Patient-specific instruments: industry’s innovation with a surgeon’s interest

Thienpont, Emmanuel; Bellemans, Johan; Delport, Hendrik; Overschelde, Philippe Van; Stuyts, Bart; Brabants, K; Victor, Jan

doi:10.1007/s00167-013-2626-5

Cited by 51 publications

(42 citation statements)

References 54 publications

(83 reference statements)

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“…As a result, the necessity of performing further high-quality investigations has been previously emphasised by other authors [14,17]. Our study was designed to verify the utility of CT-based Signature™ PSI for precise implant positioning.…”

Section: Discussionmentioning

confidence: 93%

“…Although there is a significant interest in PSI for TKA, the number of papers on this issue is still very limited, with only a few randomised trials available [17]. As a result, the necessity of performing further high-quality investigations has been previously emphasised by other authors [14,17].…”

Section: Discussionmentioning

confidence: 99%

“…The main idea behind patient-specific instrumentation (PSI) is that knee-joint arthroplasty procedures can be individualised, with benefits including precise realignment of the normal mechanical axis of the operated lower limb, minimised resection of the patient's bony tissue, reduced surgical times, simplified instrumentation, reduced peri-and postoperative blood loss, no need of femoral medullary cavity reaming and a reduced rate of thromboembolic complications [3,[13][14][15][16]. A recently published survey showed a considerable interest in PSI among surgeons, confirmed by the massively increasing numbers of PSI-aided procedures performed in Europe and worldwide; PSI use for TKA increased globally by an average of 1.5 times between 2011 and 2012 [17].…”

Section: Introductionmentioning

confidence: 99%

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Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Kotela

2014

International Orthopaedics (SICOT)

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Purpose The aim of this study was to compare radiological results of total knee arthroplasties (TKAs) performed with patient-specific computed tomography (CT)-based instrumentation and conventional technique. The main study hypothesis was that CT-based patient-specific instrumentation (PSI) increases the accuracy of TKA. Methods A prospective, randomized controlled trial was carried out between January and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients operated on with the aid of the Signature™ CT-based implant positioning system. The control group consisted of 60 patients operated on using conventional instrumentation. The radiographic evaluation of implant positioning and overall coronal alignment was performed 12 months after the surgery by using standing anteroposterior radiographs of the entire lower limb and standard lateral radiographs. Results Of the 112 patients initially enrolled for the study, 95 were included in the subsequent analyses. There were no statistically significant differences between groups in respect to coronal and sagittal component positioning and overall coronal alignment, except for frontal tibial component positioning. For this parameter, better results were obtained in the control group, with borderline statistical significance. Conclusions Our study did not reveal superiority of the CTbased PSI system over conventional instrumentation. Further high-quality investigations of patient-specific systems are absolutely indispensable to assess their utility for TKA. In our opinion, the surgeon applying PSI technology is required to have advanced knowledge and considerable experience with the conventional method.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study

Kotela

2014

International Orthopaedics (SICOT)

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“…Although the potential benefits of CCG technology for TKA have not been consistently demonstrated, the implementation of CCGs has spread rapidly [35]. Currently, seven implant manufacturers in the United States have FDA clearance and offer CCG technology [22].…”

Section: Discussionmentioning

confidence: 99%

“…Whether these findings remain true in assessments of larger cohorts with longer followup has not been established. Given that in 2012, over 82,000 TKAs worldwide were performed using CCGs, larger studies and longer followup evaluating their functional and radiographic outcomes are warranted [35].…”

Section: Introductionmentioning

confidence: 99%

The Mark Coventry Award: Custom Cutting Guides Do Not Improve Total Knee Arthroplasty Clinical Outcomes at 2 Years Followup

Nam

Park

Stambough

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Custom cutting guides (CCGs; sometimes called patient-specific instrumentation [PSI]) in total knee arthroplasty (TKA) use preoperative three-dimensional imaging to fabricate cutting blocks specific to a patient's native anatomy. Questions/purposes The purposes of this study were to determine if CCGs (1) improve clinical outcomes as measured by UCLA activity, SF-12, and Oxford knee scores; and (2) coronal mechanical alignment versus standard alignment guides. Methods This was a retrospective cohort study of patients undergoing primary TKA using the same cruciate-retaining, cemented TKA system between January 2009 and April 2012. Patients were included if they were candidates for a unilateral, cruciate-retaining TKA and met other prespecified criteria; patients were allowed to self-select either an MRI-based CCG procedure or standard TKA. Ninety-seven of 120 (80.8%) patients in the standard and 104 of 124 (83.9%, p = 0.5) in the CCG cohort with a minimum of 1-year followup were available for analysis. The first 95 patients in the standard (mean followup, 3 years; range, 1-4 years) and CCG (mean followup, 2 years; range, 1-4 years) cohorts were compared. The alignment goal for all TKAs was a hip-knee-ankle (HKA) angle of 0°. UCLA, SF-12, and Oxford knee scores were collected preoperatively and at each patient's most recent followup visit. Postoperative, rotationally controlled coronal scout CT scans were used to measure HKA alignment. Independent-sample t-tests and chi-square tests were used

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