Is TKA using patient-specific instruments comparable to conventional TKA? A randomized controlled study of one system.
Clin Orthop Relat Res
; 471(12): 3988-95, 2013 Dec.
Article
em En
| MEDLINE
| ID: mdl-23907610
ABSTRACT
BACKGROUND:
Patient-specific CT-based instrumentation may reduce implant malpositioning and improve alignment in TKA. However, it is not known whether this innovation is an advance that benefits patients. QUESTIONS/PURPOSES:
We evaluated (1) the precision of patient-specific TKA by comparing the incidence of outliers in postoperative alignment between TKAs using patient-specific instruments and TKAs using conventional instruments, and (2) the reliability of patient-specific instruments by intraoperatively investigating whether the surgery could be completed with patient-specific instruments alone.METHODS:
In this randomized controlled trial, we compared patient-specific TKA instruments from one manufacturer (n = 50) with conventional TKA instruments (n = 50). Postoperative hip-knee-ankle angles, femoral component rotation, and coronal and sagittal alignments of each component were measured. The validity of the patient-specific instrument was examined using cross-checking procedures with conventional instruments during the surgeries. When the procedure could not be completed accurately with patient-specific instruments, the procedure was converted to TKA using conventional instruments, and the frequency of this occurrence was tallied.RESULTS:
Outliers in the hip-knee-ankle angle were comparable between groups (12% in the patient-specific instrument group and 10% in the conventional instrument group). Other parameters such as sagittal alignment and femoral component rotation did not differ in terms of outliers. Patient-specific guides were abandoned in eight knees (16%) during the surgery because of malrotation of the femoral components and decreased slope of the tibia.CONCLUSIONS:
Accuracy was comparable between TKAs done with patient-specific instruments and those done with conventional instruments. However, the patient-specific instrument procedures had to be aborted frequently, incurring expenses that did not benefit patients.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Artroplastia do Joelho
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Osteoartrite do Joelho
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Articulação do Joelho
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Prótese do Joelho
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Clin Orthop Relat Res
Ano de publicação:
2013
Tipo de documento:
Article