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Author Topic: Conformis implant - expected result ?  (Read 11510 times)

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Offline Osprey

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Conformis implant - expected result ?
« on: October 23, 2008, 05:20:50 PM »
I have had several arthroscopy ops on knee, resulting in removal of just about all meniscal cartilage.
Last one 10 months ago showed significant loss of bone off head of femur, and on lateral side significant loss of articular cartilage.
As a result of continuing bone on bone damage long leg x-rays show the line between hip to ankle my knee is now 27mm out of line ..

Knee has been graded as Grade 4 Osteoarthritis.

The 2 big issues I have is that if I kneel, I cannot sit back onto my heels, pain is significant, and it just won’t bend backwards to allow this.
On sitting (car & train journeys etc) I have significant limping afterwards … which I can ‘walk off after 10 mins or so.
Any significant ‘work’ on ladders, stairs, or walking over rough ground causes swelling especially at rear of knee, and on outer side of joint.  Usually with prolonged pain afterwards.
Also after sports such as waterskiing etc.

I purchased (a very expensive) Ossur Unloader brace, to reduce damage, and help with pain.

Consultant was initially recommending an oetomy realignment, but has now decided upon a Conformis Inter Positional Device insert for lateral side.

This is classed as experimental and my insurers have refused to cover this, however all MRI scans done (3 sets) and Conformis examined and state knee is suitable.


Be interested to know what the success rate is with conformis implant, what recovery time is likely, post recovery knee use …. Will I gain full use of my knee ? for sports etc.?



« Last Edit: November 29, 2008, 05:52:29 PM by Osprey »

Offline tbrookes

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Re: Conformis implant - expected result ?
« Reply #1 on: October 23, 2008, 11:35:52 PM »
 ???

I had a Conformis implant (medial meniscus replacement) 11 weeks ago. The recovery is very slow. I have some significant patellar pain. The joint seems stable, however I still walk with a limp. I am not yet convinced this was the way to go, however my surgeon says I'm right on track. Bottom line: no pain in medial compartment anymore, but new pain that is worse. Hopefully rehab will work, eventually.

Offline cboden51

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Re: Conformis implant - expected result ?
« Reply #2 on: November 09, 2008, 04:28:15 PM »
I was diagnosed with Grade 4 arthritis medial aspect, grade 3 patella  chondromalacia in my left knee. Also had medial and lateral meniscus tears and a loose body. Had those tears and the loose body removed May 23. My pain level medially was significantly worse  after the procedures, laterally occasional pain, patella none.

On Oct. 28 I had a Conformis medial aspect . This was done on an out-patient basis. Sent home with a drain in place and a brace for stabilization, no crutches, no walker. Percocet for pain which I needed every 3 - 4 hours.  Back to the doctor's office the next day to have dressings removed and drain pulled. Redressed and sent home to start CPM and icing. CPM started at 60 degrees and increased every day by 10 degrees until 120 degrees of passive motion achieved,  Continued to need Percocet every 3 - 4 hours for about another half day then have been taking 1-2 Advil every 4-6 hours. Pain at the incision most bothersome when I lay down to sleep at night. Have developed pain in knee laterally, most significantly  when knee is fully extended on weight bearing. I did have this occasionally before the surgery. This may be related to tightness as I am lacking about 5 degrees of extension - I had a lot of problem with this after my first surgery as I was initially lacking about 15 degrees of extension then and worked hard to get to 0 degrees and try to maintain it before this surgery.

Staples removed day 9 and steri-strips placed over incision, which must be kept dry for a total of 3 weeks.

Started Physical Therapy at day 10. Range of motion is at -5 degrees extension to 110 degrees flexion actively. Able to do very good quad set, straight leg raises with a 3 lb. weight and am walking about 3/4 mile with the only pain being the lateral pain which can be completely eliminated with Advil ( I don't take it before I walk as I am afraid I would over do without this gauge).

All in all I am very pleased. Time will tell , if the lateral pain does not go away I will be unhappy because it will limit my rehab, but I will continue to cross those bridges.

I had a unicompartmental replacement on my right knee almost 3 years ago and took about 6 months to fully recover.

I am told that recovery is better for the Conformis than others but the long term limitations apply as far as return to sports.

Offline Osprey

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Re: Conformis implant - expected result ?
« Reply #3 on: November 17, 2008, 01:11:33 PM »
Had a replacement set of MRI scans .. and Conformis implant now manufactured.

Due for Op next week ...

Did ask about CPM for post op, but told not need3d, and also no need for Physiotherapy ?
« Last Edit: November 18, 2008, 04:58:07 PM by Osprey »

Offline cboden51

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Re: Conformis implant - expected result ?
« Reply #4 on: November 17, 2008, 08:49:49 PM »
My 2 cents:

I would disagree that you would not benefit from the CPM and PT.  The CPM makes the motion much easier to regain after and the PT takes up where that left off. I am working with the Therapist to regain the rest of the motion and find her help in defining the steps to take in regaining strength and balance absolutely valuable.

The doctor I have is a great surgeon but he is so busy I can't imagine him taking the time to review exercises with me. How would you know you were doing them right even if you had a list and did them on your own?

Connie

Offline Osprey

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Re: Conformis implant - expected result ?
« Reply #5 on: November 18, 2008, 09:26:42 AM »
I am not disputing their worth, that is why I asked my doc about it ....
However he says no ... and in UK if he does not approve/request it ... it doesn't happen.

