It didn’t take long for 3-D printing to enter the world of surgery. With the help of 3-D printing technology, Dr. Brad Wright can now insert a completely customized knee implant in a patient undergoing knee-replacement surgery.


The result is a knee that gives the patient better range of motion and much better results, said Dr. Wright, a board-certified orthopedic surgeon with Sports Orthopedics and Spine.


This new technology is one of many developments that have bettered the outcomes of partial and total knee-replacement surgeries as the procedure has evolved over the years, he said.


Today’s surgeons can use new techniques and insert knee implants that come in many different sizes, are gender-specific and made of better materials. Surgical instruments now tell the orthopedic surgeon where to precisely make the incision to place the implant in the joint with the least damage to surrounding tissue.


“The newer technology respects the forces in the knee more appropriately and gives the patient a more natural knee,” said Dr. Wright.


Doctors can also be more aggressive with physical therapy to get the post-operative patient in therapy as soon as possible and back to an active lifestyle quicker. “New medications can give us three to four days of excellent pain relief to get the patient going,” he said.


An implant created by 3-D printing technology takes these advancements a step further. The implant is custom created for a specific patient, and this makes a more perfect fit for the patient, Dr. Wright said.


The 3-D printed implants he uses are made by ConforMIS. By combining advanced 3-D imaging technology with the latest manufacturing capabilities, ConforMIS customizes each implant to the patient’s unique size and shape.


The process for a 3-D printed knee implant starts with a CT scan of the patient’s knee. Dr. Wright sends the scan to a ConforMIS laboratory in Boston, Mass., which then converts the CT scan to a 3-D model by mapping the knee’s articular cartilage (the smooth, white tissue that covers the ends of bones where they come together to form joints) and defines the area of the disease. Each implant is unique for that patient, which increases the potential for a natural-feeling knee.


The company also provides pre-programmed and disposable instrumentation that is based on the patient’s CT scan. Disposable instruments reduce the risk of infection, Dr. Wright said.


In any discussion of knee replacement surgery, it’s important for the patient to understand that the knee is a complex joint that supports most of the body’s weight, Dr. Wright said. The knee does far more than act like a hinge to move your leg up and down. The joint in your knee can make twisting and turning actions, and it allows your body to hold up your weight. The bones in your knee are protected by cartilage, which provides a cushion and allows those bones to glide easily.


As we get older, the cartilage in our knee joints starts thinning, and arthritis can set in. Extra weight compounds the problem, Dr. Wright said. “An extra 50 pounds of weight can feel like four to six times more weight placed across your knees.”


He finds himself talking to many patients about losing weight as one of the steps they can take to alleviate knee pain.


Knee-replacement surgery is considered only after all other non-surgical options have been exhausted, and the pain is too great for the patient. “We want to put it off as long as possible,” he said. “Once you replace a joint, there’s no turning back.”


Dr. Wright also helps the patient have realistic expectations after knee-replacement surgery.


The goal of the surgery is to help the patient return to an active lifestyle without pain, he said. “When a patient tells you, ‘I don’t even know it’s there,’ you know you’ve achieved the gold standard.”