We found that there was no significant benefit from using PS instrumentation in primary knee arthroplasty to aid in the positioning of either the tibial or femoral components .
Furthermore sagittal plane tibial component positioning was worse in the PS than the traditional ST group .
Our results suggest that at present PS instrumentation is not superior to ST instrumentation in primary total knee arthroplasty .
OBJECTIVE The aim of this study was to review the radiological alignment outcomes of patient Specific ( PS ) cutting blocks and St and ard Instrumentation in Primary Total Knee Arthroplasty .
METHODS We hypothesized that the use of PS techniques would significantly improve sagittal , coronal and rotational alignment of the prosthesis on short term .
Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation
Abstract Purpose It was our hypothesis that patient-specific instrumentation ( PSI ) can improve the accuracy of the rotational alignment in TKA based on the concept of the system and on the potential to clearly identify pre-operatively during planning the classical anatomical l and marks that serve as references to set-up the rotation both for the femur and tibia . Material s and methods In this prospect i ve comparative r and omized study , 40 patients ( 20 in each group ) operated in our institution between September 2012 and January 2013 by the 2 senior authors were included . R and omization of patients into one of the two groups was done by the Hospital Informatics Department with the use of a systematic sampling method . All patients received the same cemented high-flex mobile bearing TKA . In the PSI group , implant position was compared to the planed position using previously vali date d dedicated software . The position of the implants ( frontal and sagittal ) was compared in the 2 groups on st and ard X-rays , and the rotational position was analysed on post-operative CT-scan . Results 90 % of the patients add < 2 ° or mm of difference between the planned position of the implants and the obtained position , except for the tibial rotation where the variations were much higher . Mean HKA was 179 ° ( 171–185 ) in the PSI group with 4 outliers ( 2 varus : 171 ° and 172 ° :184 ° and 185 ° ) and 178.3 ° with 2 outliers ( 171 ° and 176 ° ) in the control group . No difference was observed between the two groups concerning the frontal and sagittal position of the implants on the ML and AP X-rays . No significant difference of femoral rotation was observed between the two groups with a mean of 0.4 ° in the PSI group and 0.2 ° in the control group ( p : n.s ) . Mean tibial rotation was 8 ° of internal rotation in the PSI group and 15 ° of internal rotation in the st and ard group ( p : n.s ) . Conclusion Based on our results , we were unable to confirm our hypothesis as PSI can not improve rotation in TKA . More work needs to be done to more clearly define the place of PSI in TKA , to keep on improving the accuracy of the system and to better define the individual targets in TKA in terms of frontal , sagittal and rotational positioning of the implant for each patient . Level of evidence Prospect i ve comparative r and omized study , Level II
We found that there was no significant benefit from using PS instrumentation in primary knee arthroplasty to aid in the positioning of either the tibial or femoral components .
Furthermore sagittal plane tibial component positioning was worse in the PS than the traditional ST group .
Our results suggest that at present PS instrumentation is not superior to ST instrumentation in primary total knee arthroplasty .
OBJECTIVE The aim of this study was to review the radiological alignment outcomes of patient Specific ( PS ) cutting blocks and St and ard Instrumentation in Primary Total Knee Arthroplasty .
METHODS We hypothesized that the use of PS techniques would significantly improve sagittal , coronal and rotational alignment of the prosthesis on short term .