Mr McDermott: I see a lot of younger patients with sports injuries, and those patients with degenerative knees and arthritis tend to be the younger patients, and that’s a very difficult cohort of patients to treat with osteoarthritis. The young patients with a severely arthritic knee who’s knee is too far gone for a biological reconstruction, but who’s in so much pain they need a knee replacement at an age where normally one might be a little bit uncomfortable doing a standard knee.
What ConforMIS has allowed is its given me a greater, a wider comfort zone, so I feel more comfortable doing artificial knees in younger patients, and what’s terribly important to me with the ConforMIS knees is they allow the complete range of options.
We can do a medial uni for just medial osteoarthritis, and what’s really important is now, for the first time, we’ve got a really decent option for a lateral uni. Then, if the patient’s got medial and patella femoral, or lateral and patella femoral, then we can do 2 compartments, and that’s a very novel approach. If the patient has 3 compartments, then we can do the full iTotal, so we’ve got the complete range, and what this allows us to do is to do the most conservative option for the patient, depending on how bad their disease is.
What were some of the reasons you switched to ConforMIS implants?
One of the deciding factors in choosing to move over to the ConforMIS knee was patient imported outcomes. What I’m finding is the patients are much happier than they tend to be with a normal standard knee.
The ConforMIS knee fits not just the size, but also the shape and the contours of the patient’s own knee, so it feels more like a normal knee, so we’re seeing better patient outcomes in terms of satisfaction of function.
From a surgical perspective, what do you feel has contributed to better outcomes?
The most obvious one is that patient specific gigs fit perfectly. The gigs allow you to get the alignment right, the cuts perfect, the positioning perfect, and that’s deeply reassuring.
In terms of the bone that’s [resected 00:02:27], the bone cuts are very, very conservative, so you end up taking away just thin slivers of bone, compared to a normal knee replacement where you take away quite decent thick wedges of bone.
I think for me personally, the real stark contrast was going from an iTotal back to a traditional bulk standard knee replacement, and only then did I appreciate how horrible it was doing the traditional knee replacement, which was much more archaic, medieval, in it’s instrumentation, shocking in how much bone I took away. It was only then I really got a firm grasp at just how good the iTotal is, and how good the [iUni 00:03:08] are.
How do you explain the difference between ConforMIS and Off-the-Shelf implants to your patients?
The first part I explained that with a standard knee, they come in different sizes. Different sizes, but all the same shape, so there’s a size A, B, C, D, E, but the problem with knees is that the geometry of a knee is very complex, so each individual not only has a different size knee, but are very different shapes, so different contours. If you have a standard knee, then it’s going to hopefully match closely. Maybe not exactly, but closely the size of your own knee.
It won’t match the exact contours, therefore it’s unlikely to feel exactly like your own knee. If you want a knee that matches the size, the shape, the contours of your knee, then you’re going to have to have it patient specific. It’s going to be tailored to the exact size, shape, and contours of your knee, and only the ConforMIS knee does that.
Once I explain to people the differences between the ConforMIS knee, and a bulk standard knee, then most patients say straight away they want the best knee. They know this knee is hopefully going to be in there for 10, 20, 30 plus years, so they want the best knee for them, which is the sensible way forward.
Given your experience, how would you compare ConforMIS to other implants on the market?
ConforMIS represents a massive leap forward. It’s a sea change in the way that we approach knee replacements. It’s a revolutionary improvement. It’s leaps and bounds above any other knee replacement that’s out there. My patients, the patients that I see in my practice, they’re very high demand, and they expect the best, and the ConforMIS knee is the best. It is significantly better than any other prosthesis I’ve ever encountered, and so I have moved over to the ConforMIS knee, as I want to provide the best possible care for my patients, and ConforMIS allows me to do that.
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