title: [Partial replacement of the knee joint with patient-specific instruments and implants (ConforMIS iUni, iDuo)].
abstract: Knee arthroplasty is a successful standard procedure in orthopedic surgery; however, approximately 20 % of patients are dissatisfied with the clinical results as they suffer pain and can no longer achieve the presurgery level of activity. According to the literature the reasons are inexact fitting of the prosthesis or too few anatomically formed implants resulting in less physiological kinematics of the knee joint. Reducing the number of dissatisfied patients and the corresponding number of revisions is an important goal considering the increasing need for artificial joints. In this context, patient-specific knee implants are an obvious alternative to conventional implants. For the first time implants are now matched to the individual bone and not vice versa to achieve the best possible individual situation and geometry and more structures (e.g. ligaments and bone) are preserved or only those structures are replaced which were actually destroyed by arthrosis. According to the authors view, this represents an optimal and pioneering addition to conventional implants. Patient-specific implants and the instruments needed for correct alignment and fitting can be manufactured by virtual 3D reconstruction and 3D printing based on computed tomography (CT) scans. The portfolio covers medial as well as lateral unicondylar implants, medial as well as lateral bicompartmental implants (femorotibial and patellofemoral compartments) and cruciate ligament-preserving as well as cruciate ligament-substituting total knee replacements; however, it must be explicitly emphasized that the literature is sparse and no long-term data are available.
authors.affiliation: Sportklinik Stuttgart, Taubenheimstr. 8, 70372, Stuttgart, Deutschland. drjbeckmann@gmx.de.
authors.forename: J
authors.initials: J
authors.lastname: Beckmann
authors.affiliation: Orthopädische Klinik König-Ludwig-Haus, Würzburg, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Steinert
authors.affiliation: Orthopädische Klinik, Heinrich-Heine Universität Düsseldorf, Düsseldorf, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Zilkens
authors.affiliation: Orthopädische Klinik, Universität Halle, Halle, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Zeh
authors.affiliation: St. Vinzenz-Krankenhaus, Düsseldorf, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Schnurr
authors.affiliation: Medical Park Chiemsee, Bernau, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Schmitt-Sody
authors.affiliation: ENDO-Klinik, Hamburg, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Gebauer
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D019544:Equipment Failure Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D057285:Precision Medicine / Q000295:instrumentation / Q000379:methods; D066330:Printing, Three-Dimensional / Q000295:instrumentation; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Arthroplasty; Individual; Knee; Partial joint replacement; Patient-specific modeling