OA in the 21st century

Knee osteoarthritis (OA) is the most common musculoskeletal disease in the world, affecting approximately 20% of the population. In the UK alone, 4.5 million people aged 40–65 suffer from radiographic knee arthritis but are not yet suitable for knee replacement.

Total Knee Arthroplasty (TKA) remains the most adopted surgical treatment particularly in elderly patients with advanced disease, however, the increasing demand for knee replacement and the large burden it places on healthcare systems is becoming unsustainable. Moreover, procedures that preserve the natural knee joint are an increasingly attractive option for patients.

TOKA is a disruptive technology which can relieve patients from pain and mitigate the societal impact of knee osteoarthritis. Designed to minimise costs within NHS-tariff, TOKA combines 3D Printing and medical imaging technologies for a truly personalised treatment benefitting patients and healthcare providers, while relieving the societal cost of knee osteoarthritis.

For young and active people effected with knee osteoarthritis, HTO has been shown to be the best solution.

Joint preserving treatments for knee osteoarthritis

Without the correction of the patients’ mechanical axes for the redistribution of the forces imposed on the knee by exercise, other treatments to address the symptoms of osteoarthritis will not be as effective. For example, the implant lifespan of a Total Knee Replacement can be reduced, forcing patients to lead a sedentary lifestyle, impacting their overall health and quality of life. The younger a patient has a Total Knee Replacement, the higher the risk of revision and complications.

Our approach is based on a well-established procedure: High Tibial Osteotomy, where the tibia is modified to redistribute load away from the medial compartment of the knee (where osteoarthritis often begins). This offers many advantages including alignment restoration, knee preservation and a return to an active lifestyle.

TOKA is a precision engineered personalised HTO surgical solution, particularly designed for young patients suffering from radiographic knee arthritis but not yet suitable for Knee-Replacement.

The TOKA solution – Simple and Individual

HTO is a craft surgery and must be performed by experienced surgeons meaning the options currently available are technically demanding and present the risk of complications – particularly those associated with not achieving the required correction angle.

With TOKA, each surgery is completely planned around the patient. This begins with the surgical instrumentation used in theatre. Compared to existing solutions, TOKA presents a tailor-made and precise personalised intervention and potentially a faster procedure and a faster recovery time.

A simple to use surgical guide based on the patient’s CT scan containing the exact information to reproduce the digitally planned surgery reducing the need for intra-operative radiology and measurements.

The TOKA system removes the need for large inventory trays by using a 3D-printed titanium cutting and drilling guide, precisely fitting patient’s bone anatomy. Uniquely, TOKA pioneered an integrated osteotomy opening mechanism – a system allowing precision bi-planar limb alignment without the need for lamina spreaders or measuring tools.

Surgical planning and training software

The holistic approach of TOKA to knee surgery is driven by the suite of planning and training tools available for surgeons to learn in an interactive 3D environment how different cut angles and ways of carrying out the operation could affect patient outcomes.

The TOKA Surgical Simulator supports surgeons select the optimum treatment for every case. By applying algorithms and computational modelling, surgeons can virtually predict the surgery and visualise patient outcomes such as the alignment of the leg, anatomical changes, and likelihood of any complications.

TOKA also provides benefits to healthcare providers by rationalising resources with no inventory of stock parts required.