- Associated Press - Saturday, January 23, 2016

LINCOLN, Neb. (AP) - Ivan Hildreth’s knees had gotten so bad he couldn’t walk up a flight of stairs without a lot of pain and effort.

He had resisted getting his knees replaced, but his wife finally convinced him last year to see an orthopedic surgeon to discuss options.

He went to Dr. Scott Bigelow at Lincoln Orthopaedic Center, because Bigelow was advertising partial knee replacements.

It turned out Hildreth wasn’t a candidate for a partial replacement, but Bigelow told him about a new procedure using a custom implant.

Hildreth went ahead and had his first knee done in June and the second at the end of November.

He’s been more than pleased at the result.

“I’ve had no pain whatsoever,” said the 61-year-old Lincoln resident.

Other than the scars, Hildreth said he doesn’t even feel like he’s had his knees replaced.

“I don’t have any sensation of not having my God-given knees whatsoever,” he said.

The Lincoln Journal Star (https://bit.ly/1VaPgth ) reports that Bigelow was the first doctor in Nebraska to start doing total knee replacements with customized implants from a Massachusetts-based company called ConforMIS. He’s now one of two in the state who do them.

Bigelow said he has been doing total knee replacement surgeries for 20 years and was looking for a better option than trying to match mass-produced implants to patients’ knee joints.

He said he talked with surgeons who had used the ConforMIS implant and came away impressed. He took a course on how to use the implant and did his first surgery with it in March.

“Six weeks after his surgery he rode his bike 50 miles,” Bigelow said.

The ConforMIS knee uses a proprietary platform to create a 3-D “map” of a patient’s knee after the patient has had a CT scan. The company then uses a 3-D printer to produce a precise wax mold that is used to form the metal components of the total knee. The result is an implant designed for optimal bone preservation and made in the exact shape and size of the patient’s natural knee.

Bigelow said the surgery needed to implant the custom knee is less invasive and patients tend to recover faster than with traditional knee implants. The implant also costs about the same as traditional models, and he said he’s had no issues with insurance companies.

Hildreth said he was out of the hospital within 24 hours after each knee replacement.

“I was walking the halls and going up the stairs before I left.”

A study published last summer at the Pan Pacific International Congress for Joint Reconstruction showed that patients with the ConforMIS implant were about twice as likely as those with traditional implants to have excellent or good results with range of motion, alignment and stability.

Other than the time it takes to get the implant made, which can be as long as two months, Bigelow said the only drawback as far as he’s concerned is the lack of long-term data on performance and durability.

Because the surgery is so new, it’s impossible to know whether the implant will last as long as traditional implants; 80 to 85 percent of them last for at least 20 years.

“That’s the big risk,” Bigelow said. “I tell people we don’t know.”

Hildreth said that’s not much of a concern for him.

“Even if it wears out quickly, I’d do it again in a heartbeat.”


Information from: Lincoln Journal Star, https://www.journalstar.com

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