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Video Transcript

In your opinion, why are nearly 20% of patients unsatisfied with their off-the-shelf total knee replacement?

Dr. Mack: One of the reasons is due to something called mid-flexion instability. And what that means it that as a person bends their knee while they are bearing weight, their knee feels unstable to them. And the reason for that is that conventional, off-theshelf implants are unable to reproduce the normal function of the ligaments that stabilize the joint in a way that approximates the way the knee was prior to being diseased. With the ConforMIS implant, because it provides a near exact reapproximation of the knee prior to becoming diseased, then the problem with midflexion instability is greatly minimized. And so, at least in the last year and a half two years since I’ve been using this total knee replacement, I haven’t seen mid-flexion instability as a problem with the iTotals as I have in other off-the-shelf designs. So, this is a big leap forward, at least from my perspective, is that finally somebody has figured out a way to come as close as possible to replicate the knee the way it was prior to becoming diseased or arthritic. And that’s truly revolutionary. That’s not something I’ve seen in the 20 plus years that I’ve been practicing orthopedics.

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What is your experience using the iUni® G2?

Dr. Mack: I’ve used a lot of the other unicompartmental replacement products on the market. I think a lot of them are very good. With respect to the ConforMIS iUni, it is a bone preserving product, so what that means to me, or at least what I’ve seen in my patients is, first of all, there is less bleeding and there seems to be less swelling afterwards. They seem to get their range of motion back a little bit sooner. Because it’s bone preserving, I have less anxiety as a surgeon that if it ever were to fail or have to be revised that I have a lot of bone stock to work with.

I’m part of the iUni clinical study, so we have been following our outcomes with that in a pretty scientific way. I am up to around 100 or so iUnis, thereabouts, and I’ve had great results. My patients are happy. When my patients are happy, I’m happy. The total joint I’ve been using for a little less than two years now, and I’m using it more and more as time goes by. As patients learn about it and see other patients with that have had good outcomes, it’s sort of feeding itself in terms of volume. I’ve been very happy with both of the products.

What has been your pre-operative experience the day of ConforMIS surgery?

Dr. Mack: Well, the ConforMIS total knee products come beautifully packed in a small box. You open it up and all the parts are right there and they are organized in a way that is very sleek and efficient. And I compare that to an off-the-shelf implant where there might be 12 or 15 very large trays of instruments that are necessary for implantation just to accommodate all the different sizes and trials that are needed.

So, there are a lot of people that are happy about that. I’m happy because there is not as much stuff in the room, there’s not as much commotion. When you are sterilizing 12 or 15 trays, not uncommonly you will find a hole in one of the drapes, which means that that tray wasn’t properly sterilized. The process has to shut down and be re-sterilized, which can put you an hour or two behind easily in the course of a day and when you have multiple surgeries going on and so forth, that’s very aggravating.

Even more important than me being happy, the nurses love it because as opposed to having an entire room of stuff that they have to inspect and lift and carry and organize, they have a little box with just a few instruments that can easily be laid out on a very small mayo stand and it’s great. We have taken pictures and posted it in some of the talks that we give to the community and look at the difference between choice A and choice B, all things being equal, which do you think is better. Well, the answer is easy. You want the simpler choice. Simpler is usually better, and that’s what we’ve found with this implant.

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