Marta Sambaer June 27, 2018

Picture this. It’s morning. A patient walks in a clinic, experiencing knee pain at every step. That same day, the same patient walks home, without the pain from before. The patient just had a total knee replacement operation.

Innovative Orthopedics

This scenario already exists in Orthoparc in the Netherlands. A clinic using an innovative patient-centric framework in which patients get all the attention. The multidisciplinary clinical team works using a one-day care concept made possible by minimizing anesthesia, surgical time, optimized nutrition programs, and physiotherapy starting immediately after surgery. Therapists are encouraged to empower patients to be mobile, and to make sure there’s minimal fear of resuming daily activities.

The key to running such a smooth operation is having a motivated team and a highly efficient process which is optimized in every manner. It’s all part of the team effort. As for the process, each step is executed in the shortest time possible while delivering a high-quality outcome and maximizing the patient’s experience by using innovative tools, including patient-specific surgical guides.  

Patient-specific knee care

Dr. Saskia Boekhorst is an orthopedic surgeon with patient-centric mindset who works at the Orthoparc clinic. Inspired by her previous clinical experience, she started implementing 3D-printed patient-specific knee guides in her surgeries. Together with her team, she is always looking for ways to improve the process so as to perform the knee surgery even more efficiently and accurately.

Dr. Saskia Boekhorst
Dr. Saskia Boekhorst

Fast-forward seven years, Dr. Boekhorst would perform hundreds of surgeries using 3D pre-surgical planning and 3D-printed patient-specific knee guides.

“I’m a big fan of the patient-specific knee guides because this technology allows me to place the components of the knee arthroplasty exactly in the right axis of the leg in all dimensions.”
- Dr. Saskia Boekhorst

Total Knee Replacement: Surgical plan

3 compelling reasons to use 3D-printed patient-specific surgical guides

Dr. Boekhorst makes a convincing case for using patient specific instrumentation. First, the alignment of knee arthroplasty a surgeon can attain is very precise. “The first one hundred cases I’ve double checked by manual measurements, because it was a different approach and I am very careful. But after seeing very nice and consistent results, I became convinced,” she says.

The second reason goes hand-in-hand with the first. Using patient-specific knee guides makes the surgery less invasive for the patient. Dr. Boekhorst explains, “There’s no need to drill into the femur canal. The conventional alignment is done with an intramedullary rod into the femur canal. Knee guides keep the intramedullary space intact.”

Finally, the surgical procedures are faster, given the fact you don’t have to make measurements during the surgery. “The positioning and alignment are already done by me within an interactive planning software in which I can rotate the knee in all directions and see how the prosthesis could be placed for a particular patient. You will never be able to see this in all these dimensions and directions with a real patient because of soft tissue,” says Dr. Boekhorst.

Total Knee Replacement

Total Knee Replacement

What other benefits are there to patient-specific knee guides?

This time benefit combined with the ease of use of these guides also means that gentler anesthesia products and painkillers can be used on patients. According to Dr. Boekhorst, a reduction in surgical time also may decrease the risk of infections, and made it possible to increase the number of surgeries per day.

The procedure can be performed in less procedure steps, which also means that less surgical instruments and trays are necessary. “This is a great upside of this technique. You don’t need measurement tools and a prosthesis of each size to test, so you don’t need to keep them sterile.” Moreover, the knee guides come in a comprehensive ‘knee in the box’ package that includes all the necessary instrumentation and two sizes of preselected implants to treat a single patient. The reduced number of sets necessary, and having less instruments to sterilize and to store inhouse, are all factors that lower the overhead and logistics costs, and the risk of unsterile instruments and procedures.

Patient-Specific Knee Guides

Patient-Specific Knee Guides

Patient-Specific Knee Guides

Turning medical images into a safer and more efficient surgical plan

Surgeons play a key role in the 3D preoperative plan that comes included with the knee guides. Overall, 3D preoperative planning offers surgeons the tremendous advantage of visualizing the surgical outline before making the first cut. This planning can even be brought into the operating room.

operating room

Knee-deep in benefits

According to Dr. Boekhorst, it is important to keep an open mind for accepting new approaches and implementing innovative technology into your daily clinical practice to improve patient outcome. The benefits are clearly there: less invasive surgery, shorter spinal anesthesia, milder pain medication, faster recovery for patients, better alignment, and less operative time leading to more surgeries per day. Thanks to a dedicated patient-centric team and the multi-facetted benefits associated with patient-specific knee guides, constantly improving efficiency and accuracy has become an integral practice, both inside and outside the operating room.

Do you want to learn more about implementing patient-specific knee guides in your clinical practice?
Please get in touch with us!