Personalized Joints

Rising expectations of today's patients spurs innovation in

total knee replacements

Lucy is an active, 48 year old mother of twin girls. Along with being a busy mom she also teaches
Pilates classes four times a week. However, her knee pain began keeping her from teaching and was
beginning g to interfere with her family's active lifestyle. So she chose to seek out a professional

opinion. After speaking with her doctor she decided to undergo total knee replacement surgery. After
few short months she was back in the studio, and able to keep up with her girls once again.

The number of total knee replacements (TKRs) performed annually in the United States doubled
annually from 1999 to 2008. lt is projected to rise by 600 percent by 2030. TKR (total knee replacement)
procedures have risen 30 percent in the past five years at the Cleveland Clinic alone. This is due to
patients Iike Lucy who are young but still extremely active, as well as the aging generation of baby
boomers.
Patients have rising expectations and are demanding more from TKR and joint replacements
than in previous years. This has generated improvements in the field including design, delivery, and
execution. These advances have led to beneficial advances in patient care. For example, creating
customized parts identical to each patient's specific anatomy. This allows surgeons to perform more
efficiently and accurately. A recent technological focus developed at Cleveland Clinic Orthopaedics are
patient-specific positioning guides, custom guides made to match an individual patient's anatomy,
potentially allowing the surgeon to perform TKR more efficiently and accurately, thus helping to improve
quality and outcomes.

Patient specific care offers several benefits. These may include reduced time in the OR,
decreased blood loss, decreased infection rates, and improved outcomes with alignment. This new
technology takes the "navigation" out of the procedure. Customization may lead to better results for
patients and a more structured plan for surgeons in the OR. ln addition, it allows surgeons to perform
the surgery more easily with more complicated cases.
The major goal of arthroplasty, joint reconstruction, is to reduce pain and restore function.
Many investigations have supported the attitude that alignment is a critical factor in achieving these
goals. Although traditional techniques aid in placement, studies have shown that there is clearly room
for improvement.
Patients today demand a healthcare system that persues the best technology, improved clinical
outcomes, and enhances efficiency. Patient instrumentation has the potential to achieve all of these
goals. lf you plan on receiving a TKR or joint replacement take your health into your own hands, ask your
doctor about patient specific care, and what they're doing to make the surgery personalized for you.

Robert Mollov, MD & Trevor Murrav. MD

Cleveland Clinic Orthopaedics