A review of rapid prototyped surgical guides for patient-specific total knee replacement

Krishnan, Shibu P.; Dawood, Andrew; Richards, Robin R.; Henckel, Johann; Hart, Alister

doi:10.1302/0301-620x.94b11.29350

Cited by 117 publications

(94 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Most reports have focused on the avoidance of alignment outliers and the potential cost-effectiveness of this technology, demonstrating mixed results [6, 14, 23-25, 33-35, 39]. With regard to component and overall alignment, studies have failed to consistently demonstrate an improved accuracy with the use of CCGs versus standard instrumentation [6,11,18,24,40]. Furthermore, the costeffectiveness of this technology has not been proven, because the potentially decreased operative times and instrument trays required might not offset the additional costs of preoperative imaging and CCG fabrication [6,33,39].…”

Section: Discussionmentioning

confidence: 99%

“…Numerous potential benefits of CCGs exist compared with both standard and computer-assisted surgical instrumentation, including their ease of use; a decrease in operative times and instrument trays; the ability to preoperatively plan for component size, alignment, and position; and an improvement in postoperative alignment versus the use of standard alignment methods [4,18,23]. However, to date the majority of reports have not confirmed these proposed benefits [6,11,33,37,39,41].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

Nam

Park

Stambough

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Custom cutting guides (CCGs; sometimes called patient-specific instrumentation [PSI]) in total knee arthroplasty (TKA) use preoperative three-dimensional imaging to fabricate cutting blocks specific to a patient's native anatomy. Questions/purposes The purposes of this study were to determine if CCGs (1) improve clinical outcomes as measured by UCLA activity, SF-12, and Oxford knee scores; and (2) coronal mechanical alignment versus standard alignment guides. Methods This was a retrospective cohort study of patients undergoing primary TKA using the same cruciate-retaining, cemented TKA system between January 2009 and April 2012. Patients were included if they were candidates for a unilateral, cruciate-retaining TKA and met other prespecified criteria; patients were allowed to self-select either an MRI-based CCG procedure or standard TKA. Ninety-seven of 120 (80.8%) patients in the standard and 104 of 124 (83.9%, p = 0.5) in the CCG cohort with a minimum of 1-year followup were available for analysis. The first 95 patients in the standard (mean followup, 3 years; range, 1-4 years) and CCG (mean followup, 2 years; range, 1-4 years) cohorts were compared. The alignment goal for all TKAs was a hip-knee-ankle (HKA) angle of 0°. UCLA, SF-12, and Oxford knee scores were collected preoperatively and at each patient's most recent followup visit. Postoperative, rotationally controlled coronal scout CT scans were used to measure HKA alignment. Independent-sample t-tests and chi-square tests were used

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

Nam

Park

Stambough

et al. 2016

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

“…However, clinical studies already suggest this new technology as a promising and useful option in the future [1][2][3][4][5][6][7][9][10][11][12][13]. Benefits of 3D models include reduced surgical time, decreased amount of blood loss, risk of infections and exposure to ionizing radiations.…”

