Medical

3D-printed plate could make for better, quicker arthritic knee surgery

3D-printed plate could make fo...
The TOKA procedure has been tested via computer simulations incorporating scans of 28 patients' tibias, plus it is now being carried out in a clinical trial in Italy
The TOKA procedure has been tested via computer simulations incorporating scans of 28 patients' tibias, plus it is now being carried out in a clinical trial in Italy
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The TOKA procedure has been tested via computer simulations incorporating scans of 28 patients' tibias, plus it is now being carried out in a clinical trial in Italy
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The TOKA procedure has been tested via computer simulations incorporating scans of 28 patients' tibias, plus it is now being carried out in a clinical trial in Italy

For many people with arthritic knees, a surgical procedure known as a high-tibial osteotomy (HTO) often brings relief. Thanks to 3D printing technology, however, it could soon be even more effective – and also safer to perform.

HTO surgery involves making a cut to the patient's tibia (shin bone) just below the knee, then using that cut to open a small gap in the bone, and finally keeping the bone in that position by fastening a stabilizing steel plate onto the cut side of the tibia. Doing so realigns the knee, so that the load is now being placed on a less-worn part of the joint.

Currently, doctors utilize "off-the-shelf" plates that aren't an exact match to the contours of the patient's tibia. This means that some time needs to be taken in selecting a plate, then positioning it on the bone and screwing it into place. Even then, the resulting knee realignment may not be precisely what was required.

In the experimental new Tailored Osteotomy for Knee Alignment (TOKA) procedure, developed at Britain's University of Bath, physicians begin by performing a 3D CT scan of the patient's tibia and knee. Using that data, they then 3D print a titanium alloy plate that is shaped exactly to that individual patient's tibia. They also print a patient-specific jig, which is used to guide the placement of the plate.

According to the university, TOKA should result in better knee alignments, increased stability of the joint, and less discomfort for the patient. Additionally, by having everything ready to go beforehand, the time of the surgery itself should be decreased from two hours to approximately 30 minutes.

In an ongoing trial being performed at Italy's Rizzoli Institute, 25 patients have undergone the procedure so far. Plans call for a UK trial to begin later this year, involving hospitals in Bath, Bristol, Exeter and Cardiff.

A paper on the research, which is being led by Prof. Richie Gill, was recently published in the journal Communications Medicine.

Source: University of Bath

3 comments
3 comments
paul314
When the surgery works, it apparently can give patients 10-20 additional years of knee function, which is probably a pretty good tradeoff. And certainly less operative work than a replacement.
czechster
I'm a candidate for knee replacement, but will put it off till the last option is exhausted. I have had one replacement and don't want to go through that again. I intend to give this info to my Orthopedic Surgeon and see if I am a candidate for this procedure. Looks like a great alternative.
Auptagdar
I had this operation on both knees in my 30's and total knee replacements a few years ago. The right knee was particularly hard to replace as they broke the screws off trying to remove the plate. Had to core drill around the screw fragments to remove them. Originally I was told it would help extend the life of the joint so I would only need one knee replacement (they tend to wear out in about 20 years). The orthopedic surgeon told me now they just go ahead and do knee replacements instead of the HTO as replacing knee replacements is not a big deal now. This article refutes that statement. Either way, I hope they can regrow cartilage before too long as an alternative to either surgery, for my sons' sake if not mine.