It came as a bit of a surprise to see this article finally in print this week. I spoke to Jonathan Gornall on number of occasions and offered various clinical references from which he could write an informative and balanced narrative, but something newsworthy and above all, something to help patients make INFORMED choices about their treatment options.
I’m delighted to see that the article makes a case for patient matched implants, bespoke or ‘Custom’ implants being the most common phraseology for this implant option, and there is very good evidence in the peer reviewed orthopaedic clinical press to support the notion that 15% of the population have ‘abnormal’ anatomy and may well benefit from Custom made implants. We need to put ‘abnormal’ into perspective, it maybe that the femoral neck shaft angle of one individual falls outside of the ‘normal distribution’ curve, or that another individual has a longer femoral neck than the ‘norm’ giving that individual a particularly large ‘offset’. These parameters are not particularly worrying but we are uncertain of the role played by these abnormal parameters in the early onset of hip arthritis.
The challenges are however significant when it comes to surgery for hip arthritis, and if a Total Hip Replacement (THR) is clinically indicated, the restoration of both offset and of the head neck angle challenging for the orthopaedic surgeon. Of course, the surgeon will endeavor to correct any leg length discrepancy as a result of the progressive joint degeneration, but this is a third parameter for consideration often means ‘compromise’ for the surgeon using standard ‘off the shelf’ implants.
Symbios have been designing and manufacturing Custom implants since 1989, we have manufactured and implanted over 20,000 Europe wide, manufactured in Switzerland in the Jura region of the country, where there are few strangers to fine engineering!
Published clinical results at 15 years follow up show remarkably constant performance, particularly in young active patients whose expectations often push the boundaries of the available technology.