Section: Discussionmentioning

confidence: 99%

Traumatological Application of 3D Model in Complex Acetabular Fractures

Battiato¹

2017

Trauma Cases Rev

View full text Add to dashboard Cite

Three-dimensional reconstruction (3D) and rapid prototyping (RPT), starting from computed tomographic (CT) examinations, is a promising technology in traumatology. It facilitates the planning and surgical results of complex fractures. Here, we used it in a complex bilateral acetabulum fracture for the assessment of the injury type and for improving knowledge of the fracture fragments. The patient was a forty-five-year-old male, with no accompanying fractures. The solid model allowed an accurate preoperative and intraoperative planning. The 3D printed model improved the understanding of anatomy of the fractures, in order to facilitate the surgical approach and the creation of dedicated pre-shaped plates. The use of the 3D model reduced surgical time, intraoperative soft tissues damage and blood loss as well as the risk of infections. Fluoro scoping imaging was also minimized. This case highlights the importance of 3D model in the management of complex fractures. Keywords Trauma, Innovations in traumatology, Rapid prototyping, PelvisWe show our experience with 3D printing on two complex fractures of both acetabula present on the same patient (fracture patterns: two columns on the left and a T-shaped on the right). Surgery was performed in a single operative session with the continued comparison of the sterilized 3D model. The 3D-printed model allowed a faster and accurate understanding of the morphology of the fracture and a more accuratepreoperative planning. In this case, surgeons simulated the operative planning (i.e. fracture reduction, screw measurement, and plate positioning). This simulation allowed the modelling of plates before surgery, thus reducing both the operating time and fluoroscopic imaging. Case ReportIn July 2015 a forty-five-year-old male patient presented to our trauma centre for a complex bilateral acetabular fracture (Figure 1) after a car accident. The patient did not present accompanying fractures or bleedings and was hemodynamically stable. At the time of presentation, CT scans were taken with conventional 16-detector CT scanners with slice thickness of 0.625 mm. The DICOM imaging files were converted in the software Mimics (Metarialise, Leuven, Belgium) by acquisition of three 2D plans (axial, coronal, sagittal) and one 3D view. 2D CT slices have a white/black appearance referring to the density of the material. Mimics is able to isolate a particular type of material starting from a selected colour (this type of process is called thresholding). Once the material has been selected, it can be transformed into a 3D image, then the file can

show abstract

“…These days, revolutionary changes within the elective knee arthroplasty have taken place due to industry driven interventions [11] . Patient specific matched guides (PSG) for TKA is a relatively new technique to align the knee prosthesis, using 3D rapid prototyped disposable cut or pin guides that fits on the native anatomy of the individual patient [12,13] . This perioperative guiding technique eliminates the use of intra-and extra medullar rods to make bony resections.…”

Section: Introductionmentioning

confidence: 99%

Patient specific guides for total knee arthroplasty are ready for primetime

Schotanus

Boonen

Kort

2016

WJO

View full text Add to dashboard Cite

AIM:To present the radiological results of total knee arthroplasty (TKA) with use of patient specific matched guides (PSG) from different manufacturer in patients suffering from severe osteoarthritis of the knee joint. METHODS:This study describes the results of 57 knees operated with 4 different PSG systems and a group operated with conventional instrumentation (n = 60) by a single surgeon. The PSG systems were compared with each other and subdivided into cut-and pin PSG. The biomechanical axis [hip-knee- RESULTS:The inter class correlation coefficient (ICC) revealed that radiographic measurements between both assessors were reliable (ICC > 0.8). Fisher exact test was used to test differences of proportions. The percentage of outliers of the HKA-axis was comparable between both the PSG and conventional groups (12.28% vs 18.33%, P < 0.424) and the cut-and pin PSG groups (14.3% vs 10.3%, P < 1.00). The percentage of outliers of the FFC (0% vs 18.33%, P < 0.000), LFC (15.78% vs 58.33%, P < 0.000) and LTC (15.78% vs 41.67%, P < 0.033) were significant different in favour of the PSG Core tip: Total knee arthroplasty (TKA) is one of the most successful and commonly performed surgical procedure for the treatment of severe knee osteoarthritis with excellent 15-20 years survivorships. This article provides an analysis on patient specific matched guides (PSG) between different manufacturers and the conventional technique and between pin-and cutting guides for TKA. In addition, we compared our results with previous studies (level 1 evidence), which are generally unambiguous, and show no radiological difference. However, in this trial, we do see difference in favour of the PSG technique.Schotanus MGM, Boonen B, Kort NP. Patient specific guides for total knee arthroplasty are ready for primetime. World J Orthop 2016; 7(1): 6168 Available from:

show abstract

A review of rapid prototyped surgical guides for patient-specific total knee replacement

Cited by 117 publications

References 31 publications

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

Traumatological Application of 3D Model in Complex Acetabular Fractures

Patient specific guides for total knee arthroplasty are ready for primetime

Contact Info

Product

Resources

About