Patient Specific Instrumentation and Total Ankle Arthroplasty
Category: Ankle Arthritis; Ankle Introduction/Purpose: Total Ankle Arthroplasty (TAA) can now be performed using Patient Specific Instrumentation (PSI). Advantages include the ability to pre-operatively plan bone resections and implant position and reduce the number of intra- operative surgical step...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011421S01012 |
| _version_ | 1811217038279966720 |
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| author | James K. Yau An Murty Rajesh Kakwani David N. Townshend MBBS, FRCS(Tr&Orth) |
| author_facet | James K. Yau An Murty Rajesh Kakwani David N. Townshend MBBS, FRCS(Tr&Orth) |
| author_sort | James K. Yau |
| collection | DOAJ |
| description | Category: Ankle Arthritis; Ankle Introduction/Purpose: Total Ankle Arthroplasty (TAA) can now be performed using Patient Specific Instrumentation (PSI). Advantages include the ability to pre-operatively plan bone resections and implant position and reduce the number of intra- operative surgical steps. The aim of this study was to compare PSI with Standard Instrumentation (SI) in a non-randomised retrospective cohort study with respect to patient reported outcomes, tourniquet time, fluoroscopy time and post-operative alignment. Methods: 159 patients (111 male, 48 female) undergoing a total of 168 INFINITY TAA using PSI (Prophecy, Wright Medical Technology) or SI between 2014 and 2020 were included with a minimum follow up of 12 months. Patient reported outcome measures (PROMS) were obtained pre-operatively and at one year and included the Manchester-Oxford Foot Questionnaire (MOXFQ), Ankle Osteoarthritis Scale (AOS) and EQ-5D Index. Coronal plane deformity correction was assessed using the midline tibiotalar angle (MTTA). Demographics, tourniquet time and intra-operative fluoroscopy times were obtained from the hospital records. Results: There were 106 TAA in the SI group and 62 TAA in the PSI group. The was no significant difference in total MOXFQ, AOS or EQ5D. There was however a significant difference (p=.032) in favour of PSI in the walking/standing domain of the MOXFQ at 12 months. There was a significantly reduced tourniquet time (PSI mean: 95.39 mins, SI mean: 116.87 mins, p<.001) and radiation exposure (PSI mean: 31 seconds, SI mean: 53 seconds, p<.001). Angular correction was more accurate in the PSI group (PSI mean: 1.29°, SI mean: 2.26°, p=.005). Conclusion: This study supports the use of patient specific instrumentation to decrease operative time, reduce intraoperative fluoroscopy and improve accuracy of implantation in TAA. The walking/standing domain of the MOXFQ has been shown to be the most sensitive to change and in this study demonstrated a further potential benefit. |
| first_indexed | 2024-04-12T06:47:17Z |
| format | Article |
| id | doaj.art-b9accd6714d14dea94f1a45888edee37 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-04-12T06:47:17Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-b9accd6714d14dea94f1a45888edee372022-12-22T03:43:29ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142022-11-01710.1177/2473011421S01012Patient Specific Instrumentation and Total Ankle ArthroplastyJames K. YauAn MurtyRajesh KakwaniDavid N. Townshend MBBS, FRCS(Tr&Orth)Category: Ankle Arthritis; Ankle Introduction/Purpose: Total Ankle Arthroplasty (TAA) can now be performed using Patient Specific Instrumentation (PSI). Advantages include the ability to pre-operatively plan bone resections and implant position and reduce the number of intra- operative surgical steps. The aim of this study was to compare PSI with Standard Instrumentation (SI) in a non-randomised retrospective cohort study with respect to patient reported outcomes, tourniquet time, fluoroscopy time and post-operative alignment. Methods: 159 patients (111 male, 48 female) undergoing a total of 168 INFINITY TAA using PSI (Prophecy, Wright Medical Technology) or SI between 2014 and 2020 were included with a minimum follow up of 12 months. Patient reported outcome measures (PROMS) were obtained pre-operatively and at one year and included the Manchester-Oxford Foot Questionnaire (MOXFQ), Ankle Osteoarthritis Scale (AOS) and EQ-5D Index. Coronal plane deformity correction was assessed using the midline tibiotalar angle (MTTA). Demographics, tourniquet time and intra-operative fluoroscopy times were obtained from the hospital records. Results: There were 106 TAA in the SI group and 62 TAA in the PSI group. The was no significant difference in total MOXFQ, AOS or EQ5D. There was however a significant difference (p=.032) in favour of PSI in the walking/standing domain of the MOXFQ at 12 months. There was a significantly reduced tourniquet time (PSI mean: 95.39 mins, SI mean: 116.87 mins, p<.001) and radiation exposure (PSI mean: 31 seconds, SI mean: 53 seconds, p<.001). Angular correction was more accurate in the PSI group (PSI mean: 1.29°, SI mean: 2.26°, p=.005). Conclusion: This study supports the use of patient specific instrumentation to decrease operative time, reduce intraoperative fluoroscopy and improve accuracy of implantation in TAA. The walking/standing domain of the MOXFQ has been shown to be the most sensitive to change and in this study demonstrated a further potential benefit.https://doi.org/10.1177/2473011421S01012 |
| spellingShingle | James K. Yau An Murty Rajesh Kakwani David N. Townshend MBBS, FRCS(Tr&Orth) Patient Specific Instrumentation and Total Ankle Arthroplasty Foot & Ankle Orthopaedics |
| title | Patient Specific Instrumentation and Total Ankle Arthroplasty |
| title_full | Patient Specific Instrumentation and Total Ankle Arthroplasty |
| title_fullStr | Patient Specific Instrumentation and Total Ankle Arthroplasty |
| title_full_unstemmed | Patient Specific Instrumentation and Total Ankle Arthroplasty |
| title_short | Patient Specific Instrumentation and Total Ankle Arthroplasty |
| title_sort | patient specific instrumentation and total ankle arthroplasty |
| url | https://doi.org/10.1177/2473011421S01012 |
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