The knee replacement is a surgical procedure to replace the weight-bearing surfaces of the knee joint to relieve pain and disability. It is most commonly performed for osteoarthritis and also for other knee diseases such as rheumatoid arthritis.
The surgery involves exposure of the knee joint with the distal end of the femur and the proximal end of the tibia. The ends of these bones are then accurately cut to shape using cutting guides oriented to the long axes of the bones. Then metal components are impacted onto the bone or fixed using surgical cement.
The appropriate adjustments of the implants to bones and accurate cuts are responsiblefor the success of the intervention and the implant survival.
We use a specific guides based designed from MRI or CT scan of whole leg, looking for more precise cuts and better adaptation of the implants.
This system is very useful with Unicompartmental arthroplasty in the knee, where there are three compartments:
1. Lateral compartment (the outside part of the knee)
2. Medial compartment (the inside). Usually this has more wear.
3. Patellofemoral (the joint between the kneecap and the thighbone)
With the system of specific guides PSI® Zimmer (Patient Specific Instruments), we achieve a perfect balance between unicompartmental prosthesis and the patient's own anatomy. This is difficult to achieve by only orienting the axes of the bones. In the end it is also necessary a proper balance of loads in both compartments.
Once the patient has been chosen to be bearer of a knee prosthesis with PSI® Guides, it is necessary to collect all information:
A completed form with basic information of
· X-ray tests:
o MRI (Magnetic Resonance Imaging of whole leg) or
o CT scan – Computed Tomography scan of whole leg (from hip to foot)
information allows the engineers to do a perfect 3D copy of intramedullary
canal and the extra medullary anatomy with specific software. In this way they
can design the guides that will orientate the cuts of the bone and in the end the implants get the best load transfer.
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