Offline digginit

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Re: Conformis implant - expected result ?
« Reply #6 on: November 18, 2008, 09:56:25 AM »
FWIW, my surgeon didn't think I needed CPM either, as he said that there are early benefits, but at 6 months folks without CPM tend to do as well as those with it. 

He left PT up tp me.  I chose to go a couple times a week, and I enjoy it, but I think I'd do no worse on my own.  As much as anything, the guidance and reassurance are helpful. 

I didn't have a ConorMIS surgery, but standard ol' TKA.  At 7 weeks (today, YAY) I'm back to working full days, bicycling on my road bike, with 135 flexion and full extension.  Still trying to build that quad back up.  :)

You can do it.  Just spend time at home with your exercises.  You don't have to have a bunch of specialized equipment to do well with this!

~dig

Offline Osprey

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Re: Conformis implant - expected result ?
« Reply #7 on: November 18, 2008, 10:26:12 AM »
did a bit of googling around .... seems there is quite a lot of evidence against any CPM benefits ...
take a look at:
]]http://www.jbjs.org.uk/cgi/content/abstract/79-B/6/914

Please note I am not against (or for) CPM, just finding out more.

Offline cboden51

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Re: Conformis implant - expected result ?
« Reply #8 on: November 18, 2008, 03:20:05 PM »
Good luck with your surgery.

No difference in the US - if the doc doesn't order it the insurance doesn't pay.

I couldn't get to the site you referenced but I did find several other studies that said the same thing- no difference at 6 weeks, which surprised me.

I am a self starter and from the sounds of it so are you so I am sure you will do well.  I agree with Dig- I like the guidance of the PT but if you have to go without at least you can come here and ask questions.

I particularly liked the idea of the Conformis since it was made just for me and involved much less cutting and am very happy with it. I am at 3 weeks today and while I am not ready to be on my feet full days I can do everything without that old nagging arthritic pain. I would say my limitation now is swelling after being on my feet for too long but a little icing and I am ready to go again.

Connie

Offline Osprey

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Re: Conformis implant - expected result ?
« Reply #9 on: November 18, 2008, 05:03:04 PM »
My surgeon explained all the possibilities to me, and due to age, damage etc. ... there were only 3 options
1. Total knee replacement
2. Partial knee replacment
3. IPD  (Conformis Iform)

Option 1   - he thought would result in removal of the medial and front joint - which is in good condition. It also meant significant cutting away of the bone, limiting further options in future.
Also due to my level of activity, it could well restrict my future sports.

Option 2 - absolutley agnist these at presnt - simply not very succesful.

Option 3 - as it involves no removal of bone, it 'burnt no bridges'   ... if all fails, it can be simply removed ... and joint is back 'as is'.
The hope of course is that if will realign my leg, and prevent the severe bone on bone wear.
Disadvantage is that it is not accepted an approved procedure - insurance turned it down.

If it is a success (and I trust the Surgeon on this), it may get me another 10 years before I need a knee replacement, and as they change design every few months - they should be much better by then.    :)


Be interesting going through X-ray at airports in future   


Sorry the link did not work, try this short cut
http://tinyurl.com/6qhbd2

« Last Edit: June 20, 2011, 09:13:04 PM by Osprey »

Offline Cik

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Re: Conformis implant - expected result ?
« Reply #10 on: November 21, 2008, 02:31:19 PM »
Just found this site . . . not too tech savvy, so I'll re-edit. A couple months ago, following a year of an combination of offloader brace really not doing it for me, and either was Visco supplementation. I found that conformis site (iforma) and glad i did get referred to a surgeon. rehab seemed to be similar to a joint replacement from what i'm told, but i was more interested in preservation and 3months later im liking the result. . .for the most part non-selfmanagement pain free. The other thing is that my vocal uncle is a candidate for something for his localized medial compartmental pain and is talking to a doc that deals in their patient-specific mnimally invasive uni...i'llkeep you posted.
« Last Edit: November 21, 2008, 02:39:41 PM by Cik »

Offline Osprey

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Re: Conformis implant - expected result ?
« Reply #11 on: November 25, 2008, 10:32:04 PM »
If it is of any use, I had my Confrmis iForma operation today ... have tracked results in post op sub-folder:
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=45266.0

Offline cboden51

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Re: Conformis implant - expected result ?
« Reply #12 on: November 26, 2008, 04:36:08 PM »
Forgot to tell you that I was able to look at the link- very interesting. I had the uni myself.

Offline Peg Leg

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Re: Conformis implant - expected result ?
« Reply #13 on: April 26, 2009, 10:34:15 PM »
I am scheduled for a ConFormis iDuo Bicompartmental replacement on June 25th.  I have been following your comments here with interest and was wondering how things are going for you now?  I've done my research and i am hopeful that this will help to put an end to my 2 1/2 years of knee problems.  I started my diary in the Uni-compartmental section for lack of a better option!  I would love an update from you Osprey.

Thanks,

peg Leg
10/06  Miicrofracture Rt knee on mfc
defect was 1.3x2, small defect under patella
04/07 Arthroscopy/Cell harvest for Carticel
06/28/07 Carticel surgery ,Rt. Knee
12/27/07  Scope to debride Patella lesion,Rt. Knee
4/17/08  Fulkerson AMZ, Rt. Knee
6/25/09 ConforMis BiCompartmental Knee Replacement

Offline cboden51

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Re: Conformis implant - expected result ?
« Reply #14 on: April 26, 2009, 11:37:11 PM »
I am 6 months out from my uni conformis and doing great in every respect. I am very anxious to hear about your surgery and will follow your recovery when it begins.

Best of luck to you,

Connie