As a specialist in orthopedics and orthopedic surgery at the Orthopoint Sports and Joint Clinic in Pfäffikon (SZ), Dr Waldemar Komorek specializes in injuries to the foot, ankles and knees, although shoulder joint surgery is also one of his main areas of surgical expertise. He also enjoys a first-class reputation as a hip specialist – precisely because his focus is always on preserving the joints. He is best known for his expertise in artificial knee joints. In this field, he is one of the internationally renowned specialists, particularly in the area of so-called 3D prostheses, which he customizes to meet individual requirements. He granted the Leading Medicine Guide an insight into his high level of expertise.
Leading Medicine Guide: Dr Komorek, you are certainly one of the few orthopedic surgeons who really know the subject of sports injuries from the inside.
Dr Waldemar Komorek: I’m sure you’re referring to my time as a competitive footballer in professional football in my younger years and later as a team doctor in the Bavarian First Football League. Indeed, in this job you see a great deal of sports injuries. After all, football is not a low-risk sport; the legs, the ankles, the knees – in fact, every part of the lower limbs is vulnerable and can sustain complex injuries while playing the sport.
Leading Medicine Guide: What tops the list of typical football injuries?
Dr Waldemar Komorek: These are muscle injuries – the well-known strains or torn muscle fibers – followed by the dreaded ligament injuries to the knee joint – or the ankle joint. As team doctors, we don’t often have to treat fractures, but of course, the ankle can sometimes be hit quite badly. And when that happens, it’s usually not a simple fracture, but something more complicated.
Leading Medicine Guide: Apart from a great deal of specialist knowledge – what is absolutely essential for a team doctor?
Dr Waldemar Komorek: Strong nerves, a cool head and a great deal of psychological sensitivity. You have to be able to assess the situation very quickly, then make the correct diagnosis and take the appropriate decision: Does the player go back onto the pitch, sit on the bench, or does he require further medical treatment? Incidentally, every player decides for themselves whether to return to the match. My role is an advisory one, but the lads naturally trust me. Except in the case of head injuries and obvious loss of consciousness – in those situations, as the team doctor, I really do have the final say. Team doctors are only allowed to enter the pitch at the referee’s signal, unless there is a suspected heart attack or a head injury.
Leading Medicine Guide: And as a team doctor, you have to be a proven expert in the field of sports orthopedics and sports surgery. Is that correct?
Dr Waldemar Komorek: I gained my medical experience in various orthopedic clinics, a private clinic and as Medical Director of a clinic and a surgical center. Over time, I have been able to build up and refine comprehensive specialist knowledge through more than ten thousand operations.
Leading Medicine Guide: On top of that, you have numerous memberships in orthopedic professional associations and have authored several scientific publications. What is your specific area of expertise today?
Dr Waldemar Komorek: At the moment, alongside all joint-preserving surgical options, I am particularly fascinated by 3D customization for artificial knee joints. This allows us to achieve excellent results. We must bear in mind that the large joints such as the hip, knee, ankle and shoulder are subjected to enormous strain over the years. At some point, almost everyone experiences minor or major signs of wear and tear, which often cannot be treated satisfactorily with conservative therapies. We have been familiar with joint replacement for decades, but the fact that knee prostheses can now be individually and precisely fitted represents a technical and medical advance. Because one thing must be borne in mind: patients have become more demanding; they do not just want to be free of pain, but they want to continue leading an active life. And they have become younger, demanding greater resilience, durability and functionality from the prosthesis. And the really great thing about 3D implants is that they feel significantly less artificial – that’s what patients tell me.
Leading Medicine Guide: Can you describe to us what is different about 3D customization compared to previous methods?
Dr Waldemar Komorek: Every joint has an individual shape, or morphology, as we doctors say. Broadly speaking, all hip or knee joints look the same, of course, but they differ in subtle ways, and these nuances are ultimately crucial for achieving the most natural possible range of motion, which naturally requires extensive training during the rehabilitation period. There is no getting around this, even with a 3D implant. However, with 3D scanning, we collect detailed data on the leg axis and the shape of the joint prior to surgery and analyze the bone structures and the entire surrounding soft tissue envelope. Using all this information, a truly custom-fit, individual implant can be created that is precisely tailored to the patient’s anatomy and their mechanical capabilities.
Leading Medicine Guide: That sounds like a huge improvement.
Dr Waldemar Komorek: I personally consider this a milestone. For the first time, it is truly possible to customize the prosthesis to the patient’s anatomy. And this is of enormous significance, particularly for the knee. This is because this joint involves a complex interplay of bone structure, the range of motion of the ligaments and the resulting very specific mechanics. With a standard prosthesis, we can approximate this kinematics – as this complex interplay is known – to a certain extent. But only to a certain extent. However, if we adapt the artificial joint precisely to the individual anatomy, rather than the other way round, we achieve very different results. Of course, one’s own joint is always best, which is why the criteria for an artificial joint replacement must always be strictly applied and all other conservative and surgical options must be exhausted.
Leading Medicine Guide: That sounds as though the use of 3D joint implants requires very extensive preparation?
Dr Waldemar Komorek: That is indeed the case. It involves detailed digital preparation. However, this also has the advantage that we can test and optimize the mechanics on the model. With the wealth of data collected, the entire surgical procedure can be planned more precisely and carried out more gently. With precisely fitted joint replacements, we observe that patients quickly regain a natural range of motion, report fewer residual symptoms and have a significantly lower revision rate. Science is still a long way from reaching the end of its development of individual replacement solutions tailored to the patient. Here at Orthopoint, we keep track of these developments and stay up to date with the latest scientific advancements so that we can treat our patients as effectively as possible.
Leading Medicine Guide: You mentioned earlier that patients want to be able to resume their usual sports without discomfort after surgery. Is that possible without restriction?
Dr Waldemar Komorek: In principle, yes; at least sports such as cycling, swimming, sailing, diving, golf and bowling can be practiced without hesitation. Tennis or skiing is a bit more difficult, but not impossible. Here, advice and decisions must be made on an individual basis depending on fitness and training levels. Unfortunately, contact sports such as football, handball or basketball are no longer an option.
Dr Komorek, thank you very much for this fascinating insight into the promising field of 3D medicine!
Anyone wishing to contact Dr Komorek directly can do so via his profile page on the Leading Medicine Guide.
