We did not find any differences between PSI and SI with respect to any other parameters .
Conclusions PSI  has advantages in axial alignment of the femoral component , operative time , and perioperative blood loss relative to SI .
No significant differences were found between PSI and SI with respect to alignment of the remaining components , number of outliers , or length of hospital stay .
Purpose The purpose of the present study was to compare patient-specific instrumentation ( PSI ) with st and ard instrumentation ( SI ) in patients undergoing total knee arthroplasty ( TKA ) .
PSI is hypothesized to have advantages with respect to component alignment ; number of outliers ( defined as alignment > 3 ° from the target alignment ) ; operative time ; perioperative blood loss ; and length of hospital stay .
This new surgical technique is expected to exhibit superior performance .
Patient-specific Guides Do Not Improve Accuracy in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial
Background Recently , patient-specific guides ( PSGs ) have been introduced , cl aim ing a significant improvement in accuracy and reproducibility of component positioning in TKA . Despite intensive marketing by the manufacturers , this cl aim has not yet been confirmed in a controlled prospect i ve trial . Questions / purpose sWe ( 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 r and omized 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 ab and oned and marked as an outlier . When cranial-caudal position or size was adapted , the PSG was marked as modified . All patients underwent long-leg st and ing 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 ab and oned 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 ab and oned with some frequency . Level of Evidence Level I , therapeutic study . See instructions for authors for a complete description of levels of evidence
We did not find any differences between PSI and SI with respect to any other parameters .
Conclusions PSI  has advantages in axial alignment of the femoral component , operative time , and perioperative blood loss relative to SI .
No significant differences were found between PSI and SI with respect to alignment of the remaining components , number of outliers , or length of hospital stay .
Purpose The purpose of the present study was to compare patient-specific instrumentation ( PSI ) with st and ard instrumentation ( SI ) in patients undergoing total knee arthroplasty ( TKA ) .
PSI is hypothesized to have advantages with respect to component alignment ; number of outliers ( defined as alignment > 3 ° from the target alignment ) ; operative time ; perioperative blood loss ; and length of hospital stay .
This new surgical technique is expected to exhibit superior performance .