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Erschienen in: Current Reviews in Musculoskeletal Medicine 4/2012

01.12.2012 | Customization in Arthroplasty (BS Parsley, Section Editor)

The use of customized TKA implants for increased efficiency in the OR

verfasst von: Raj K. Sinha

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 4/2012

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Abstract

Efficiency in surgical procedures saves time and money and can decrease medical complications. Several sources of inefficiency exist in the operating room, including preoperative and intraoperative. The instruments used during TKA are frequently redundant. Customized instruments and implants can improve efficiency by reducing steps. Additional benefits may include improved alignment and kinematics. This chapter addresses the various sources of inefficiency, provides suggestions to overcome them, and introduces the concept of customized guides and implants as a method to improve efficiency.
Literatur
1.
Zurück zum Zitat Jaffer AK, Barsoum WK, Krebs V, Hurbanek JG, Morra N, Brotman DJ. Duration of anesthesia and venous thromboembolism after hip and knee arthroplasty. Mayo Clin Proc. 2005;80:732–8.PubMed Jaffer AK, Barsoum WK, Krebs V, Hurbanek JG, Morra N, Brotman DJ. Duration of anesthesia and venous thromboembolism after hip and knee arthroplasty. Mayo Clin Proc. 2005;80:732–8.PubMed
2.
Zurück zum Zitat Willis-Owen CA, Konyves A, Martin DK. Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br. 2010;92:1128–33.PubMedCrossRef Willis-Owen CA, Konyves A, Martin DK. Factors affecting the incidence of infection in hip and knee replacement: an analysis of 5277 cases. J Bone Joint Surg Br. 2010;92:1128–33.PubMedCrossRef
3.
Zurück zum Zitat Prasad N, Padmanabhan V, Mullaji A. Blood loss in total knee arthroplasty: an analysis of risk factors. Int Orthop. 2007;31:39–44.PubMedCrossRef Prasad N, Padmanabhan V, Mullaji A. Blood loss in total knee arthroplasty: an analysis of risk factors. Int Orthop. 2007;31:39–44.PubMedCrossRef
4.
Zurück zum Zitat Ong KL, Lau E, Manley M, Kurtz SM. Effect of procedure duration on total hip arthroplasty and total knee arthroplasty survivorship in the United States Medicare population. J Arthroplasty. 2008;23(6 Suppl 1):127–32.PubMedCrossRef Ong KL, Lau E, Manley M, Kurtz SM. Effect of procedure duration on total hip arthroplasty and total knee arthroplasty survivorship in the United States Medicare population. J Arthroplasty. 2008;23(6 Suppl 1):127–32.PubMedCrossRef
5.
Zurück zum Zitat •• Watters TS, Mather III RC, Browne JA, Berend KR, Lombardi Jr AV, Bolognesi MP. Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv. 2011;20(6):112–6. This study compares custom guide based, navigation based, and standard TKA. Costs were similar between standard and custom guide TKA, but surgical time of the latter was, on average, 28 minutes shorter. PubMed •• Watters TS, Mather III RC, Browne JA, Berend KR, Lombardi Jr AV, Bolognesi MP. Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv. 2011;20(6):112–6. This study compares custom guide based, navigation based, and standard TKA. