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Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXIX | Pages 34 - 34
1 Jul 2012
Brooks F Akram T Chandratreya A Roy S Pemberton D
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This study was designed to evaluate the performance of a new patient specific interpositional knee device. Treatment of osteoarthritis is evolving, allowing surgical treatment options at an earlier stage. The interpositional knee device is a recently developed patient specific implant used for the treatment of mild to moderate uni-compartmental osteoarthritis. The benefits over traditional methods of surgical management are: it's less invasive, can be a day procedure and does not limit future options. Young Adults with early uni-compartmental arthritis are suitable. A MRI scan of the patient's knee is reviewed by local and US radiologists to decide if the patient is suitable for the implant. A bespoke implant is produced. Prior to insertion an arthroscopic procedure is undertaken to allow proper positioning of the implant.

We treated 27 patients with the iForma Conformis interpositional knee implant in South Wales at the Princess of Wales Hospital, Bridgend and the Royal Glamorgan Hospital, Llantrisant since November 2007. The pre- and post-operative WOMAC scores were recorded. The average age was 54.7 years, BMI 32; 10 females and 20 males. The average pre-operative WOMAC score was 42.2 improving to 62.9 post-operatively. 35 implants were used. 7 patients experienced post-operative problems. No dislocations were reported. Average follow-up was 12.6 months.

Our early experience suggests patient selection plays a role in the outcome following surgery. It indicates that this device is a viable and safe alternative to a uni-compartmental knee replacement.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XVII | Pages 9 - 9
1 May 2012
Brooks F Akram T Chandratreya A Roy S Pemberton D
Full Access

Treatment of osteoarthritis is evolving, allowing more options of surgical intervention at an earlier stage. The interpositional knee device is a recently developed patient specific implant used for the treatment of uni-compartmental osteoarthritis. It is designed for use in mild to moderate osteo-arthritis only. The benefits it offers are, that it is less invasive than traditional methods, can be performed as a day procedure and does not limit future options.

Young adults with uni-compartmental arthritis are suitable for this implant. A MRI scan of the patient's knee is reviewed by radiologists to decide if the patient is suitable. A bespoke implant, based on the MRI data, is produced. Prior to insertion an arthroscopy is undertaken to allow proper positioning of the implant.

We have treated 26 patients with the iForma Conformis interpositional knee implant in South Wales at the Princess of Wales Hospital, Bridgend and the Royal Glamorgan Hospital, Llantrisant since November 2007. The pre- and post-operative WOMAC scores were recorded. Average age was 54.7 years, BMI 32; 9 females and 17 males. The average pre-operative WOMAC score was 42.2 with an improvement to 62.9. 33 implants were used (19 right, 14 left). 7 patients experienced post-operative problems (5 implants removed and 2 MUAs). No dislocations were reported. Average follow-up time was 12.6 months (range 6-26 months).

Our early experience suggests patient selection plays a vital role in the outcome of patients following surgery. It indicates that the interpositional knee device is a viable and safe alternative to a uni-compartmental knee replacement.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XII | Pages 4 - 4
1 Apr 2012
Brooks F Akram T Chandratreya A Roy S Pemberton D
Full Access

Treatment of osteoarthritis is evolving, allowing surgical treatment options at an earlier stage. The interpositional knee device is a recently developed patient specific implant used for the treatment of mild to moderate uni-compartmental osteoarthritis. The benefits over traditional methods of surgical management are: it's less invasive, can be a day procedure and does not limit future options. Young Adults with early uni-compartmental arthritis are suitable. A MRI scan of the patient's knee is reviewed by radiologists to decide if the patient is suitable. A bespoke implant is produced. Prior to insertion an arthroscopy is undertaken to allow proper positioning.

We treated 27 patients with the iForma Conformis interpositional knee implant in South Wales at the Princess of Wales Hospital, Bridgend and the Royal Glamorgan Hospital, Llantrisant since November 2007. The pre- and post-operative WOMAC scores were recorded. The average age was 54.7 years, BMI 32; 10 females and 20 males. The average pre-operative WOMAC score was 42.2 improving to 62.9 post-operatively. 35 implants were used. 7 patients experienced post-operative problems. No dislocations were reported. Average follow-up was 12.6 months.

Our early experience suggests patient selection plays a role in the outcome following surgery. It indicates that this device is a viable and safe alternative to a uni-compartmental knee replacement.


Orthopaedic Proceedings
Vol. 92-B, Issue SUPP_III | Pages 414 - 414
1 Jul 2010
Kempshall P Moideen A Pemberton D Roy S
Full Access

Aim: To evaluate the effectiveness of all inside meniscal repair technique in treating bucket handle tears of the meniscus in the athletic population.

Method: From 2005–2008, 40 patients underwent meniscal repair for bucket handle tear of the meniscus, either as a primary procedure or combined with ACL reconstruction. All patients were contacted by clinical review, letter or telephone retrospectively. All patients were scored using the Tegner Knee score. All patients had been participating in sport at international level, semi professional level or club level. Failure was defined as a recurrence in symptoms necessitating reoperation and success as a return to competitive sport.

Results: There were 27 medial meniscal tears and 13 lateral, in 38 knees. The average age was 23 years (16–39). The average length of follow up was 1.5 years (0–2–3.1) years, and the average time from injury to surgery was 47 weeks. 9 patients were treated with fast fix (Smith and Nephew Endoscopy) and 31 Rapidloc (DePuy Mitek). There was an average of 2.85 sutures used. The overall cumulative survival rate at two years was 83.9% (4 Failures). All reoperations were preceded by a subsequent traumatic event to the knee resulting in a recurrence of symptoms. Time to return to sport in patients with associated ACL reconstruction was not affected by conincidental meniscal repair. Of the primary meniscal repairs the time to return to previous sport was less than 4 months.

Conclusion: This study shows that meniscal repair has a high success rate for sporting individuals with meniscal tears and has a high chance of the individual returning to competitive sports.