Monday Medical: One size doesn’t fit all |

Monday Medical: One size doesn’t fit all

Lindsey Reznicek/For Steamboat Today

Monday Medical

There are many products on the market that are labeled "one size fits all." But does one size really fit all? Some products can work that way, but others, such as things you wear, are probably more "one size fits most."

Now, think about a knee replacement. Until about five years ago, knee replacements fell in the "one size fits all/most" groups. What if you could have a knee replacement that was custom to your body?

Thanks to advancements in the orthopedic industry, you can now have just that.

Dr. Michael Sisk, an orthopedic surgeon in Steamboat Springs, says custom knees have been in development for the past five years.

"If you need a new knee, do you want something off the shelf, a one-size fits all model, or do you want something custom built for your body?" he said. "Traditional knee replacements work, but custom knees are proving an even better way to maintain an active lifestyle if your original knees should fail."

In an active town such as Steamboat, knee injuries are fairly common. Twisted, strained or sprained knees can lead to a sore joint. Inflammation can occur, deterioration can begin, ACLs and meniscuses can tear and cartilage can become non-existent.

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"It's a dreadful change in someone's quality of life, with the human knee reaches the end of its service life," Sisk said. "You go from a knee that bugs you while running or skiing to a 24/7 deal, where you can't do anything, because bare bones with nerve endings are rubbing on each other."

Before considering a knee replacement, Sisk recommends exhausting all conservative treatment options available. Patients should consult their primary care provider or an orthopedic surgeon and look to physical therapy, injections, braces and other non-surgical options before discussing surgery.

With a traditional knee replacement, the knee doesn't match the patient's normal anatomy every time. Like people, knees come in all shapes and sizes. Knee alignment is also different in each person; some knees point straight, while others turn inward or outward.

During a traditional knee replacement surgery, the surgeon is solely responsible for the new knee aligning properly. The weight of the body should go centrally through the knee, with the inside and outside of the knee bearing the same amount of weight.

"Improper alignment can wear not only on the replaced knee, but on other parts of the body," Sisk said. "Think about a tire. If it isn't balanced properly, instead of 50,000 miles, you'll only get 30,000 miles out of it. Traditional knee replacements have a life of 10 to 15 years; if you receive one earlier in life, there's a great potential for a knee replacement to wear out and need to be revised. That would require another surgery and a more complicated one, at that."

With a custom knee replacement, not only is the knee built to more accurately replace a human knee, the materials and technology utilized push its useful life even further.

The custom implant, a combination of metal and polyethylene plastic, is made following an MRI or a CT of the patient's knee. Specific measurements are taken, not only to construct the implant, but also to guide placement and proper alignment during the surgery. The patient's name is etched into the implant to complete the customization.

"Think about Cinderella's slipper," Sisk said. "One hundred maidens could try it on, but only one will fit the slipper perfectly. That's the brilliance of custom knees."

In addition to the customization and fit of custom knee replacements, Sisk said studies indicate higher patient satisfaction due to shorter surgeries and hospital stays, less bleeding and trauma to the body and lower complication rates.

"We're seeing quicker recovery periods in patients with custom knees," Sisk said. "I support my patients getting back to their normal activity levels as soon as they are comfortable."

While longevity studies are still out, it's hoped that custom knees will push toward 30 years of useful life, a positive for younger patients facing a knee replacement.

"Thirty years of 100 days on the mountain eventually takes its toll," Sisk said. "Looking at a custom knee that is going to last you hopefully twice as long as a traditional knee replacement is really exciting."

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Lindsey Reznicek is an outreach specialist at Yampa Valley Medical Center. She can be reached at

Yampa Valley Medical Center’s New Mobility Joint Replacement Program consistently helps patients before, during and following their procedure. Outcomes include the following.

• Number of days in hospital: YVMC — 1.83 National — 3.2

• Percentage of patients who go directly home versus. a rehab facility: YVMC — 95 percent National— 27 percent

• Rate of readmission within 30 days due to complications related to surgery (including infection, blood clots, severe bruising): YVMC —0.9 percent National — 5 percent