Biomechanical and Clinical Effect of Patient-Specific or Customized Knee Implants: A Review

Abstract

(1) Background: Although knee arthroplasty or knee replacement is already an effective clinical treatment, it continues to undergo clinical and biomechanical improvements. For an increasing number of conditions, prosthesis based on an individual patient’s anatomy is a promising treatment. The aims of this review were to evaluate the clinical and biomechanical efficacy of patient-specific knee prosthesis, explore its future direction, and summarize any published comparative studies. (2) Methods: We searched the PubMed, MEDLINE, Embase, and Scopus databases for articles published prior to 1 February 2020, with the keywords “customized knee prosthesis” and “patient-specific knee prosthesis”. We excluded patient-specific instrument techniques. (3) Results: Fifty-seven articles met the inclusion criteria. In general, clinical improvement was greater with a patient-specific knee prosthesis than with a conventional knee prosthesis. In addition, patient-specific prosthesis showed improved biomechanical effect than conventional prosthesis. However, in one study, patient-specific unicompartmental knee arthroplasty showed a relatively high rate of aseptic loosening, particularly femoral component loosening, in the short- to medium-term follow-up. (4) Conclusions: A patient-specific prosthesis provides a more accurate resection and fit of components, yields significant postoperative improvements, and exhibits a high level of patient satisfaction over the short to medium term compared with a conventional prosthesis. However, the tibial insert design of the current patient-specific knee prosthesis does not follow the tibial plateau curvature.

No difference in patient-reported satisfaction after 12 months between customised individually made and off-the-shelf total knee arthroplasty

“…One reason may be the high variability of knee phenotypes between individuals, ethnicities and sex [ 4 , 7 , 13 , 19 , 22 ]. Customised individually made (CIM) TKA have been developed to overcome these problems and improve outcome after TKA [ 5 , 17 , 44 ]. CIM TKA incorporate a bone-preserving approach using custom planning images, implants and instrumentation [ 44 ].…”

Global trends in the development of complex, personalized, biomedical, surgical implant devices using 3D printing/additive manufacturing: A review

“…While the US has performed similar trials nationwide, China has become a world leader in innovative and complex bone replacement surgeries as illustrated for example in Figure 5 (Cai, 2015;Xia et al, 2019). China has also embarked on programmes to manufacture SLM and EBM systems and Gadia et al, 2018;Huang et al, 2019;Kalaskun, 2017;Lee et al, 2020;Murr, 2019Murr, , 2020Tofail et al, 2018;Wohlers Report, 2019, 2019Woo et al, 2020;Zhang & Chen, 2019). This trend in global customizing of biomedical devices might be popularly referred to as mass-personalization which is made possible by 3D printing in point-of-care surgical service centres, along with other emerging technologies (Marr, 2020).…”

“…While COVID‐19 has variously dominated hospital functionalities worldwide in the first half of 2020, the passing of this global pandemic will likely see a rapid return to the proliferation of patient‐specific, complex, open‐cellular biomedical implant device development, clinical trials and the establishment of bone‐related surgical service centres producing a wide range of custom bone replacement devices; based in part on contemporary applications and market analyses (Ahangar et al, 2019; Dall’Ava L et al, 2019; Gadia et al, 2018; Huang et al, 2019; Kalaskun, 2017; Lee et al, 2020; Murr, 2019, 2020; Tofail et al, 2018; Wohlers Report, 2019, 2019; Woo et al, 2020; Zhang & Chen, 2019). This trend in global customizing of biomedical devices might be popularly referred to as mass‐personalization which is made possible by 3D printing in point‐of‐care surgical service centres, along with other emerging technologies (Marr, 2020).…”

Klinische Studien in Unfallchirurgie und Orthopädie: lesen, interpretieren und umsetzen

“…Technologischer Fortschritt und Informationsexplosion Praxis, Forschung und Lehre in Unfallchirurgie und Orthopädie haben sich seit Beginn des neuen Jahrtausends grundlegend gewandelt. Auf der Technologie-, Struktur-und Prozessebene haben u. a. biologische und augmentierte Osteosyntheseverfahren, minimal-invasive Zugangswege, Navigation und Robotik [2,3,4], individualisierte Interventionen und Implantate [5], "Fast-track"-Konzepte [6], evidenzbasierte, partizipative Entscheidungsfindung [7], "value-based medicine" [8] und Maßnahmen zur Patientensicherheit [9] Einzug in den klinischen Alltag gehalten. Bei geschätzt etwa 3 Mio.…”