Developments in Knee Surgery: Signature Knee and Chondrotissue Scaffold Graft
The Signature Knee System is a method of implantation of a knee replacement with accuracy that in my opinion far outweighs the eyeballing that is performed at surgery in the present way and includes all the benefits of computer navigated surgery without the additional risks of pin placement and cost.
Following on from my having performed the first computer navigated knee replacement at Margate, I have been on the look out for a system that is more accurate and more user-friendly and I believe that the Signature Personalised Arthritis Care allows this. I would ask that you visit www.signatureknee.com and this will give you further detailed information about the advantages of this system.
In summary, the prosthesis that is implanted is a tried and tested prosthesis that I have been using since its introduction into this country in 2007 and therefore there should not be any concern that we are implanting a new prosthesis that has not been tried and tested. The advantages of this system are that the patient undergoes an MRI scan, which is very quick and cheap compared to a normal MRI scan, incorporating the hip, knee and ankle to give long leg alignment. This long leg alignment is then used to reproduce the knee alignment at surgery using specific femoral and tibial cutting blocks that are generated for the individual patient. This way of combining precision patient specific positioning of guides allows for excellent accuracy. I have been aware of this system since 2007, but have resisted using it until at least 1,000 cases were performed worldwide. I am the first East Kent surgeon to attend the instructional course; the first one took place with an international faculty in early February. I believe that the technology has advanced to a level of accuracy that we can now consider this for our East Kent patients.
The advantages of this system are more accurate reproduction of long leg alignment with the implant, the intra- medullary canal is not breached for the purposes of referencing for alignment and therefore this reduces blood loss and reduces the risk of fat embolus, knee swelling and more rapid rehabilitation and hopefully discharge.
The Vanguard implant is known to have a better flexion range than the conventional AGC knee replacement and has significantly more sizes to cope with gender specific issues, particularly in female patients.
A further development that I would like to make you aware of is the use of a chondrotissue scaffold in young patients with isolated chondral defects in the knee. These patients were traditionally managed with simple microfracture, but the advantage of the scaffold which is used as a device to contain the haematoma following microfracture is increased success rate at a good scar forming in the defect within the knee.
I hope this information helps you. Please do not hesitate to contact me should you require any further information or clarification of these exciting new developments.
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