Accuracy of MRI-based vs. CT-based patient-specific instrumentation in total knee arthroplasty: A meta-analysis

An, Vincent V.G.; Sivakumar, Brahman; Phan, Kevin; Levy, Yadin D.; Bruce, Warwick

doi:10.1016/j.jos.2016.10.007

Cited by 34 publications

(21 citation statements)

References 26 publications

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“…Several meta‐analyses comparing imaging modalities in total knee arthroplasty demonstrate that MRI‐based patient‐specific instrumentation were at least as good, if not better than CT‐based instrumentation at reducing alignment outliers 14 ,. 15 Additionally, patient‐specific instrumentation has been shown to be at least as good, if not better than conventional instrumentation. Preoperative planning allows determination of resection margins, and implant size and position, in order to improve component alignment and ultimately revision rates 4 ,.…”

Section: Discussionmentioning

confidence: 99%

Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Kanawati

Fernandes

Gee

et al. 2021

Robotics Computer Surgery

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Background This study will examine the differences between human lumbar vertebrae, three‐dimensional (3D) scans of these bones, 3D models based on ‘Black‐bone’ magnetic resonance imaging (MRI) scans, and 3D‐printed models. Materials and Methods 3D mesh models were created from the “Black‐bone” MRI data from two cadaveric human spines, and then 3D printed. Four models were analysed and compared: anatomic bones, 3D‐scanned models, MRI models and 3D‐printed models. Results There was no significant difference between when comparing the average of all measurements between all model types (p = 0.81). The mean dice coefficient was 0.91 (SD 0.016) and the mean Hausdorff distance was 0.37 mm (SD 0.04 mm) when comparing the MRI model to the 3D‐scanned model. The mean volumes for the MRI model and the 3D scanned model were 10.42 and 10.04 ml (p = 0.085), respectively. Conclusions The ‘Black‐bone’ MRI could be a valid radiation‐free alternative to computed tomography for the 3D printing of lumbar spinal biomodels.

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Section: Discussionmentioning

confidence: 99%

Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Kanawati

Fernandes

Gee

et al. 2021

Robotics Computer Surgery

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“…For example, PSI designs are based on a three-dimensional graph models, which are obtained by computed tomography (CT) or magnetic resonance imaging (MR) reconstruction. Although many studies have shown that MR based PSI is more accurate than CT based one 27,28 , the latter has many advantages, such as quick access, cheap, automatic software based reconstruction, etc., and more importantly, easier to obtain thinner slices (0.625mm in this study), which is critical for reproducing the anatomical articular details. After weighing the pros and cons, CT based PSI with better cost-effectiveness was applied in this study.…”

Section: Discussionmentioning

confidence: 99%

Surgeon Dominated Design Can Improve the Accuracy of Patient-specific Instruments in Kinematically Aligned TKA

Wang¹,

Liang²,

Zhang³

et al. 2020

Preprint

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Precise bone resection is mandatory for kinematically aligned total knee arthroplasty（KA-TKA). Patient-specific instrumentation (PSI) has been applied to improve the accuracy of bone resection in TKA for many years. The purpose of this study was to investigate whether surgeons’ domination in PSI design can improve accuracy in KA-TKA. A total of 24 patients (24 knees) who underwent KA-TKA in our institution were assigned into engineer designed PSI group (10 knees) and surgeon designed PSI group (14 knees). The bone resection discrepancies of every key facets were used to evaluate the accuracy of PSI in bone resection, while the absolute differences of joint line orientation before and after surgery were used to evaluate the accuracy of PSI in joint line restoration. The overall discrepancy of bone resection was reduced by surgeon designed PSI compared to engineer designed PSI by 0.33mm (P<0.001). Surgeon designed PSI could reduce the outliers in terms of relative discrepancies in bone resection as well. Moreover, surgeon designed PSI could significantly improve the accuracy of PSI in the restoration of the joint line (p=0.01). This study indicate that the dominance of surgeons in both PSI design and subsequent surgical operation should be emphasized in efforts to improve the accuracy of PSI.

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“…Computerized systems including PSI have been advocated in the last decade to improve postsurgical extremity alignment for TKR patients. Numerous research on this field have been published with variable results 6, 7, 17, 18, 19, 20, 21. The current research on the field is plagued by a couple of rough points which creates bias on the results as well as the interpretation.…”

Section: Discussionmentioning

confidence: 99%

Postoperative mechanical alignment analysis of total knee replacement patients operated with 3D printed patient specific instruments: A Prospective Cohort Study

Gemalmaz

Sariyilmaz

Özkunt

et al. 2019

Acta Orthopaedica et Traumatologica Turcica

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ObjectiveTotal knee replacement (TKR) is a surgical treatment for final stage gonarthrosis. The lifespan of the prosthetic implants used in TKR surgery is a major interest for the orthopaedic research community.Previously, proper implant alignment of the implants has been advocated for longevity of the TKR surgery. Recently, patient-specific (PSI) instruments have been proposed to improve the mechanical alignment of the TKR by permitting better implant positioning over conventional TKR surgery. The aim of this study is to compare the mechanical alignment results of patients operated with PSIs and conventional instruments.MethodsTwo groups of 20 patients chosen in a quasi-random manner have been compared in this study. In the first group femoral distal and tibial osteotomies were made by a PSI which was produced by the patients' computed tomography scans. All osteotomies in the control group were made with the TKR set's routine instruments by conventional means. Patients' preoperative and postoperative mechanical femorotibal angles (mFTA), femoral coronal angles (FCA), tibial coronal angles (TCA) were measured and the number of outliers which showed more than 3° of malalignment were counted in both groups for comparison.ResultsThe average postoperative mFTA was found to be 2.09° for the PSI group and in was found to be 2.84° for the control which was not statistically significant. The comparison of postoperative FCA and TCA also did not show significant difference between the groups. The number of outliers showing more than 3° of malalignment per group were found to be 1 out of 20 (5%) for the PSI group and 7 out of 20 (35%) for the control which was statistically significant.ConclusionIn this study patient-specific instrumentation provided significantly better mechanical alignment compared to conventional TKR for the frequency of outlier cases with malalignment beyond 3°. PSI proved no significant difference when the groups were compared for mFTA, FCA and TCA. Our findings support that PSI may improve TKR alignment by improving the ratio of the outlier patients with marked malalignment.Level of EvidenceLevel III, Therapeutic Study.

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Accuracy of MRI-based vs. CT-based patient-specific instrumentation in total knee arthroplasty: A meta-analysis

Cited by 34 publications

References 26 publications

Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Geometric and volumetric relationship between human lumbar vertebrae and “Black‐bone” MRI‐based models

Surgeon Dominated Design Can Improve the Accuracy of Patient-specific Instruments in Kinematically Aligned TKA

Postoperative mechanical alignment analysis of total knee replacement patients operated with 3D printed patient specific instruments: A Prospective Cohort Study

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