alexa Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial.


Orthopedic & Muscular System: Current Research

Author(s): Victor J, Dujardin J, Vandenneucker H, Arnout N, Bellemans J

Abstract Share this page

Abstract BACKGROUND: Recently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial. QUESTIONS/PURPOSES: We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG. METHODS: In this randomized controlled trial, we enrolled 128 patients. In the PSG cohort, surgical navigation was used as an intraoperative control. When the suggested cut deviated more than 3° from target, the use of PSG was abandoned and marked as an outlier. When cranial-caudal position or size was adapted, the PSG was marked as modified. All patients underwent long-leg standing radiography and CT scan. Deviation of more than 3° from the target in any plane was defined as an outlier. RESULTS: The PSG and conventional cohorts showed similar numbers of outliers in overall coronal alignment (25\% versus 28\%; p = 0.69), femoral coronal alignment (7\% versus 14\%) (p = 0.24), and femoral axial alignment (23\% versus 17\%; p = 0.50). There were more outliers in tibial coronal (15\% versus 3\%; p = 0.03) and sagittal 21\% versus 3\%; p = 0.002) alignment in the PSG group than in the conventional group. PSGs were abandoned in 14 patients (22\%) and modified in 18 (28\%). CONCLUSIONS: PSGs do not improve accuracy in TKA and, in our experience, were somewhat impractical in that the procedure needed to be either modified or abandoned with some frequency.
This article was published in Clin Orthop Relat Res and referenced in Orthopedic & Muscular System: Current Research

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Peer Reviewed Journals
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version