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Orthopedist cites advantages of custom-fit TKA with guides

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LAHAINA, Hawaii — Performing total knee arthroplasty using custom-fit femoral and tibial cutting guides can be effective for restoring natural alignment and motion to a valgus knee, said one surgeon.

This custom-fit total knee arthroplasty (TKA) approach is also effective at aligning the knee naturally similar to that of the Oxford knee (Biomet); preserving the ligaments, including the PCL; and restoring ligament length by removing osteophytes, according to Stephen M. Howell, MD. He discussed these principles at the Orthopedics Today Hawaii 2008 meeting here.

Howell said orthopedic researchers have long been looking for better ways to perform TKA.

To perform custom-fit TKA, a surgeon must first create a 3-D arthritic knee model based on magnetic resonance images. Next, "We naturally align the 3-D arthritic knee model and shape-match the femoral and tibial components on the rotational axes," Howell said.

After that, Howell and his colleagues incorporate custom-fit femoral and tibial cutting guides. In the end, this approach "simplifies the operating room set-up" because it streamlines the number of tools and components needed to do the TKA, he said.

Howell said that in more than 1,100 knees implanted nationwide using the custom-fit approach, custom-fit positioning and naturally aligning a TKA with the femoral component on the flexion/extension rotational axis of the femur "restores alignment, motion, comfort and stability without the need for ligament releases."

Furthermore, "custom femoral and tibial cutting guides give us an accurate method to perform TKA with good results," he said.

For more information:

• Stephen M. Howell, MD, is a co-founder and unpaid consultant for OtisMed Corp., manufacturer of the OtisKnee.
• Howell SM. Custom fit TKA with custom fit femoral and tibial cutting guides. Presented at Orthopedics Today Hawaii 2008. Jan. 13-16, 2008. Lahaina, Maui, Hawaii.