If your doctor has told you that you're a candidate for knee replacement, here’s good news!
St. Rose physicians are now performing iTotal knee replacements using implants that are custom-made to mimic your own anatomy.
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How osteoarthritis affects the knee
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Q: What is osteoarthritis?
A: Osteoarthritis, the most common form of arthritis, is a degenerative joint disease that affects millions of people. It is caused by the breakdown and eventual loss of joint cartilage, which causes the bones to rub together resulting in extreme pain. Osteoarthritis resulting from “wear and tear” is the most common reason people undergo knee replacement surgery.
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Q: What are the benefits of total knee replacement surgery?
A: Total knee replacement can completely or significantly diminish knee pain caused by osteoarthritis thereby giving people their mobility back. Orthopedic surgeons don't advise a grin-and-bear-it approach to knee pain; however, they generally do not recommend knee replacements until other less-invasive treatment options – including rest, pain medication, cortisone shots, physical therapy, weight loss and arthroscopic surgery – have been explored. In addition, some younger patients may benefit from a less-invasive procedure called osteotomy, which shifts the alignment of the knee so the weight-bearing part of the knee is moved away from diseased cartilage and onto healthier tissue.
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Conventional vs. iTotal Knee Replacement
Conventional knee replacement surgery works for most patients, but because the implants come in “standardized” sizes, they are approximations – rather than exact fits – of patient knee sizes, which means orthopedic surgeons must shave down portions of a patient’s actual bone (femur) during the replacement procedure to make the implant fit.
The iTotal procedure, on the other hand, uses state-of-the-art diagnostic imaging and highly-specialized software to create a patient-specific knee implant that Dr. Robert Tait, an orthopedic surgeon who performs ConforMIS iTotal knee replacements at St. Rose, says, “provides a ‘spot on’ or nearly perfect fit to the shape and load-bearing capabilities of a person’s own knee.” That’s important because preserving or restoring the natural shape of the femur allows the implant to bend, flex, move and carry weight more like a natural knee.
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Traditional knee replacements come in standardized sizes which require shaving the femur bone to fit the implant. It may result in “overhang” or “underhang,” which describes the mismatch between the size and shape of the patient’s femur and the implant. iTotal knee replacement implants are custom made to fit each individual patient, thus bend, flex, move and carry weight more like a healthy, natural knee.
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Another benefit of the custom fit iTotal knee replacement is that it reduces “overhang” or “underhang,” which is the degree of mismatch between the size and shape of a patient’s femur and the knee implant. “Approximately 40 percent of those who have conventional knee replacement suffer from some amount of residual pain,” says Dr. Tait. “We know from studies that even a couple millimeters of overhang or underhang can cause lingering pain long after surgery.”
According to Dr. Tait, reducing the amount of bone that must be shaved down to make a femur fit with a knee implant is especially beneficial for patients who require total knee replacement as early as their mid-40s and 50s. “Both conventional and iTotal replacements are expected to last 15 to 20 years,” says Dr. Tait. “For a patient who is only 50, the bone sparing iTotal procedure provides a more comfortable fitting implant now and leaves the door open for a wider range of treatment options if the need arises down the road.”
The ConforMIS iTotal Procedure
Several weeks before iTotal knee replacement surgery, a series of CT images are taken of the knee, hip and ankle. The images are then evaluated by Dr. Tait and uploaded to a sophisticated software program that created a 3-D virtual model of the knee. That model is then used to make the custom iTotal implant.
A computer analysis using the CT scans of the entire leg is also performed to provide Dr. Tait a visual “game plan” of sorts. “Technology has not only allowed us to make an improved knee replacement, it has better prepared us to accurately position the new knee for optimal alignment, stability and load-bearing capabilities,” says Dr. Tait.
“This new technology has eliminated two steps that are crucial to conventional knee replacement surgery: 1) the insertion of a positioning rod inside the femur to align the implant to the rest of the leg and 2) the cutting of the posterior cruciate ligament to stabilize the new implant. Eliminating these steps typically results in less blood loss during surgery and a quicker recovery period.
To find a St. Rose orthopedic surgeon who performs iTotal knee replacement, please call 702-616-4900.
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