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- Title
Assessing the accuracy of patient-specific guides for total knee arthroplasty.
- Authors
Seon, Jong-Keun; Park, Hyeong-Won; Yoo, Seung-Hyun; Song, Eun-Kyoo
- Abstract
<bold>Purpose: </bold>Patient-specific guides have been introduced recently as a means of making accurate bone cuts through custom cutting blocks constructed based on pre-operative three-dimensional imaging. However, the controversy concerning the improved results of patient-specific guides have not been resolved yet; in addition, there have been no studies to investigate the causes of variable with inconsistent results and solutions for the causes.<bold>Methods: </bold>Thirty eight patients (38 knees) underwent total knee arthroplasty with patient-specific guides. The mean age of the patients was 68 years (SD ± 6.3), and all patients had a minimum 2-year follow-up. An intra-operative alignment using navigation and the causes of outliers were evaluated.<bold>Results: </bold>An average coronal alignment of PSI jigs was 0.5° (SD ± 0.9°) in femur and 0.1° (SD ± 0.8°) in tibia, and the number of outliers was two and three cases, respectively. An average sagittal alignment was 0.6° (SD ± 0.9°) in femur and 5.5° (SD ± 1.1°) in tibia, and the number of outliers was three and five cases, respectively. All outliers resulted from large osteophytes near the contact point of patient-specific guides which disturb sitting of the guide.<bold>Conclusion: </bold>It was suggested that patient-specific guides were an effective and safe method to achieve accurate alignments, with no additional intra-operative complication. It is important to note that surgeons need to be precautious using the patient-specific instrumentation in patients with severe varus deformity. In addition, existing osteophytes which disturb sitting of the guides should be carefully evaluated pre-operatively and intra-operatively.<bold>Level Of Evidence: </bold>IV.
- Subjects
TOTAL knee replacement; BONE surgery; FEMUR; TIBIA; MEDICAL imaging systems; THREE-dimensional imaging; BONE spurs; FEMUR surgery; TIBIA surgery; KNEE diseases; METAPLASTIC ossification; OSTEOARTHRITIS; COMPUTER-assisted surgery
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2016, Vol 24, Issue 11, p3678
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-014-3429-z