Clinical Outcome of Total Knee Arthroplasty Performed Using Patient-Specific Cutting Guides

Abstract

BackgroundPatient-specific instruments have recently gained attention for ensuring the accuracy of osteotomy and correct alignment in total knee arthroplasty (TKA). We aimed to report our experience with TKA performed by using CT-based 3D model of cutting guides in our clinic.Material/MethodsA total of 36 patients (mean age, 67.58±8.46 years; 24 females, 12 males) who underwent TKA with 3D patient-specific cutting guides in our clinic were included in the study. Differences between preoperatively planned bone resections and actual bone resections were calculated. Femoral and tibial component angles were measured on radiographs of the knee. The change in knee pain was evaluated by patients on a 10-point visual analog scale (VAS). Patients were followed up for 6 months postoperatively.ResultsThe actual bone resection was 0.5–1.5 mm higher than the planned resection for all sides, being statistically significant for posterior lateral and distal medial sides (1.1±1.3 mm and 1.5±0.9 mm, respectively; p<0.05). On postoperative radiographs, coronal tibial component angle was 88.8°±0.9° and coronal femoral component angle was 95.2°±1.6°, showing good postoperative alignment. The VAS pain score of patients significantly decreased from preoperative 3.9±0.8 to 1.1±0.9 at 6 months after the operation. One patient developed superficial tissue infection on postoperative follow-up, which was effectively treated. No other pathology was detected in the postoperative period.ConclusionsPatient-specific cutting guides can provide intraoperative guidance for better placement of the implant in TKA and increase the accuracy of osteotomy and postoperative alignment.

Three dimensional patient-specific printed cutting guides for closing-wedge distal femoral osteotomy

“…b After the wedge was removed, the locking guide was fixed on the femur with the remaining K-wires. c After the wedge was closed accurately, the bolt was inserted patient-specific cutting guides to provide intra-operative guidance for better placement of the implant in total knee arthroplasty (TKA) and to increase the accuracy of osteotomy and post-operative alignment [20]. In the present study, 3Dprinted cutting guides and locking guides were used to locate the osteotomy cut plane and to facilitate closing the wedge respectively for MCWDFO.…”

Patient-Specific Instrumentation for Medial Closing Wedge Distal Femoral Osteotomy With Patellar Osteochondral Allograft

“… 16 3D-PSIs have emerged as an alternative technique to conventional methods due to their ability to mold to patient-specific anatomy and have shown high accuracy and consistency in pathologies. 17 , 18 , 19 Previous systematic reviews have found that 3D-PSIs have accurate coronal plane alignment with decreased operative times and intraoperative fluoroscopy for osteotomies. 12 , 14 This technique has demonstrated good short-term outcomes postoperatively.…”