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Custom 3D Printed Knee Replacement

King’s is pleased to offer the latest medical advancements in 3D printed knee replacement technology.

Knee implants are becoming common in younger, active individuals prompting experts in the medical field to advance in implant designs that would enhance its functionality and longevity. With the advancement in technology came the custom 3D printed knee replacement implant.

Standard Knee Replacement

A knee replacement implant is comprised of three basic components. The tibial component of the knee replacement is fit on top of the shin bone. The femoral component is placed on the end of the thigh bone. Between the two above implants is a plastic component known as the spacer. Occasionally, there might be a fourth component which is a small plastic piece that is fitted on the backside of the kneecap.

Custom 3D Knee Replacement

A 3D knee replacement is custom-made to the patient’s anatomy unlike the traditional knee replacement which tends to be off-the-shelf. It has a unique personalized design that is based on the patient’s knee CT scan.

Getting the knee replacement personalized and sized correctly involves taking CT scans of the hip, knee, and ankle. The image-to-implant software platform uses this information to convert the 2D CT scan into a 3D model of the patient’s knee by mapping the contours of the bone and correcting the areas damaged by the disease. A total knee joint implant is then fabricated to fit the exact contour and shape of the knee.

Traditional knee replacements offer a fixed design in different sizes meaning they offer the ‘best fit’ rather than a personalized fit. They are gender specific with an off-the-shelf design with the female knee replacement design being slightly smaller side to side and front to back compared to the male size.

A custom knee replacement on the other hand feels so much like the patient’s natural knee and works in unison with the patient’s ligaments and tendons. It therefore provides a more rapid recovery with good range of motion restoration and natural biomechanics.

Conformis iTotal® Total Knee Replacement System

At King’s we offer the Conformis iTotal knee replacement implant. It is the only custom-made posterior stabilized total knee replacement, which makes the implant fit the patient rather than force the patient to fit the implant. Its femoral and tibial components are customized for each patient to avoid overhang, under-coverage, and sizing compromises.

Good Candidate for a Custom 3D Printed Knee Replacement

Active patients who are eligible for a partial or total knee replacement are suitable candidates for custom knee replacement. However, patients with large bone loss or severe bone deformity are not good candidates for this procedure. The best candidates are active, young, and motivated candidates.

Benefits of 3D Custom Knee Replacement with the Comformis iTotal ® Implant

Two of the main benefits include:

  • Improved fit of the knee joint prosthesis
  • Preservation of the knee’s natural joint line and shape

The benefits below are described in more technical terms:

  • Broad coronal radius and coverage allows for high contact area with low constraint
  • Patient-specific offset poly inserts replicate femoral offset respecting the patient’s joint lines
  • Off-the-shelf implants alter patient’s natural joint lines potentially compromising natural motion
  • Comformis iTotal ® implant optimizes tibial fit and rotation, while off-the-shelf implant has maximal coverage, improper rotation but downsized tibial component with potential for tibial loosening or subsidence
  • Comformis iTotal ® implant achieves optimal femoral and tibial fit, while off-the-shelf implant’s force sizing compromises which can lead to soft tissue impingement and pain

Fitting Process of the  Comformis iTotal ® Implant

  • Patient CT scan through the hip, the affected knee, and ankle to digitally recreate the mechanical axis
  • Leg re-aligned to neutral mechanical axis
  • Articulating surface of the joint mapped using proprietary software
  • Individualized implant designed using patient data
  • Patient-matched J-curves corrected for deformity
  • 6-cut design for a thinner implant that preserves bone
  • Patient-matched condylar (a round part at the end of a bone that forms part of a joint) offset
  • Pre-navigated rotational alignment
  • Patient-specific shape matched to profile of resected tibia
  • Dual Balancing technology facilitates proper balancing of medial and lateral joint lines

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