Customised bi-compartmental knee arthroplasty shows encouraging 3-year results: findings of a prospective, multicenter study

Abstract

Purpose The purpose of this study was to assess the clinical and patient-reported outcomes of a customised, individually made (CIM) bi-compartmental knee arthroplasty (BKA). Methods A prospectively recruited cohort of 79 patients was implanted with a CIM-BKA (patello-femoral plus either medial or lateral tibio-femoral, iDuo G2 system, Conformis, Billerica MA) at eight centres in the US and Germany. Patients were assessed for the 2011 KSS, KOOS, and ROM pre-operatively and at 2 weeks, 6 weeks, 12 weeks, 1 year, and 2 years post-operatively. ResultsThe objective KSS score significantly improved from 69 at the pre-operative visit, to 94 at the 2-year post-operative time-point. Similar improvements were observed for the KSS function and satisfaction domains. Significant improvements from pre-operative levels were observed across all five domains of the KOOS. Two patients have undergone surgery to revise their CIM-BKA implant to total knees, resulting in a survivorship rate of 97.5% at an average follow-up of 2.6 years. Conclusions CIM-BKA compares favourably to published scores as well as revision rates for previously available monolithic OTS-BKA implants. CIM-BKA implants provide surgeons with a viable and patient-specific monolithic implant solution as an option for patients presenting with bi-compartmental disease, who might, otherwise, be treated by performing unicondylar + patello-femoral joint or bicruciate sparing TKA surgeries. Longer follow-up and higher numbers have to be awaited for further validation of these encouraging early results. Level of evidence 3b (individual case-controlled study).

Robotic‐arm assisted bicompartmental knee arthroplasty: Durable results up to 7‐year follow‐up

“…However, the modular implant is time-and technique-demanding and requires a high level of surgical expertise due to the multiple instrumentation and orientations with the multiple implants. 18,19 An advantage of the monolithic implant is possibly easier implementation for the surgeon, but the survivorship is unacceptable. 15 Another potential solution is patient-specific customized monolithic implants which have promising early survivorship and short-term results.…”

Higher Component Malposition Rates with Patient-Specific Cruciate Retaining TKA than Contemporary Posterior Stabilized TKA

“…A single published study has supported improved patient-reported outcome scores and acceptable early component survival with CIM CR bicompartmental knee arthroplasty. 18 The kinematic performance of CIM implant systems may be impacted by the accuracy of the three-dimensional component femoral and tibial implant placement during TKA. Pairing of CIM-CR implant systems with patient-specific instrumentation (PSI) offers the potential to increase precision and accuracy in component placement.…”

Contemporary knee arthroplasty: one fits all or time for diversity?

“…Improvements in knee mobility, as well as in knee scores (KSS and KOOS) were observed. Ninety-seven percent of implants survived after 2.6 years [ 73 ]. Ogura et al could confirm these results, showing a survival rate of 98% after 2 years and 92% after 5 years.…”