1. Patient Matched Instrumentation
Dr. Vivek Mittal
Sr Consultant
Delhi Institute of Trauma & Orthopaedics, Sant Parmanand Hospital, Delhi

2. TKA : What are we seeking?
Accuracy
Alignment
Balance
Longevity
2 wks Postop

4. Line of sight remains the best
CAS / Navigation
Clinical assistance?
Learning Curve
Rotational Align’t
Accuracy?
Outliers?
Sales technique?
Line of sight remains the best

5. Patient Matched Instrumentation
One of the most exciting and visionary technologies to hit the Orthopedics market in years!
Game-changing possibilities
Surgical efficiencies for surgeon and the O.R.
Patient benefits
Company inventory reduction!

6. Patient Matched Instrumentation
What is it?
Manufactured
medical grade Nylon-12
Single use cutting blocks
Distal Femur
Proximal Tibia

7. Patient Matched Instrumentation
What is it?
Utilizes
Pre-Operative MRI and Full-Leg X-ray
To design from & built to pt’s specific anatomy
Alignment
based off the gold standard of Mechanical Axis

8. How Is It Done?

9. Design Features AP Axis AP Axis Cutting Slot
Match Standard MIS Cutting Block
Patient Information
Epicondylar Axis
Set Alignment and Rotation
Match pins from AP block

10. Design Features Oblique Fixation Pin Medial 1/3 of Tibia Tubercle
Cutting Slot
Match Standard MIS Cutting Block
Patient Information
Set Alignment and Rotation
Match pins holes on tibial trial

11. Week 5

12. Week 5

13. Vs Standard TKA PMI Eliminates intra-medullary canal violation
reducing blood loss and complications from fat emboli

14. Eliminate large number of surgical steps
vs. Standard TKA & CAS
PMI Reduces
Eliminate large number of surgical steps
Step 1
Step 2
Step 3

15. vs. Standard TKA & CAS PMI Improves Alignment and sizing
Whiteside Line
Alignment and sizing
Patient Information
Epicondylar Axis
Built into the design
Alignment, rotation and sizing are
Osteophytes included in block design
Set Alignment and Rotation
Match pins from AP block

16. vs. Standard TKA & CAS PMI Advantage Compatibility Incorporates
with standard instrumentation for intra-operative adjustments
Incorporates
pre-operative, surgeon specific design parameters

17. The Opportunity What is it? Why we want it?
Patient matched cutting blocks built from the patient’s own preop images
Disposable, single patient use distal femoral and proximal tibial cutting blocks; based off the mechanical axis
Why we want it?
Surgical efficiency – removes all alignment instruments
Improved outcomes – gives the accuracy of CAS
Reduced complications – no IM rod reducing incidence of fat emboli
Reduced inventory – sizing determined preoperatively

18. Patient Matched Instrumentation
Who Benefits?
Surgeons
More efficient surgery – less instruments
Greater accuracy – preop determination of alignment and sizing
Hospitals
Cost savings
Increase in orthopaedic surgeries – market technology to patients in local and regional campaigns

19. Patient Matched Instrumentation
Who Benefits?
Patients
Reduce Complications– preserve I/M canal
Faster surgery – less blood loss & anesthesia
Faster Recovery
Expensive as of today
Waiting Period of 4 wks
3rd Postop Day