Total Knee Arthroplasty in Osteopetrosis Using Patient-Specific Instrumentation

Mayer, Stephanie W.; Hug, Kevin T.; Hansen, Benjamin J.; Bolognesi, Michael P.

doi:10.1016/j.arth.2011.12.007

Cited by 20 publications

(18 citation statements)

References 12 publications

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“…PSI remains a valid instrument to handle complex extraarticular deformities or address cases in which difficulties in intramedullary rod passage are present due to deformity, retained hardware, or pathological bone disease and when it is mandatory to reduce blood loss. [47][48][49] Computer-assisted surgery and minimally invasive TKA have also been described as potentially beneficial in reducing blood loss. Computer-assisted surgery promises a greater accuracy of component position and joint alignment; however, the results concerning blood loss reduction are controversial, with some authors reporting a significantly reduced loss of Hb or drain loss, 50,51 while other denying any significant difference with respect to conventional TKA.…”

Section: Discussionmentioning

confidence: 99%

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

et al. 2018

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Patient-specific instrumentation (PSI) may contribute to reduced blood loss related to total knee arthroplasty (TKA). The purpose of this study was to compare the estimated hemoglobin (Hb) and red blood cell volume (RBC) losses in two groups of patients undergoing TKA with PSI and conventional instrumentation. Pre- and postoperative blood samples were collected from 22 patients randomly assigned to receive a PSI-assisted or conventional TKA. Post- to preoperative Hb difference was calculated and RBC loss was estimated according to Sehat et al. A significant difference in Hb reduction in favor of the PSI group was registered on the last day of stay ( = 0.0084) and significant treatment effect ( = 0.027) on Hb reduction after intervention was found with a regression model for longitudinal measurements. This study demonstrated that PSI leads to a significant trend in earlier Hb regain. These promising results suggest a beneficial effect of PSI in blood loss reduction.

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Section: Discussionmentioning

confidence: 99%

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

et al. 2018

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“…Magnetic resonance imaging (MRI)-or computed tomography (CT)-based patient-specific instrumentation (PSI) may potentially achieve more reliable alignment parameters, decrease operative time, blood loss, and increase efficiency when compared with conventionally instrumented TKA. 18,[32][33][34][35][36][37] However, a previous report 38 suggested that frequent intraoperative surgeon-directed changes may still be required. Thus, there is a need for more evidence-based data that evaluate and quantify the accuracy and reliability of PSI.…”

mentioning

confidence: 99%

Reliability of Templating with Patient-Specific Instrumentation in Total Knee Arthroplasty

et al. 2013

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Magnetic resonance imaging (MRI) or computed tomography-based patient-specific instrumentation (PSI) may allow for reliable alignment and fewer outliers when compared with conventionally instrumented total knee arthroplasty (TKA). However, some authors have suggested that frequent intraoperative surgeon-directed changes may still be required. This study evaluated the accuracy of PSI to predict component sizing and alignment during TKA. A total of 84 patients (89 knees) who underwent a TKA using a PSI system were evaluated. An MRI-based preoperative plan of every knee was provided and approved by the surgeons. This demonstrated the proposed prosthetic component alignment, as well as the femoral, tibial, and bearing insert component size and position. Intraoperative changes to these components were prospectively recorded and compared with the computerized preoperative plan. Major changes were defined as any changes in femoral or tibial resection, size, and position of the components. Minor changes were defined as any change in the size of the polyethylene bearing insert. The preoperative plan was able to correctly predict the size of the implanted tibial and femoral component in 93 and 95.5% of the cases, respectively. Thirteen major intraoperative changes were made. In one knee, the proposed femoral resection was not acceptable (because of the presence of significant amount of osteophytes) and was abandoned in favor of a manual extramedullary guide. In another patient, the proposed femoral and tibial components were upsized. In two other patients, the femoral components were downsized, in four patients, the tibial components were downsized, and in another patient, it was upsized. There were also 16 minor changes, which included 2-mm upsizing of the polyethylene liner in 13 knees and 4-mm upsizing in 3 knees. Surgical experience is necessary to recognize improper component size, incorrect surgical resection, or nonideal alignment when performing TKA using PSI. The authors believe that the design and manufacture of PSI combined with a comprehensive templating resulted in excellent intraoperative concordance of the preoperative plan at the default settings with minimal changes.

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“…10.4172/2161-0533.S2-007 femoral condyle [41]. However, no details on alignment or other objective results were given.…”

Section: Extra-articular Deformities and Conditions Precluding Use Ofmentioning

confidence: 99%

Customised Jigs in Primary Total Knee Replacement

Bardakos¹,

Lilikakis²

2014

Orthopedic Muscul Sys

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Patient-specific surgery employing customising jigs for bone resections is becoming increasingly popular for total knee replacement surgery. Theoretical advantages of this technology include, but are not limited to, more accurate limb alignment and reduced surgical time, blood loss and in-patient hospital stay. In turn, these may result in more cost savings when compared with standard techniques of performing knee replacement surgery. The literature published so far has primarily examined alignment data but has failed to consistently confirm the previously proposed benefits. It appears that longer-term data, focusing on patient function and implant survival, will be required before the clinical and cost utility of these guides can be determined. This article briefly outlines the manufacturing process and surgical technique of patient-specific jigs and presents the clinical evidence pertaining to key elements of this new technology.

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Total Knee Arthroplasty in Osteopetrosis Using Patient-Specific Instrumentation

Cited by 20 publications

References 12 publications

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

Patient-Specific Instrumentation Affects Perioperative Blood Loss in Total Knee Arthroplasty

Reliability of Templating with Patient-Specific Instrumentation in Total Knee Arthroplasty

Customised Jigs in Primary Total Knee Replacement

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