Patient specific guides for total knee arthroplasty are ready for primetime

• 作者: Bert Boonen Martijn GM Schotanus Nanne P Kort
• 来源期刊: 世界骨科杂志
• 学科: 医学
• 关键词: Total knee ARTHROPLASTY PATIENT SPECIFIC matched GUIDES PATIENT matched INSTRUMENTS Single SURGEON Alignment Conventional INSTRUMENTS Cutting GUIDES Pin GUIDES
• 年，卷（期）: 2016,（1）
• 页码范围: 61-68
• 页数: 8页
• 分类号: R

摘要

AIM:To present the radiological results of total knee arthroplasty(TKA)with use of patient specific matched guides(PSG)from different manufacturer in patients suffering from severe osteoarthritis of the knee joint.METHODS:This study describes the results of 57 knees operated with 4 different PSG systems and a group operated with conventional instrumentation(n=60)by a single surgeon.The PSG systems were compared with each other and subdivided into cut-and pin PSG.The biomechanical axis[hip-knee-ankle angle(HKA)],varus/valgus of the femur[frontal femoral component(FFC)]and tibia(frontal tibial component)component,flexion/extension of the femur[flexion/extension of the femur component(LFC)]and posterior slope of the tibia[lateral tibial component(LTC)]component were evaluated on long-leg standing and lateral X-rays.A percentage of>3°deviation was seen as an outlier.RESULTS:The inter class correlation coefficient(ICC)revealed that radiographic measurements between both assessors were reliable(ICC>0.8).Fisher exact test was used to test differences of proportions.The percentage of outliers of the HKA-axis was comparable between both the PSG and conventional groups(12.28%vs 18.33%,P<0.424)and the cut-and pin PSG groups(14.3%vs 10.3%,P<1.00).The percentage of outliers of the FFC(0%vs 18.33%,P<0.000),LFC(15.78%vs 58.33%,P<0.000)and LTC(15.78%vs 41.67%,P<0.033)were significant different in favour of the PSG group.There were no significant differences regarding the outliers between the individual PSG systems and the PSG group subdivided into cut-and pin PSG.CONCLUSION:PSG for TKA show significant less outliers compared to the conventional technique.These single surgeon results suggest that PSG are ready for primetime.