No radiographic difference between patient-specific guiding and conventional Oxford UKA surgery

Kerens, B.; Schotanus, Martijn G.M.; Boonen, Bert; Kort, Nanne P.

doi:10.1007/s00167-014-2849-0

Cited by 32 publications

(32 citation statements)

References 10 publications

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“…In our study, improvement was observed in both groups at 3 months and 1 year without any difference between the two groups. We had to recut the tibial plateau in 10% of our PSI UKA cases; this number is lower than in the Bell et al [6] series reporting 43% of perioperative modifications, but higher than the Kerens et al series (no perioperative modification in 30 PSI UKA) [14]. The number of intraoperative changes in our experience was limited but not null, and this may be related first to the time spent by the surgeon on edition and validation of the preoperative planning and second to the fact that we would not accept intraoperatively an inappropriate cut.…”

Section: Discussionmentioning

confidence: 64%

“…Jaffry et al [11] investigated implant positioning among PSI UKA, conventional instrumented UKA, and robotic-assisted UKA; their results showed that PSI UKA provided more accurate positioning than conventional instrumentation, no difference between robot and PSI UKA, and finally concluded that PSI UKA took half the time as robotic-assisted UKA to implant. Recently, Kerens et al [14] compared radiographic positioning of implants in 30 conventional Oxford UKA (Biomet Inc, Warsaw, IN, USA) compared with 30 patientspecific guided Oxford UKA. They found no statistically differences between the two groups, except for the positioning of the femoral component in the frontal plane (better in the PSI group).…”

Section: Discussionmentioning

confidence: 99%

“…However, studies differ as to whether PSI for UKA results in improved alignment [7,14] and there are few data demonstrating whether any differences achieved in alignment will translate into clinically relevant differences that a patient might perceive [15]. To our knowledge, there are no randomized clinical trials on this important topic.…”

Section: Introductionmentioning

confidence: 99%

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The John Insall Award: No Functional Benefit After Unicompartmental Knee Arthroplasty Performed With Patient-specific Instrumentation: A Randomized Trial

Ollivier

Parratte

Lunebourg

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Component alignment can influence implant longevity as well as perhaps pain and function after unicompartmental knee arthroplasty (UKA), but correct alignment is not consistently achieved. To increase the likelihood that good alignment will be achieved during surgery, smart tools such as robotics or patient-specific instrumentation (PSI) have been introduced. Questions/purposes We hypothesized that UKA performed with PSI would result in improved level gait as ascertained with three-dimensional analysis, implant positioning, and patient-reported outcomes measured by a validated scoring system when compared with conventional instrumentation 3 months and 1 year after surgery. Methods We randomized 60 patients into two groups using either the PSI technique or a conventional technique. All patients were operated on using the same technique and the same cemented metal-backed implant. Mean age of the patients was 63 ± 4 years (range, 54-72 years) and mean body mass index was 28 ± 3 kg/m 2 . Patients were evaluated preoperatively, at 3 months, and 1 year after surgery by an independent observer blind to the type of technique. Gait parameters were assessed with threedimensional analysis during level walking preoperatively and at 1 year, frontal and sagittal position of the implant was evaluated on full-length radiographs at 3 months, and subjective functional outcome and quality of life using routine questionnaires (SF-12, new Knee Society Score [KSS], Knee Injury and Osteoarthritis Outcome Score) at 3 months and 1 year. This study had 80% power to detect a 15% difference in walking speed at the p \ 0.05 level. Results One year after surgery, there were no differences between the two groups in the analyzed gait spatiotemporal parameters, respectively, for PSI UKA and conventional UKA : double limb support 31% (25%-54%) versus 30% (23%-56%; p = 0.67) and walking speed ( No difference was observed between the two groups in terms of lower limb alignment (PSI group 178°± 3°, conventional group 178°± 4°; p = 0.24) or implant positioning on mediolateral and anteroposterior radiographs. There were no differences in the functional score between the PSI and conventional TKA groups at 3 months and 1 year after surgery: KSS objective knee scores (PSI: 85 ± 8 points at 3 months, 87 ± 5 points at 1 year and conventional

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

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The John Insall Award: No Functional Benefit After Unicompartmental Knee Arthroplasty Performed With Patient-specific Instrumentation: A Randomized Trial

Ollivier

Parratte

Lunebourg

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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“…With respect to the use of PSI in medial UKR (MUKR) surgery, Trong et al [21] reported excellent implant alignment when comparing patients' post-operative CTs to pre-operative plans. Kerens et al [22] found that PSI improved the position of the femoral component in the frontal plane, but had no effect on other implant placement parameters. However, Ollivier et al [23] found no differences in functional score, gait, lower limb alignment or implant positioning between PSI and conventional instrumentation.…”

Section: Discussionmentioning

confidence: 99%

Patient-specific instrumentation improves alignment of lateral unicompartmental knee replacements by novice surgeons

Newman

Harris

et al. 2017

International Orthopaedics (SICOT)

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Purpose Patient-specific instrumentation (PSI) has the potential to offer numerous benefits-not least of all, improved resection accuracy; but its potential has not been realised in clinical studies. An explanation may be the focus of such studies on the total knee replacement (TKR-a common procedure, with which surgeons are generally very familiar. Consequently, we sought to investigate the potential role of PSI in guiding novice surgeons to perform the more technically demanding and less familiar lateral unicondylar knee replacement (LUKR). Methods Twelve orthopaedic trainees naive to LUKR were instructed to perform the procedure according to a preoperative plan. These were carried out on synthetic sawbones and were completed once with conventional instrumentation alone and once with the adjunct of PSI, allowing a comparison of the plan adherence achieved by the two sets of instrumentation. Results There was a tendency for PSI to demonstrate improved plan adherence, though a statistically significant improvement was only seen in compound rotational error of the femoral implant (p = 0.004). PSI was, however, able to produce narrower standard deviations in the mean translational displacement of the femoral implant and also the mean rotational displacement of both implants, suggesting a higher degree of precision.Conclusions Our study provides some evidence that PSI can improve the ability of novice surgeons to replicate a preoperative plan, but our results suggest the need for largerscale clinical studies to establish the role of PSI in this procedure.

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“…There was no control group in this study, and the femoral component was not assessed, although the authors did note this, explaining that for this implant, femoral component orientation is based on the tibial cut. Kerens et al 41 compared radiographic positioning of implants in 30 conventional Oxford UKA compared with 30 Patient Specific Guided (PSG) Oxford UKA. They found no statistically or clinically significantly differences between the two groups, except for the positioning of the femoral component in the frontal plane.…”

Section: Haptic Robotic Systemsmentioning

confidence: 99%

(iv) Technology assisted unicompartmental knee replacement: results and functional outcomes

Imbuldeniya

Ieong

Picard

et al. 2014

Orthopaedics and Trauma

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No radiographic difference between patient-specific guiding and conventional Oxford UKA surgery

Abstract: III.

Cited by 32 publications

References 10 publications

The John Insall Award: No Functional Benefit After Unicompartmental Knee Arthroplasty Performed With Patient-specific Instrumentation: A Randomized Trial

The John Insall Award: No Functional Benefit After Unicompartmental Knee Arthroplasty Performed With Patient-specific Instrumentation: A Randomized Trial

Patient-specific instrumentation improves alignment of lateral unicompartmental knee replacements by novice surgeons

(iv) Technology assisted unicompartmental knee replacement: results and functional outcomes

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