In-Vivo Alignment Comparing Patient Specific Instrumentation with both Conventional and Computer Assisted Surgery (CAS) Instrumentation in Total Knee Arthroplasty
Section snippets
Materials and Methods
Between October 2009 and December 2010, 78 primary TKA subjects were prospectively enrolled using TruMatch Personalized Solutions (DePuy Synthes, Warsaw, IN). TruMatch Personalized Solutions (TM) consists of disposable, customized patient specific instrumentation (PSI). TM utilizes a full length CT scan, which measures mechanical alignment, bone deficiencies and bone morphology. A Web-based case submission is performed, followed by digital surgical planning. The surgeon may adjust the design
Results
The TM group was demonstrated to be non-inferior to the conventional group for the primary endpoint of absolute value of mechanical axis alignment with a non-inferiority P value < 0.001. The ANCOVA retained one significant covariate: patient weight (P = 0.002). Least squares means adjusted for this significant covariate provided absolute mechanical alignment values of 2.15° for TM and 2.14° for conventional. Morbidly obese TM patients had a large absolute mechanical axis alignment (mean = 5.33, SD =
Discussion
The literature contains few reports on the use of patient specific instrumentation in total knee arthroplasty. Hozack et al reported on 4 patients who underwent the use of patient specific instrumentation [16]. That report was quite negative with regard to the use of a particular type of patient specific instrumentation for total knee arthroplasty.
Lombardi et al presented results on 54 TKAs done with patient specific instrumentation created using magnetic resonance imaging. Radiographic
References (18)
- et al.
Comparison of radiographic alignment of imageless computer-assisted surgery vs conventional instrumentation in primary total knee arthroplasty
J Arthroplasty
(2011) - et al.
Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case–control study of 235 cases compared with 235 conventionally implanted prostheses
J Arthroplasty
(2005) - et al.
Learning curve in navigated total knee replacement. A multi-centre study comparing experienced and beginner centres
Knee
(2008) - et al.
Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery
J Arthroplasty
(2007) - et al.
Computer navigation versus conventional implantation for varus knee total arthroplasty: a case–control study at 5 years follow-up
Knee
(2008) - et al.
Custom-fit total knee arthroplasty (OtisKnee) results in malalignment
J Arthroplasty
(2008) - et al.
Malalignment: forewarned is forearmed
Orthopedics
(2009) - et al.
Optimizing femoral component rotation in total knee arthroplasty
Clin Orthop
(2001) - et al.
Computer-assisted knee arthroplasty versus a conventional jig-based technique. A randomised, prospective trial
J Bone Joint Surg
(2004)
Cited by (58)
Population-based effect of total knee arthroplasty alignment on simulated tibial bone remodeling
2020, Journal of the Mechanical Behavior of Biomedical MaterialsMedical 3D Printing Cost-Savings in Orthopedic and Maxillofacial Surgery: Cost Analysis of Operating Room Time Saved with 3D Printed Anatomic Models and Surgical Guides
2020, Academic RadiologyCitation Excerpt :In conclusion, the potential cost-savings for using 3D printed models and surgical guides for patients’ operative care can be substantial. The present study used previously published data (9,15–44) to illustrate the potential value 3D printing can offer in terms of reducing the number of operating room minutes, using studies published with maxillofacial and orthopedic focuses. Studies to validate these analyses using single- and multiple institutional data are needed given the heterogeneity of sources used for analysis.
Patient‐specific instrumentation in total knee arthroplasty. Should we adopt it?
2017, Revista Brasileira de OrtopediaAmbient intelligence for health environments
2016, Journal of Biomedical Informatics
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.06.029.