Custom made knees – the way forward for total knee replacement surgery

Knee replacement surgery, also known as arthroplasty, involves replacing a damaged, worn or diseased knee with an artificial joint.

Knee replacements have been performed since the 1970s and according to the National Joint Registry in England and Wales there are now approximately 80,000 total knee replacement procedures performed each year.  

Since the inception of knee replacement surgery, there have been continual developments in design, with implants and techniques developing rapidly.

Standard cutting instruments take a “one size fits all” approach to your total knee replacement surgery. They mean that your surgeon has to make adjustments as necessary during surgery to fit the implants to your anatomy.

Using standard cutting jigs can result in implants that are too big or too small, that do not follow your natural shape and are an imperfect fit, whilst also offering variable precision in placing the implant.

Patient Specific Instrumentation (PSI) Knee Replacements is a major technological innovation, using customised cutting blocks, is embraced by our knee specialists, Mr Rupert Clifton and Mr Richard Hartley,  Fitzwilliam Hospital (at our sister hospita in Peterborough) who regularly perform total knee replacement (TKR) surgery (in excess of 120 cases each per year).

Custom cutting guides are disposable patient-matched cutting blocks that are used to cut the bones during TKR. They are manufactured based on each individual patient’s preoperative images so that the inner shape of the cutting guide matches the outer shape of your thigh and shin bones at their meeting point in your knee joint. This hand-in-glove fit allows your surgeon to make the precise bone cuts to position your knee implant in the optimal alignment.

Detailed MRI scans and a full leg x-ray provide a 3D data set that is used to computer-generate the design of the cutting blocks specific to the patient.

Mr Rupert Clifton, orthopaedic consultant at Fitzwilliam Hospital, specialises in knee replacement surgery and is an advocate of these new custom blocks.

He says “Custom cutting blocks are beneficial to the patient and surgeon. This customised approach helps achieve the optimum cutting block fit for each individual patient so that the surgeon can make accurate bone cuts.”

“The patient benefits from precise placement, reduced operating and recovery times, lessened complication risk and decreased postoperative pain.”

Mr Richard Hartley, consultant orthopaedic surgeon who also performs custom made knee surgery at Fitzwilliam Hospital, continues. “The surgeon is able to be more efficient during surgery as multiple steps are eliminated and less instrumentation is required whilst ensuring accurate bone cuts and implant placement, yet adjustments can be made as needed during the procedure.”

There are many benefits of using custom cutting blocks in TKR. They include:

A set of cutting guides that are tailored to your unique anatomy. These better fitting custom cutting blocks are specifically made to fit your knee joint rather than the surgeon choosing from a limited range of ready-made blocks. Accurate alignment, rotation and sizing using preoperative images to help understand your specific alignment needs. Decreased operating time and reduced length of stay in hospital. Reduced risk of intraoperative complications and postoperative pain. A simplified surgical environment with less steps and surgical instruments required for surgery. More accurate placement to maximise results and the lifetime of your implants.

The idea of the surgery is akin to using a Modern iMAC to produce a laser printed document rather than an old fashioned type writer.... the ultimate result can be the same (i.e an excellent balanced and well fitting knee replacement) but the way of getting there is different and far more advanced than previously.

For more information on the procedure call our Hospital Services Advisor :  01733 842304