Breakthrough Technology for Customizing Knee Replacement Surgery
Friday, January 06, 2012
The past decade has brought many improvements in orthopedic surgeries, and Northern Westchester Hospital is keeping pace with leading-edge technology for customizing total knee replacements. The new, advanced surgery is less invasive than traditional knee replacement surgery, meaning less blood loss, quicker recovery time, and better implant fit and knee alignment for patients.
Photo: Stuart T. Styles, M.D., FAAOS
The next generation of computerized technology that helps customize total knee replacements for patients employs custom-designed cutting blocks during surgery. According to Stuart T. Styles, M.D., FAAOS, board-certified orthopedic surgeon and Co-Director of Joint Replacement at Northern Westchester Hospital’s Orthopedic and Spine Institute, the custom-fit technology can preserve more of patients’ own bone and improve ligament balancing and stability. This may ultimately result in a greater range of motion and faster recovery time.
“With the advent of custom cutting blocks, I can now work in a much smaller field, so the surgery is less invasive. More of the patient’s bone and ligaments can be spared — which enables a faster recovery — and I get a precise fit each time I place an implant, so they are expected to last longer,” says Dr. Styles.
The blocks are made of medical-grade nylon and precisely align to the mechanical axis of a patient’s knee, serving as a cutting guide during surgery.
“I know exactly where to make the bone cuts, so the knee replacement is customized for the individual patient,” says Dr. Styles, “and the blocks enable greater accuracy by removing the guesswork when making cuts. This is a significant advancement because alignment is critical when performing knee replacement surgery. Eight out of 10 knee implants that fail do so because the implant is misaligned. With the new procedure, we’re delivering some amazing results for our patients.”
Pre-Op Preparation Is Critical
The process starts several weeks prior to surgery with an MRI scan and X-rays that map the exact dimensions of the patient’s knee. Through the use of computer software, the images are transformed into a 3-D model. The technology virtually corrects any deformity to return the knee to its prearthritic state. Custom cutting blocks are then fabricated so Dr. Styles can determine accurate implant size, alignment and bone cut placement. Because each knee is unique, each cutting block is one-of-a-kind and matches the fit and placement of the new knee implant to the patient’s unique anatomy.
Prudent Patient Selection
Candidates for the new technology include only those undergoing primary knee replacements. Patients with severe bilateral osteoarthritis — where both knees need replacing — may be particularly good candidates for this surgery.
Dr. Styles explains that the surgery is suitable for a wide range of patients, although it is not recommended for patients who have hardware around the knee or other contraindications for an MRI, such as pacemakers or vascular clips. “I would not apply this technology to patients who had previous corrective knee surgery or those with knee ligament damage or injuries that have torn or seriously stretched the ligaments around the knee,” he adds.
Greater Flexibility, Better Patient Outcomes
One of the aspects of the new technology Dr. Styles values is that it affords him a lot of flexibility when operating.
“Every case is different, so I am able to utilize computer technology with amazing graphics to develop a preop plan that is precisely tailored to meet the needs of my patients,” he says. “Any necessary adjustments can be made well in advance of surgery. This approach enables me to deliver the best outcomes for each of my patients by combining a high degree of precision with an amazing degree of flexibility.”
For more information about orthopedic services at Northern Westchester Hospital or to refer a patient, visit www.nwhc.net.
MD News December 2011, Lower Hudson Bronx
Is it possible to use this procedure on a knee that has been replaced with an artificial knee but there is still major problems?