Patient-specific template shortens the operative time in total knee arthroplasty in comparison to the conventional technique

M, Elnemr; Hafez, Mahmoud A.; Aboelnasr, K; Radwan, Mohamed A

doi:10.1097/bco.0000000000000343

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…The available custom-made cutting guides could be limited in late-presentation cases or for old patients, which could be explained by the fact that the technique does not depend on CT scans. 12 …”

Section: Discussionmentioning

confidence: 99%

Hospital-based Patient-specific Templates for Total Knee Arthroplasty: A Proof of Concept Clinical Study

Hafez

Hamza

Nabeel

2018

Techniques in Orthopaedics

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Introduction:All available patient-specific instruments or patient-specific templates (PSTs) are controlled by implant companies. Most of these companies outsource some of the steps of the PST such as imaging, preoperative planning, manufacturing of PST, and packing/sterilization. This is a proof of concept clinical study on the hospital-based PST system for total knee arthroplasty (TKA).Methods:A total number of 257 TKA procedures were performed on the basis of a new concept of hospital-based PSTs. All 5 steps of the PST [ie, imaging (computed tomographic scanning), planning, PST production, packing/sterilization, and surgery] were performed by the hospital. All cases included in this work are documented in the Egyptian Community Arthroplasty Register.Results:All cases had their surgeries performed without resorting to conventional intramedullary guides. Computed tomography–based imaging was easy and affordable. Planning was controlled by the surgeon. Polyamide nylon was the best available material and it was autoclavable. Desktop 3-dimensional printers were able to produce PSTs made of nylon, but it was difficult and time consuming. Industrial printers were superior in quality to desktop printers but more expensive. The whole process could be performed in as short a duration as 3 working days.Conclusions:Hospital-based PST was feasible and it was facilitated by the introduction of desktop 3-dimensional printers. This technique was less expensive and more time saving than commercially available PSTs as well as the conventional TKA.

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Section: Discussionmentioning

confidence: 99%

Hospital-based Patient-specific Templates for Total Knee Arthroplasty: A Proof of Concept Clinical Study

Hafez

Hamza

Nabeel

2018

Techniques in Orthopaedics

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“…PSI was first introduced for total knee arthroplasty (TKA) and shoulder arthroplasty. In total knee arthroplasty, PSI improves the accuracy of the femoral component and global mechanical alignment but might increase the risk of outliers for the tibial component alignment, while it can deliver better outcomes of operative time and blood loss in TKA [ 7 , 8 ]. THA using PSI assistance was also developed for better accuracy of hip surgery than conventional THA and the postoperative functional outcomes [ 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

A Novel Technique for Autograft Preparation Using Patient-Specific Instrumentation (PSI) Assistance in Total Hip Arthroplasty in Developmental Dysplasia of Hip (DDH)

Lin,

Chou,

Luo

et al. 2023

JPM

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Due to the change in the structure of the proximal femur and acetabulum in patients with developmental dysplasia of the hip, total hip arthroplasty (THA) was difficult to perform for surgeons. To elevate the acetabular coverage rate, we developed a technique in the use of a patient-specific instrumentation (PSI) graft in patients with developmental dysplasia of hip (DDH) undergoing surgery. This study aims to evaluate the peri-operative outcomes of THA with PSI graft in patients with DDH. This study recruited 6 patients suffering from Crowe I DDH with secondary Grade IV osteoarthritis. All the patients underwent THA with PSI graft performed by a well-experienced surgeon. Perioperative outcomes included surgical procedures, blood loss during operation, the volume of blood transfusion, length of hospitalization, complications, and the mean difference in hemoglobin levels before and after surgery. All the outcomes analyzed were assessed by mean and standard deviation. The average duration of the surgical procedure was found to be 221.17 min, with an SD of 19.65 min. The mean blood loss during the operation was 733.33 mL, with an SD of 355.90 mL. The mean length of hospital stay was calculated to be 6 days, with an SD of 0.89 days. Furthermore, the mean difference between the pre- and postoperative hemoglobin levels was 2.15, with an SD of 0.99. A total of three patients received 2 units of leukocyte-poor red blood cells (LPR) as an accepted blood transfusion. There were no reported complications observed during the admission and one month after the operation. This study reported the peri-operative outcomes in the patients with DDH who underwent THA with PSI graft. We found that THA with PSI graft would provide a safe procedure without significant complications. We assumed that the PSI graft in THA may increase the coverage rate of the acetabulum, which may increase the graft union rates. Further cohort studies and randomized controlled trials were needed to confirm our findings.

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The difference in leg lengths following total knee replacement for patients with severe osteoarthritic deformity

Hafez,

Mosa,

Abdelaal

et al. 2023

International Orthopaedics (SICOT)

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Purpose Increased height after total knee replacement surgery (TKR) may offer patients higher satisfaction as well as the quality of life. Therefore, in this paper, we aim to document the changes in leg length after TKR in patients with severe bilateral deformities. Methods The data of 61 patients were collected from the Egyptian Community Arthroplasty Register; of them, 21 patients had unilateral TKR while 40 had bilateral simultaneous TKR. The patterns of changes in height of 101 osteoarthritic knees were followed up for 1 year after having TKR. All patients had standing leg X-rays, before and after surgery, to document the length of the femur and tibia before and after TKR. Correlations were assessed using the two-sample t-test. Results The sample was mostly females (56/61, 91.8%). The distribution of the operated side was nearly equal (right knee was 47/101, 46.5%). The overall average leg length difference was 5.4 (SD = 2.3); for the unilateral group, the average was 4.6 (SD = 2.6); and for the bilateral group, the average was 5.6 (SD = 2.3), p = 0.119. We found that leg length may differ according to the varus deformity angle (p < 0.001) as well as fixed flexion deformity (p < 0.001). Conclusions Leg length increased significantly 1 year after TKR. However, there is not enough evidence to suggest that the bilateral group had a greater height increase when compared to the unilateral group.

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Patient-specific template shortens the operative time in total knee arthroplasty in comparison to the conventional technique

Cited by 4 publications

References 14 publications

Hospital-based Patient-specific Templates for Total Knee Arthroplasty: A Proof of Concept Clinical Study

Hospital-based Patient-specific Templates for Total Knee Arthroplasty: A Proof of Concept Clinical Study

A Novel Technique for Autograft Preparation Using Patient-Specific Instrumentation (PSI) Assistance in Total Hip Arthroplasty in Developmental Dysplasia of Hip (DDH)

The difference in leg lengths following total knee replacement for patients with severe osteoarthritic deformity

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