Patient-specific instrumentation in total knee arthroplasty: a review of the current literature

Abstract

Total knee arthroplasty (TKA) is one of the most frequently performed interventions in the field of Orthopaedic surgery. Over the last decades the implantation technique has improved continuously. The majority of patients is satisfied with the clinical outcome of TKA. However in various clinical follow-ups, up to 20% of unsatisfied patients can be observed. Periprosthetic infection and aseptic loosening seem to be the most common reasons for failure. Malalignment has been discussed as a cause of aseptic loosening and often leads to revision surgery. In order to increase the precision of implant positioning and alignment, new technologies such as patient-specific instrumentation (PSI) have been developed. Since the introduction of PSI, multiple clinical studies have been performed analyzing the clinical and radiological outcome of TKA with PSI technique. This review covers the recent literature of PSI in respect to surgical accuracy, clinical outcome, time- and cost-effectiveness.

Osteosarcoma After Total Knee Arthroplasty

“…Treatment of these complex tumors should be guided by multidisciplinary teams and take into consideration the neoplastic type, cancer stage, implant involvement, and patient characteristics 1,2 . In the 6 reviewed case reports, only 1 patient was able to undergo limb salvage surgery with wide surgical excision and endoprosthesis reconstruction (16.7%) 5,9 ; the remaining 5 patients required amputation (83%) 3,4,6,7 . No patients in this cohort received adjuvant chemotherapy or radiation therapy.…”

“…The presentation of a primary malignant tumor in the context of a primary or revision total knee arthroplasty (TKA) is extremely rare. There are only few cases reported [3][4][5][6][7] . All of them have in common the difficulty of its diagnosis and the severity of this rare condition, which may lead to aggressive limb salvage procedures, amputation, or even death.…”