you wake up safely from anesthesia. After waking up, you will be given pain medications and instructions on postoperative care, including exercises, mobility guidelines, and wound care. The length of hospital stay varies but is typically a few days. During this time, physical therapy may begin to help you regain strength and mobility. You will have follow-up appointments with your surgeon to monitor your recovery, check the healing of the surgical site, and make any necessary adjustments to your rehabilitation plan.
Risks and Complications
As with any surgical procedure, Conformis custom knee replacement carries certain risks and potential complications, such as:
- Infection
- Blood clots
- Implant dislocation
- Nerve or blood vessel damage
- Implant wear or failure
- Joint stiffness or instability
- Adverse reactions to anesthesia
