@wisco50 what you describe as custom with the CT scan and CAD and model is what Nanoknee markets itself as doing , and charges $8500 out of pocket for this custom design. I wasn't aware anyone else was doing this. May I ask where you had it done and where it is done? Also, another surgeon who had some inside info on Nanoknee through a doctor he knew who went to train with them , said that often what happens with Nano knees is that the custom implant is found not to fit once in surgery, so an implant from off the shelf is used (whether they reveal this to the patient who has paid $8500 out of pocket for the custom fit I don't know.) Also when I had a consult with Dr. Ferro the NanoKnee founder, he said that the process took several weeks, and yet when I went to schedule it, they wanted me coming to CA two days prior to surgery to have the CT scan so they could have it ready for surgery two days later. When I asked the scheduler about this, she said oh yeah, they can make it really fast. Sounded very questionable to me. There were also some other very questionable experiences I had with them as well which planted enough doubt in my mind that I cancelled surgery. The surgeon I mentioned called Nanoknee an out and out scam.