Dr. Durbhakula: The way a traditional knee replacement is done is with an intramedullary rod placed into the femur to match the patient’s mechanical and anatomic axis. With ConforMIS, you’re getting a true representation of that axis before you enter the operating room, because you’re using CT technologies to do so. For that reason, the guides are already built in to adapt to the patient’s individual anatomic and mechanical axis. I think where ConforMIS really has a unique advantage is because the instruments are very much minimized. Also, by not going intramedullary, you’re not going to have as much bleeding and pain. The thing I’m happy with is they seem to recover their function a lot better, strength, also range of motion, so if the patient is happy, I’m happy.
What is it about the ConforMIS system that allows for these benefits?
Dr. Durbhakula: With an off-the-shelf implant, you’re basically doing a standard cut off a guide, and unfortunately every patient is built a little bit differently, and the anatomic variance are such that sometimes you’re taking off a little bit more bone than you need to. As a result of that, you’re changing part of their biomechanics that they naturally had. With the ConforMIS, because you’re basing those cuts truly on the patient’s unique anatomy and the cutting guides are adjusted accordingly for that, you’re really taking the minimal amount of bone. You’re really just taking the cartilage surface. And so, for that reason, you’re not changing anything in the normal anatomy of the patient’s knee.
I think that with a lot of the other traditional implants, because those cuts are based off standard measurement guides and standard receptions, that’s where you get into a variability with rotation. Also, that’s where you get into flexion-extension imbalances. So, by truly just contouring the knee shape to just where the diseased bone and cartilage that needs to be removed is, in fact, removed, I think that’s where you’re avoiding a lot of other issues patients are dealing — the doctors are dealing with as far as instability and inflexion-extension mismatch.
What it comes to saving bone, how would you compare ConforMIS with off-the-shelf implants?
Dr. Durbhakula: By preserving that, the patient’s bone stock, we’re essentially preserving their ability to have more surgery if, in fact, it’s needed down the road. So, for me, that’s a very, very important part of my job as a surgeon for joint replacement and also revision joint replacement, is thinking about that next step. If the patient ends up needing more surgery, have I equipped them to be able to handle that easier down the road? Bone preservation and less bleeding as well as quicker recovery and more accuracy of component placement, for me, have been real advantages of ConforMIS.
I have a very active patient population, and it’s very, very important for these folks to get back to their normal daily routine as quickly as possible. And I think by doing a technology such as ConforMIS, I’m allowing them to do that. By having a quicker recovery, by having a more anatomic range of motion and by preserving their bone stock, I think we’re accomplishing a lot of the goals we ultimately wanted to achieve with our knee replacement surgery.
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