Custom Knee Replacement Surgery

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iTotal® Customized Knee Replacement System

The ConforMis iTotal® CR is an individualized patient specific implant for replacement of all the three compartments of the knee. It is thus most appropriate for patients with knee arthritis and knee damage requiring implant for not one or two but all the three compartments of the knee. It is designed specifically to match the natural shape of the articulating surfaces of the patient’s knee. This is done by mapping the articulating surfaces of the femur and tibia using the data from the CT scan of the patient’s knee. It also comes with disposable patient specific iJig instrumentation with built-in image guidance which simplifies the surgical procedure and improves the outcome.

The several advantages of this patient specific or iTotal customized total knee replacement implants over the regular traditional implants are:

iTotal® Customized Knee Replacement System

No compromise on the size of the implant as is patient specific.
No compromise on the size of the implant as is patient specific
Provides better fit of the implant as the implant conforms to the patient’s unique shape of the articulating surfaces of the knee joint.
Provides better fit of the implant as the implant conforms to the patient’s unique shape of the articulating surfaces of the knee joint
Maximizes the implants contact area decreasing the polyethylene contact stress thereby prolonging the life of the implant.
Maximizes the implants contact area decreasing the polyethylene contact stress thereby prolonging the life of the implant
Preserves more natural bone.
Preserves more natural bone
Maximizes proximal tibial coverage and thus reduces the risk of tibial implant caving in and loosening.
Maximizes proximal tibial coverage and thus reduces the risk of tibial implant caving in and loosening

Indications For Use

Chronic joint disease due to trauma, osteoarthritis, rheumatoid arthritis or osteonecrosis of the knee.
Chronic joint disease due to trauma, osteoarthritis, rheumatoid arthritis or osteonecrosis of the knee
Moderate varus, valgus or flexion deformity with not much damage to the ligaments.
Moderate varus, valgus or flexion deformity with not much damage to the ligaments
Revision surgery for failed osteotomy, hemiarthroplasty and unicondylar, patella-femoral or bi-compartmental implants.
Revision surgery for failed osteotomy, hemiarthroplasty and unicondylar, patella-femoral or bi-compartmental implants

The iTotal CR implant require the use of bone cement for fixation.

Although iTotal Customized total knee replacement systems are recommended in various conditions, they are not appropriate in patients with:

Although iTotal Customized total knee replacement systems are recommended in various conditions, they are not appropriate in patients with:

Local or systemic infection
Local or systemic infection
Insufficient bone stock on the femoral or tibial surfaces
Insufficient bone stock on the femoral or tibial surfaces
Young patient with skeletal immaturity
Young patient with skeletal immaturity
Severe fixed valgus or varus deformity of greater than 15 degrees
Severe fixed valgus or varus deformity of greater than 15 degrees
Sensitivity to metals such as nickel
Sensitivity to metals such as nickel
Conditions of the knee joint such as osteoporosis, joint neuropathy and others in which the bone, muscle or nerves of the knee to be operated are compromised.
Conditions of the knee joint such as osteoporosis, joint neuropathy and others in which the bone, muscle or nerves of the knee to be operated are compromised<
Severe instability due to major loss of osteochondral structure or absence of collateral ligament integrity.
Severe instability due to major loss of osteochondral structure or absence of collateral ligament integrity

American Academy of Orthopaedic Surgeons

The American Board of Orthopaedic Surgery

A total hip replacement is one of the most successful operations that orthopedic surgeons perform. A hip replacement is an elective surgery, which means patients decide if and when to have their hip replaced. As a physician, I never tell patients they have to have a hip replacement surgery, but many times surgery may offer the only possibility for pain relief. Although the surgery is elective, it is covered by most insurance companies; however, depending on your policy you maybe required to make a small co-payment. My philosophy is to give my patients as much information as they need to make informed decisions regarding their health and hip pain and then treat their hip pain according to their wishes.

A hip joint is basically a ball and socket joint. A hip replacement involves removing the ball (femoral head) and replacing it with a metal prosthetic ball. The femoral prosthesis is inserted into the hollow part of the femoral shaft. The socket of the pelvis is machined into a hemisphere and a metal hemisphere is inserted into the socket. The new metal ball and new metal socket form the new hip joint and allow the same and often times more motion than the native hip joint. The femoral and acetabular prosthesis are attached to your bones by creating a space in the bone that is slightly smaller than the metal prosthesis and then pressing the metal prosthesis into this tight space. Occasionally, the metal prosthesis is attached to the bone with bone cement. The parts are made of stainless steel, titanium, ceramic and/or polyethylene. I typically make an incision about 3-4 inches long for a hip replacement.

The purpose of this web page is to educate patients about the major aspects of hip replacement surgery. Many studies have shown that an informed patient will have less surprises and more satisfaction with their surgery. I do not intend to scare people away from getting their hip pain treated. Although the following information is a reasonable overview of what I consider the major aspects of hip surgery, it is not a substitute for a clinical consultation where I can directly answer your questions. If you would like more information, please schedule an appointment to see me.