“A good alternative to robotics”

Dr Jens Peters, Head Physician in the Department of Orthopaedics and Trauma Surgery at the Diepolz District Clinics in Sulingen, has been using the 4-motion® knee system with his team for almost four years. We spoke to him about the advantages he sees in the 4-motion® knee system and why he thinks it is a good alternative to robotics.

The Sulingen-based company found its way into the 4-motion® knee system via the coated tibia component for allergy patients. ARTIQO has this component in stock and does not need to be customised. ‘That was the beginning of everything. The positive experience with the preoperative 3D planning and the very good surgical results led us to get involved,’ recalls Dr Peters.

Advantage of anatomical alignment

For him, an important argument in favour of the 4-motion® knee system is that it can be aligned to the human anatomy. For a long time, orthopaedists assumed that knees had to be fitted at 90 degrees. ‘But anatomical alignment is an option, because very few knees are 90/90, and we wonder why we can’t satisfy around 20 per cent of patients,’ says Dr Peters, explaining why he is convinced by the philosophy of the 4-motion® knee system.

Precision of preoperative planning

Preoperative 3D planning is extremely helpful in Sulingen for the implementation of the implantation: ‘It starts with the fact that I do the planning in a relaxed situation at my desk, while I can concentrate on the actual operation in the operating theatre. Intraoperatively, we almost always implement the millimetre-precise planning 1:1 – we very rarely deviate from it.’ The highlight is that the incision blocks specify exactly how the resection should be performed. ‘The human factor is well reduced in terms of susceptibility to errors.’

Shorter operating time

Compared to conventional instrumentation, the Sulingen-based company also saves time. ‘Operating theatre time is the most valuable time. If I can operate more quickly, it’s good for the patient and the hospital. With the 4-motion® knee system, we are usually a good 15 minutes faster. That adds up over the course of the day,’ states Dr Peters.

The production time for the patient-specific instruments is not an obstacle for the team in Sulingen: ‘Nowadays, it’s more the shortage of rehab places that causes longer waiting times.’

Good alternative to the industry hype of robotics

Dr Peters draws a parallel between the preoperative planning of the 4-motion® knee system and the currently highly advertised robotic systems. ‘The key question is: what is the most stable way to guide the joint? If you don’t want to go down the path of robotics – either because of the lack of scientific evidence or because of the costs – then preoperative planning based on CT is very similar to robotics. Here too, we receive precise specifications in terms of angle or cutting depth. This can be a good alternative to robotics,’ says Dr Peters.

Very good and reproducible results

The feedback from patients in Sulingen has been consistently positive. As of today, the team has implanted around 250 4-motion® knees and is taking part in the multi-centre study. This study comprises a total of 135 patients, including 30 from Sulingen, who are being followed up as part of the study. Dr Peters summarises the current status as follows: ‘In the 3-year follow-up, the results are very promising, the scores recorded are largely above the expected benchmarks. Of course, we still have to wait for further follow-up periods, but the results so far are very encouraging.’

Dr. Jens Peters, Sulingen