Patient satisfaction - A comparison between patient-specific implants and conventional total knee arthroplasty

Abstract

Background: Despite recent innovations in total knee arthroplasty, 20% of the patients are not completely satisfied with the clinical results. Regarding patient-specific implants (PSI), the study aims to compare individual and off-the-shelf implant (OSI) total knee arthroplasty (TKA) concerning the postoperative outcome like function and global patient satisfaction. Methods: In 2013/14 228 patients received a TKA due to primary osteoarthritis with an indication for a bicondylar, cruciate retaining prosthesis. 125 patients received a PSI and 103 an OSI TKA. The outcome after surgery was evaluated retrospectively by two questionnaires and a clinical follow-up examination. The Knee Society Score (KSS) was used to evaluate function. To compare the satisfaction the Knee Injury and Osteoarthrosis Outcome Score (KOOS) and a modified EuroQol (EQ) including five additional questions were used. Finally, 84 patients with PSI and 57 with OSI completed follow-up. Results: Concerning demographic data, the PSI group showed a significantly younger age, five years on average. The ROM was comparable in both groups. The KSS and the separate function score achieved significantly better results in the PSI group. For subjects with PSI TKA, the global satisfaction showed significant better values. Conclusions: The significantly higher values in KSS and its function score lead to a better basic daily function in PSI group. In addition, the PSI TKA achieved a higher global patient satisfaction. Nevertheless, both should mainly be assessed in the context of average younger age and the influence of expectations.

New Technologies in Knee Arthroplasty: Current Concepts

“…Very few studies have reported clinical outcomes after custom implants. Reimann et al described that the patient-specific implants might increase patient satisfaction at 2 years [ 20 ]. Schwarzkopf et al and White et al, found no significant difference in clinical outcomes, with only a tendency to decreased range of motion [ 21 , 22 ].…”

Clinical and Radiological Outcomes after Knee Arthroplasty with Patient-Specific versus Off-the-Shelf Knee Implants: A Systematic Review

“…In contrast, Schwarzkopf et al [ 24 ] reported a decrease of 3.44° (range, −83° to 55°) in ROM after TKA with PSI, whereas patients receiving OTS implants showed an increase of 1.54° (range, −80° to 90°, p < 0.1). The remaining authors did not observe statistically significant differences in ROM between both groups [ 20 , 22 , 25 , 26 , 27 ].…”

“…The literature search yielded a total of 1430 publications and, after allocation processes shown in Figure 1 , 13 articles met the criteria for this systematic review. Of these articles, 11 investigated the outcomes after TKA [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ] and two investigated the outcomes after UKA [ 27 , 28 ] with PSI versus OTS implants. There were four prospective cohort studies and nine retrospective cohort studies.…”

The Use of Customized Total Knee Arthroplasty Implants to Increase Efficiency in the Operating Room and Improve Patient Outc

“…There is now over a decade of experience with customized implants, including over 100,000 implantations worldwide. Previous peer-reviewed studies confirm that patient specific TKA implants provide improved fit and alignment 9,10,11,12 , better kinematic function 13,14 , reduced short-term complication rates 15,16 , higher patient satisfaction 17,18 , and overall cost savings 15,16,19,20 when compared to standard off the shelf implants. Data from the UK National Joint Registry (UKNJR), recently released by Beyond Compliance, highlight a lower cumulative revision rate for the custom cruciate retaining implants than that of all other knee implants in the UKNJR 21 .…”