The orthopedic department at Hôpital de La Tour is already at the forefront of its field, particularly through its use of NextAR™ technology. A new milestone was reached on June 10, 2022, with the implantation of a custom-made knee replacement, made possible by technology developed by the Swiss company Symbios. This marks a first in Geneva. Dr. Philippe Alves, an orthopedic surgeon and knee surgery specialist, answers our questions.
When is a knee replacement necessary, and what are the outcomes?
Knee replacement is performed in cases of osteoarthritis where all other treatment options have failed (physical therapy, injections, etc.). In the medical literature, the reported patient satisfaction rate following knee replacement is very good but does not reach the rate reported for hip replacements, which is close to 100%. It should be noted that in centers where, as at La Tour, orthopedic surgeons specialize by joint, this rate is close to 90%.
How can patient satisfaction be further increased?
Dissatisfaction among patients who have undergone knee surgery can be explained, among other things, by the fact that implants with a standardized shape do not adapt optimally to all knees. However, it is the alterations made to the knee that are partly responsible for the side effects observed postoperatively. That is why the less the patient’s knee is altered—and the closer the prosthesis remains to the patient’s natural anatomy—the better the results will be. By using a custom-made knee prosthesis rather than a “conventional” one, the goal is to improve the patient’s overall satisfaction.
In which cases is a custom-made knee prosthesis particularly recommended?
The custom-made prosthesis from Symbios is an additional tool adopted by Hôpital de La Tour, particularly for treating patients with unique bone configurations: the custom-made prosthesis offers them a more accurate anatomical fit than a standard prosthesis.
What are the benefits of a custom-made knee prosthesis for the surgeon and the healthcare team?
For the surgeon, the advantage lies in case planning. Indeed, all anatomical aspects are taken into account prior to surgery. A CT scan is performed, and Symbios handles the planning according to a specialized protocol, covering both shape and positioning. For their part, the surgeon shares the observations made during the consultation, particularly regarding the patient’s mobility and morphology. This exchange makes it possible to fabricate a prosthesis that is as well-suited as possible to the patient’s anatomy and to plan its positioning as accurately as possible. The surgical plan provided by Symbios to the surgeon—who then validates it—allows for the anticipation of potential difficulties. And for the surgical team, the reduced number of instruments enhances the flow of the procedure.
Is this type of prosthesis stronger? More durable?
The materials used, as well as the technique for securing the prosthesis to the bone, are comparable to those of other prostheses. However, it is reasonable to expect that its durability will be improved because the better the prosthesis fits the patient’s anatomy, the longer it is likely to last.
We will conduct retrospective studies to tangibly assess the benefits, taking these parameters of durability and strength into account. We will also seek to evaluate whether patients who undergo surgery experience less pain, recover more quickly, and gain greater stability and flexibility.
Is the custom-made knee prosthesis more expensive?
No, Symbios has managed to offer these prostheses at no additional cost.
Is the custom-made knee prosthesis intended to become standard practice at Hôpital de La Tour?
No. For now, they are intended for patients with specific anatomical characteristics. With these custom-made prostheses, Hôpital de La Tour has access to additional cutting-edge orthopedic technology. Dr. Billières and I will be able to use them, for the benefit of the patient, on a case-by-case basis.