There was a trend towards a protective effect  with PSCB for the risk of femoral component outliers , but the opposite was observed for the tibial component .
Conclusions This meta- analysis found no evidence that using patient-specific cutting blocks provides superior accuracy to using manual instrumentation during TKA
Purpose Because published studies on the accuracy achieved with patient-specific guides during total knee arthroplasty ( TKA ) contradict each other , this systematic review and meta- analysis sought to compare radiological TKA outcomes when patient-specific cutting blocks ( PSCB ) were used to the outcomes when st and ard manual instrumentation was used .
Patient-specific Total Knee Arthroplasty Required Frequent Surgeon-directed Changes
Background Patient-specific instrumentation potentially improves surgical precision and decreases operative time in total knee arthroplasty ( TKA ) but there is little supporting data to confirm this presumption . Questions / purpose sWe asked whether patient-specific instrumentation would require infrequent intraoperative changes to replicate a single surgeon ’s preferences during TKA and whether patient-specific instrumentation guides would fit securely . Methods We prospect ively evaluated the plan and surgery in 60 patients treated with 66 TKAs performed with patient-specific instrumentation and recorded any changes . A subset of six postoperative radiographic changes to the femoral and tibial components ( implant size , coronal and sagittal alignment ) was analyzed to determine if surgeon intervention was beneficial . Each guide was evaluated to determine fit . We compared patient demographics and implant sizing in the patient-specific instrumentation group with a control group in which traditional instrumentation was used . Results We recorded 161 intraoperative changes in 66 knee arthroplasties ( 2.4 changes/knee ) performed with patient-specific instrumentation . The predetermined implant size was changed intraoperatively in 77 % of femurs and 53 % of tibias . We identified a subset of 95 intraoperative changes that could be radiographically evaluated to determine if our changes were an improvement or detriment to reaching goal alignment . Eighty-two of the 95 changes ( 86 % ) made by the surgeon were an improvement to the recommended alignment or size of patient-specific instrumentation . The guide did not fit securely on eight femurs ( 12 % ) and three tibias ( 5 % ) . Tourniquet time and blood loss were not improved with patient-specific instrumentation . Conclusions We caution surgeons against blind acceptance of patient-specific instrumentation technology without supportive data .Level of Evidence Level III , therapeutic study . See Guidelines for Authors for a complete description of levels of evidence
There was a trend towards a protective effect  with PSCB for the risk of femoral component outliers , but the opposite was observed for the tibial component .
Conclusions This meta- analysis found no evidence that using patient-specific cutting blocks provides superior accuracy to using manual instrumentation during TKA
Purpose Because published studies on the accuracy achieved with patient-specific guides during total knee arthroplasty ( TKA ) contradict each other , this systematic review and meta- analysis sought to compare radiological TKA outcomes when patient-specific cutting blocks ( PSCB ) were used to the outcomes when st and ard manual instrumentation was used .