3D imaging, printing speed knee replacement recovery

July 23, 2018

Severe arthritis and 26 years of high-impact activity took its toll on Bowie, Maryland, fitness instructor Howard Harriston, who endured countless painkilling injections and numerous operations to remove damaged cartilage from his left knee.

“I was afraid. ... I thought my career was over,” he said.

Mr. Harriston, 48, needed a replacement, but not just any knee would meet the demands of his active lifestyle. Technology provided the perfect solution in the form of a personalized replacement crafted by way of 3D imaging and printing.

“He is doing things like splits that normal people shouldn’t do after having a routine knee replacement,” said Dr. Korboi Evans, the orthopedic surgeon who replaced Mr. Harriston’s knee in December at Holy Cross Hospital. “Howard is unique because he’s young. Patients who require knee replacements are much older.”

Dr. Evans, a member of the Greater Washington Orthopedic Group, specializes in hip/knee replacements and performs more than 100 customized knee replacements each year.

He orders implants from Conformis, a Massachusetts-based 3D imaging and printing software company that focuses on customized joint replacements. The surgeon said the technology reduces surgery and recovery time and gives patients better-fitting, more comfortable replacements than traditional one-size-fits-all implants.

A detailed computerized image of a patient’s lower body is sent to Conformis, which then customizes a 3D printed model knee based on the patient’s specific anatomy. The process takes five weeks.

“This was a custom-fit, total knee replacement, which was important for what I do,” said Mr. Harriston, who teaches at Fitness 4 Less in Bowie. “This was important because the alignment had to be perfect. So once that was done, the knee replacement got approved and then they did the surgery.”

Dr. Evans said the typical post-op patient uses a walker for the first couple of weeks in the hospital and then transitions to a cane. About six weeks after surgery, the patient usually walks without the aid of any devices.

Mr. Harriston was sent home three days after surgery because he was walking too fast with the walker.

“After I started walking with the walker, [the nurses] got me a cane, and the cane was perfect,” said Mr. Harriston, who needed the cane for three weeks. “I walked up and down the hallway twice. We could have walked up some stairs too, but I decided to chill until tomorrow.”

Six weeks after surgery, Mr. Harriston went back to teaching fitness classes Monday through Saturday. He was working out for an hour before class and performing splits.

“Once I felt that there was no pain, there was no stopping me,” Mr. Harriston said. “I’m even quicker now than I was. I mean, who can come back from a knee replacement just as hard?”

Dr. Evans said that when he was performing knee replacements 15 years ago in training, patients could not get out of bed for three or four days.

“With advancement in technology and surgical techniques and other pre-operative management tools, patients are up and walking that same morning,” the orthopedic surgeon said.

Dr. Evans said traditional knee replacement operations take about 75 minutes, but customized surgery takes only 45 minutes, reducing risks for the patient.

Customized knee implants usually last up to 20 years, depending on how the joint is used, he said, adding that osteoarthritis patients are the primary candidates for 3D technology.

According to Global Market Insights, a market research and strategy consulting firm, the health care 3D printing market will exceed $2.2 billion by 2024.

“The growth for knee replacement is relatively robust,” said Mark Augusti, chief executive officer and president of Conformis, which has created more than 100,000 3D printed implants nationwide. “It’s growing at a nice rate.”

Mr. Harriston is grateful for the 3D printing company, which works with about 500 surgeons across the country.

“This was an injury that I didn’t think I could come back from. They have no idea what they saved,” he said. “If you can’t do what you were born to do, it’s hard to get back up from that.”

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