Dr. Levengood: As a sports medicine doctor, I’m all about trying to save as much bone as possible, trying to save as much tissue as possible. By using the ConforMIS, I can make minimal bone cuts. I was basically replacing the patient’s own anatomy. Most of the time when we make the femoral cut, we were taking 10mm off with the off-theshelf components. Most of these with ConforMIS, we take about 6mm off. When we had a patient that had a flexion contracture, we would have to take a bit more femoral bone off because we couldn’t get the prosthesis to fit correctly given the deformity the patient had. Well, all of those compromises I don’t have to do anymore. I’m still taking 6mm off the bone whether the patient has a flexion contracture or not. Because, once I do that and once I put it back the way it is supposed to, all their ligaments come back into balance.
Many surgeons believe balancing the soft tissue plays a key role in the success of a knee replacement. What has your experience been using ConforMIS implants?
Dr. Levengood: When I talk to orthopedics surgeons that have done a lot of total joints or that have trained in a total joint program, it is very difficult for them to grasp this concept because they are all about soft tissue balancing. And when I explain to them that this is really not a total knee per se, this is a resurfacing of your knee. We are taking a lot less bone and what we are really doing is putting it back to where it’s at its homeostatic state where it’s basically back to normal. And once you do that, it just fits perfectly and the patients – their flexion returns, their extension returns and their stability returns.
Have you used ConforMIS implants to treat patients significantly out of alignment?
Dr. Levengood: I had a patient come in that had about a 15-degree flexion contracture and had about 10 degrees of varus, and varus means that they were bow-legged. And so, I had this patient that was really a difficult patient, under any circumstance. You would have to do a lot of soft tissue balancing, you’d have to do a lot of bone resection to get this patient back to a neutral alignment. And what was interesting in just using the jigs and making the cuts and putting back the patient’s normal anatomy, all of that resolved. And I just sat there scratching my head because I couldn’t believe that I could take a patient that was that far out of alignment and put him back into alignment without having to do a lot of extensive soft tissue work. And that patient was amazed, too, because they didn’t think they’d ever see a straight leg again. I mean, these patients are truly happy. And, it’s really interesting because I’ve done a number of these with patients that have an off-the-shelf knee in one knee that was functioning quite well, and then we did the ConforMIS in the other knee, and they were like, “Can you go back and redo my other knee because I really like the way this feels because it feels like a normal knee. It feels like my knee.” And in fact, it is.
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