Personalised Knee and Hip Replacements
There is a significant amount of ongoing research into the use of patient specific implants and patient specific instruments to help guide surgery and make surgery more accurate in orthopaedics and joint replacement.
Total knee replacements have good success rates, often in the region of 90 – 95% in most patients over a ten to fifteen year period. However, a small percentage of patients often continue to have a degree of pain or do not return to the level of function that they would like. Patient specific implants may go some way to addressing this.
My own experience would suggest that patients can recover more quickly and to higher levels of function with custom made implants. The major difference between a patient specific implant and an off-the-shelf modular knee replacement is that it is designed specifically for the individual patient.
Prior to surgery the patient has a CT scan taken of their knee and the implant is designed and made to fit their knee specifically. This will hopefully ensure that the alignment is good, achieving a better overall fit that is similar to the patient’s knee or hip anatomy and may improve function in the short-term and longevity of the implant in the long-term. In all other respects the patient specific knee replacement looks very similar to a normal surface replacement.
It will take many years, however, to see whether or not a patient specific implant is better functionally or will last longer than a traditional knee replacement but early results are very encouraging.
In addition, the use of the robotic arm to align the knee in the correct biomechanical axis may be another advance that leads to better results. I have used the robotic surgical arm as an aid to surgery in the United States and undertake patient specific knee replacements at New Hall Hospital. With the help of computer navigation and robotic assisted surgery the placement of the implants within the bone is more accurate leading to better alignment and hopefully lower complication rates.
The robotic arm and patient specific implants can also be used in hip replacements, again allowing better alignment, less bone resection and lower complication rates, including dislocation.
I would be happy to discuss the advances in joint replacement in consultation at New Hall Hospital. Please contact New Hall’s Enquiry Centre on 01722 442 301 to arrange an appointment with me to discuss if a patient specific implant is right for you.
Mr David Cox, MBBS, LRCP, MRCS, FRCS(Orth)
Orthopaedic Consultant, New Hall Hospital, Salisbury