Today I am going to be talking about a Conformis iView. The first page of the iView will give us all the detailed information as it relates to the tibial section of the procedure.

The first image in the tibial section is going to show us the placements of the first tibial cutting jig, otherwise known as the T1. What we are looking for here is to see if there are any osteophytes that are on the bone that the jig needs to reference in order to ensure proper placements. As the surgeon proceeds with the procedure, once he arrives at this step, he will reference this picture to make sure that the cutting jig is placed and pinned at the correct location.

The next image that the surgeon will take a look at will be the tibial bone resection. Conformis will provide this image and show the surgeon what the resected bone will look like as well as how thick each section of the cut bone will be. After the surgeon makes his cut, he can take this resected bone to his back table and measure the thickness of it and see how that compares to the thicknesses Comformis provided. If there are any discrepancies, the surgeon can go back to this jig and continue to cut more bone until the proper amounts of bone has been resected.

The next image is going to show us the placements of the final tibial implants. The surgeon will reference this image when placing the final tibial trial to make sure that the implant is placed with the proper rotation, as well as making sure that there is no overhang or under coverage of the final implants.

Since every implants is customized to respect the natural geometry of the patient, there should never be an instance where the knee is malrotated or there is significant overhang or undercoverage. The next image is going to show the patient’s medial and lateral insert offset. For this particular patient the distal femoral offset is 0.8 millimeters.

This means that the lateral side of the patient’s poly inserts are going to be 0.8 millimeters thicker than the medial side of the poly. So if the medial poly is 6.1 millimeters, the lateral poly will be 6.9 millimeters. This offset helps to ensure that we are achieving neutral mechanical alignment.

The next page of the Conformis iView gives us detailed information about the femoral side of the procedure. The first image is going to show us how the distal femoral cutting jig should be seated on the bone. The surgeon will be given multiple reference points to ensure the jig’s proper placement. Once the proper placement has been confirmed, the surgeon can then pin this jig into place and then cut away and then cut the distal femoral bone.

After the bone has been cut, the surgeon can take the resected bone and bring it to his back table and measure the thicknesses. And he can compare this measurement to the measurements that Conformis provided. If there are any discrepancies, the surgeon can then go back to this jig and continue to resect bone until the amount of bone resected matches the values that Conformis provided.

The next image is going to show the 3 in 1 block, otherwise known as the F4. With this jig, it is important that the surgeon ensure that the medial portion of the jig matches the medial portion of the patient’s femur. If these rules are met, the surgeon can then pin the jig in place and then cut his anterior bone followed by his posterior condylar bone.

After this bone has been resected, the surgeon can go to his back table and measure the resection values and compare that to the resection values Conformis provided. If there is a mismatch, the surgeon can go back to this jig and make adjustments as necessary to ensure that the proper amount of bone has been resected.

The final images on the femoral page of the iView are going to show how the final implants will look in the patient’s knee. The images provided will show the implanted knee. The final images provided will show the appearance of the implanted knee as the knee is straight from both the front and the back, as well as how the final implants will look while the knee is bent from both the front and the side.

Dr. Nakul Karkare

I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.

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