A comparison of alignment using patient specific guides, computer navigation and conventional instrumentation in total knee arthroplasty

MacDessi, Samuel J.; Jang, Bob; Harris, Ian A.; Wheatley, Emma; Bryant, Carl; Chen, Darren B.

doi:10.1016/j.knee.2013.11.004

Cited by 63 publications

(54 citation statements)

References 17 publications

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“…This is consistent with other studies which also found a reduction in duration of surgery, owing to more time-efficient positioning and sizing during surgery [16,27,36,37,48]. We also found a shorter duration of surgery in the MRI-based patient-specific instrumentation group compared with the CT-based patient-specific instrumentation group.…”

Section: Discussionsupporting

confidence: 92%

“…However, the rate of outliers greater than 3°representing more clinical effect also was reduced in both patient-specific instrumentation groups in all three planes. Although this has been shown in several studies for coronal alignment [10,15,27], numerous studies have shown no difference in postoperative coronal alignment between patient-specific instrumentation and conventional instrumentation [2,24,26,37,49]. Less information is available regarding sagittal and rotational alignment [10,18,38,46].…”

Section: Discussionmentioning

confidence: 98%

“…However, the goals of the study were to investigate immediate postoperative alignment and early postoperative outcome. Patient-specific instrumentation is advocated to be less invasive owing to the intact femoral medullary canal [16,27]. In the case of fast-track rehabilitation protocols early postoperative outcome might be of interest.…”

Section: Discussionmentioning

confidence: 99%

“…While there have been studies comparing patient-specific instrumentation with conventional instrumentation the published results are not consistent and most focus on coronal alignment [2,10,14,27,[35][36][37]. There are only a few studies looking at sagittal alignment [10,15,24,27,39] and even fewer looking at rotational alignment [27,39].…”

Section: Introductionmentioning

confidence: 99%

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Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

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Background Patient-specific instrumentation in TKA has the proposed benefits of improving coronal and sagittal alignment and rotation of the components. In contrast, the literature is inconsistent if the use of patient-specific instrumentation improves alignment in comparison to conventional instrumentation. Depending on the manufacturer, patient-specific instrumentation is based on either MRI or CT scans. However, it is unknown whether one patient-specific instrumentation approach is more accurate than the other and if there is a potential benefit in terms of reduction of duration of surgery. Questions/purposes We compared the accuracy of MRIand CT-based patient-specific instrumentation with conventional instrumentation and with each other in TKAs. The three approaches also were compared with respect to validated outcomes scores and duration of surgery. Methods A randomized clinical trial was conducted in which 90 patients were enrolled and divided into three groups: CT-based, MRI-based patient-specific instrumentation, and conventional instrumentation. The groups were not different regarding age, male/female sex distribution, and BMI. In all groups, coronal and sagittal alignments were measured on postoperative standing long-leg and lateral radiographs. Component rotation was measured on CT scans. Clinical outcomes (Knee Society and WOMAC scores) were evaluated preoperatively and at a mean of 3 months postoperatively and the duration of surgery was analyzed for each patient. MRI-and CT-based patientspecific instrumentation groups were first compared with conventional instrumentation, the patient-specific instrumentation groups were compared with each other, and all three approaches were compared for clinical outcome measures and duration of surgery. Results Compared with conventional instrumentation MRI-and CT-based patient-specific instrumentation showed higher accuracy regarding the coronal limb axis

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Small Improvements in Mechanical Axis Alignment Achieved With MRI versus CT-based Patient-specific Instruments in TKA: A Randomized Clinical Trial

Pfitzner

Abdel

Roth

et al. 2014

Clinical Orthopaedics &Amp; Related Research

101

View full text Add to dashboard Cite

show abstract

“…In rare cases those pins can be a potential source for infection or fracture, so that this can be stated as a disadvantage. Another disadvantage is the fact that those small alterations, like pin placement or palpation of anatomical landmarks add time to the surgical procedure, 7 in particular at the beginning of the learning curve and with …”

Section: First Years Of Experience With Casmentioning

confidence: 99%