What is the history of custom prosthesis?
Dr. Mark Myerson: Let’s start with ankle replacement. Back in the early to mid 1990’s, there was a sudden change in this country as to the level of interest in replacing ankle joints. The skill, the technology, the prosthesis that had been available prior to that had not been of sufficient standard to meet our requirements for patient care. Compared with the knee and the hip, there was a tremendous difference in the outcome of joint replacement in the ankle, in the 90’s in particular, compared with the functional outcome as well as the longevity of the prosthesis. There were many complications — the complication rate in the 1990’s was in the order of about 20 percent. The main problem that was occurring was that the prosthesis was sinking into bones and patients were coming in years later with a prosthesis that was no longer stable. It was sinking into bone and worsening arthritis, or bone was crushed so that it was now impossible to do anything. If we step back a little and you look
