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radius of motion is not the only benefit that individualized implants offer, says Dr. Levengood. An implant whose design is based on a patient's own anatomy means surgeons and their patients won't have to settle for one that's over- or under-sized. This in turn can reduce the procedure's lasting impact, since a surgeon may not have to remove as much bone to accommo- date the implant. "It's really more of a resurfacing than a replacement," he says. Additionally, conventional knee replacement surgery requires inten- sive soft tissue maintenance in order to rebalance ligament tension. Since customized implants are pre-balanced, that effort isn't neces- sary. Implanting customized knees is accessible to any ortho doc who's per- forming the traditional procedure, says Dr. Levengood. With the help of regional anesthesia, an effective pain management plan, and a home- based physical therapy regimen, they can even be done outpatient. Dr. Levengood's patients can walk the hospital corridors shortly after their surgeries. As an added bonus, the delivery of customized implants and instruments means there's no expensive inventory to consign and store. The ideal candidates for custom-made knees, he says, are healthy patients in their late 50s or early 60s who are active and want to remain active, but "it works across the spectrum, as young as 45, as old as 90. It's best with patients who don't have a lot of deformity in the joint." There's no reason, he says, why the specialty knees can't run as long as traditional implant options do. "We don't have 20-year data, but the materials are the same as off-the-shelf models," he says. "Nothing in the metallurgy, nothing in the polyethylene, nothing in the cement is differ- ent. The difference is more about the shape than the composition, and the difference in shape means a difference in wear. You get less wear 5 4 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 1 6