Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty
Purpose To compare patient-specific instrumentation (PSI) with conventional instrumentation in total knee arthroplasty (TKA) in terms of component alignment, operating time, and the learning curve required in a non-teaching hospital. Methods Records of 33 men and 29 women aged 50 to 88 (mean, 71) ye...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2016-08-01
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| Series: | Journal of Orthopaedic Surgery |
| Online Access: | https://doi.org/10.1177/1602400211 |
| _version_ | 1818993718124871680 |
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| author | Warwick Chun-Wang Chan Elizabeth Pinder Mark Loeffler |
| author_facet | Warwick Chun-Wang Chan Elizabeth Pinder Mark Loeffler |
| author_sort | Warwick Chun-Wang Chan |
| collection | DOAJ |
| description | Purpose To compare patient-specific instrumentation (PSI) with conventional instrumentation in total knee arthroplasty (TKA) in terms of component alignment, operating time, and the learning curve required in a non-teaching hospital. Methods Records of 33 men and 29 women aged 50 to 88 (mean, 71) years who underwent TKA for osteoarthritis using PSI (n=31) or conventional instrumentation (n=31) by a single surgeon were reviewed. The choice of instrumentation was made by the patient; the surgeon did not express any preference and had not used PSI before. All patients used the same cemented, cruciate-retaining system. Results The PSI and conventional instrumentation groups were comparable in terms of age, body mass index (BMI), American Society of Anesthesiologists grade, pre- and post-operative haemoglobin level, and the need for blood transfusion. Compared with conventional instrumentation, PSI resulted in a smaller coronal femoral component angle (7.7° vs. 6.4°, p=0.003) and posterior tibial slope angle (6.4° vs. 3.2°, p=0.0001), and smaller variance of the respective angles (p=0.006 and p=0.003). In patients with a BMI ≥30, PSI still resulted in a smaller posterior tibial slope angle (5.8° vs. 3.1°, p=0.015) and variance of the angle (p=0.02). The mean tourniquet time was shorter in the PSI group in all patients (p=0.013) and in patients with BMI ≥30 kg/m 2 (p=0.0008), and its variance was also smaller in the PSI group (p=0.0004). There was no learning curve required. Conclusion PSI was simple to use, with no learning curve required. It can be used in non-teaching hospitals and in patients with a high BMI and in cases where the use of an intramedullary alignment guide would be problematic due to previous femoral trauma. |
| first_indexed | 2024-12-20T20:46:30Z |
| format | Article |
| id | doaj.art-e97d808f795c47e99d434530b5d9cf55 |
| institution | Directory Open Access Journal |
| issn | 2309-4990 |
| language | English |
| last_indexed | 2024-12-20T20:46:30Z |
| publishDate | 2016-08-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Orthopaedic Surgery |
| spelling | doaj.art-e97d808f795c47e99d434530b5d9cf552022-12-21T19:27:02ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902016-08-012410.1177/1602400211Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee ArthroplastyWarwick Chun-Wang ChanElizabeth PinderMark LoefflerPurpose To compare patient-specific instrumentation (PSI) with conventional instrumentation in total knee arthroplasty (TKA) in terms of component alignment, operating time, and the learning curve required in a non-teaching hospital. Methods Records of 33 men and 29 women aged 50 to 88 (mean, 71) years who underwent TKA for osteoarthritis using PSI (n=31) or conventional instrumentation (n=31) by a single surgeon were reviewed. The choice of instrumentation was made by the patient; the surgeon did not express any preference and had not used PSI before. All patients used the same cemented, cruciate-retaining system. Results The PSI and conventional instrumentation groups were comparable in terms of age, body mass index (BMI), American Society of Anesthesiologists grade, pre- and post-operative haemoglobin level, and the need for blood transfusion. Compared with conventional instrumentation, PSI resulted in a smaller coronal femoral component angle (7.7° vs. 6.4°, p=0.003) and posterior tibial slope angle (6.4° vs. 3.2°, p=0.0001), and smaller variance of the respective angles (p=0.006 and p=0.003). In patients with a BMI ≥30, PSI still resulted in a smaller posterior tibial slope angle (5.8° vs. 3.1°, p=0.015) and variance of the angle (p=0.02). The mean tourniquet time was shorter in the PSI group in all patients (p=0.013) and in patients with BMI ≥30 kg/m 2 (p=0.0008), and its variance was also smaller in the PSI group (p=0.0004). There was no learning curve required. Conclusion PSI was simple to use, with no learning curve required. It can be used in non-teaching hospitals and in patients with a high BMI and in cases where the use of an intramedullary alignment guide would be problematic due to previous femoral trauma.https://doi.org/10.1177/1602400211 |
| spellingShingle | Warwick Chun-Wang Chan Elizabeth Pinder Mark Loeffler Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty Journal of Orthopaedic Surgery |
| title | Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty |
| title_full | Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty |
| title_fullStr | Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty |
| title_full_unstemmed | Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty |
| title_short | Patient-Specific Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty |
| title_sort | patient specific instrumentation versus conventional instrumentation in total knee arthroplasty |
| url | https://doi.org/10.1177/1602400211 |
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