Dr. Huber: Patient-specific implants more reliably allow my patients to meet those milestones of return to sporting activities quicker compared to an off-the-shelf-implant. Several weeks ago, I saw one of my patients who was a bilateral ConforMIS total knee. He came to see me at ten weeks, which was a little prior to his three-month follow-up. He had no symptoms and wanted to go back to skiing, so I allowed him to go back to skiing after bilateral total knee replacements at ten weeks.
Several years ago with a traditional implant you would have had an occasional rogue patient who may have ben able to resume that level of sporting activity, resuming skiing at three months, but it wasn’t routine. Now what we are seeing with ConforMIS personalize implants is that has become a more routine, reliable situation and even as early as ten weeks I’m seeing people with bilateral total knees resume full skiing activities.
Do these patients represent your typical cases?
Dr. Huber: These are just patients that are my routine patients. As part of my follow-up care, I videotape and also take pictures of patients, both their walking gate pattern as well as their flexion/extension limits. And it really is sort of jaw-dropping how quickly people are recovering and to see people walking better even as early as three or four weeks after surgery- pretty amazing. I mean those are the kinds of people that I would occasionally see in my practice that would come in that early, and now I’m seeing it very routinely.
You know, I have one lady who is an Irish jig dancer. She started dancing in the hallway at one month. I have a lady who is probably in her late 60s who was wearing a dress and just sashaying doing the hallway like “Look at me, no issues, my knee is back…one month.” She got 130 degrees of motion already, full extension, barely any swelling, and she’s flying. Now, if you reach that milestone at one month, you can imagine how far ahead you are going to be at three months. So, that’s the kind of scenario that we typically see. And, when they get to that milestone quicker for motion, swelling, and so forth, that allows them to get back to stair climbing, sporting activity, develop their muscles quicker, and all of those things start to feed on each other and it’s a layered effect. So, now we are seeing patients doing certain activities at a much faster rate. Have I had a few patients that are going a little bit slower than that group? Yes, but reliably, most patients are reaching those milestones, as I said, at a quicker rate.
How did you find transitioning to ConforMIS technology?
Dr. Huber: The ConforMIS implant is probably the easiest adoption of new technology that you’ll ever do. Let’s just say that I can perform a total knee, off-the-shelf implant and have that “Wow, it fits perfectly” feeling half the time, 60% of the time. Then maybe 20-30% of the time, it fits pretty well and you make some compromises. And then the others, maybe it’s not quite perfect, but that’s their unique anatomy. With ConforMIS personalized implants, you get that reliably all the time. So, when you are adapting this new technology, it’s actually making the process of going through a knee replacement even easier for the surgeon. So, for adopting new technology, this is a nobrainer.
And for a surgeon, I wouldn’t be worried about adopting this new technology at all, because half of the work is already done by the computer program and the algorithm before the surgery. So, when we normally do a knee off-the-shelf implant, we actually open the knee up and we have a bit of an algorithm that we go through with intramedullary guides and we set angles and measurements and have our algorithm that we go through making three degree rotation and six degree valgus. That whole program is set for us on a computer. So, as soon as we open the knee, we put the customized jig right on the knee, it fits perfectly. And every time, it fits perfectly and when we are finished and we go to straighten the knee out and bend the knee, it’s balanced, it fits, it goes from full extension to full flexion, and that’s what we want as surgeons.
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