Diagram of knee anatomy

As with any medical procedure or product, what counts is the evidence, not the marketing.

Knee replacement (or rather, resurfacing) has come a long way in the past decade. You might be tempted to assume that, like most other things in life, the improvement has been driven by IT, and certainly we have seen an increasing role for computers in surgery. But we’re a (very) long from way from being able to let the computer take over.

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Computer aided?

Around a decade ago, we started seeing the first computer assisted/navigated knee replacements. These involved placing a pin containing an infra-red array in the thigh and shin. The pin cleverly tracked the joint, enabling knee surgeons to see a real time 3D model of the knee which the computer could then size and then tell you where to place the implant.

All of which sounds great, except that experienced knee surgeons don’t need to be told where to place knee implants – that’s why they’re knee surgeons. As a result, interest in computer assisted knee replacement dwindled, the procedure making no difference to outcomes but adding about 30 minutes to the length of the operation.

 

Image guided knee replacement

Four or five years ago, the concept of custom knee replacements (or image guided replacements) appeared. Here, an MRI or CT scan which would be used to make a 3D model of the patient’s knee. A 3D printer would then create a custom block to place on the patient’s knee during surgery to show the surgeon precisely where to cut.

Again, there was a lot of industry excitement around the process but, in general, the research doesn’t support the claim that patient outcomes are better with an image guided knee replacement.

There are exceptions here. Where, for example, a patient has experienced a bad leg break previously, or has a long pin in their thigh as a result of prior surgery, the modelling can be of significant help. But few knee replacements are quite so complex.

 

The advancements that do work

Computer aided knee surgery sounds good. There’s perhaps a natural assumption that the more ‘Star Trek’ a procedure sounds the better it will be. But, with few exceptions, the research just doesn’t support that at present.

Lest you think Yorkshire Knee Clinic’s knee specialists are standing at the shoreline, Canute-like, trying to hold back the tide of advancement, it’s worth reflecting that we are eager to adopt the advances that are proven to work.

Only last month in this blog, we covered the launch of the Persona Partial Knee, a knee implant that, with its improved range of sizes and better instrumentation, is improving outcomes for patients.

It’s just that when it comes to the surgery required to implant it, the better (and quicker) option remains to rely on the knee surgeon, not the computer.

Want to explore the latest proven techniques that can help reduce or remove your knee pain? Talk to the consultants of Yorkshire Knee Clinic.

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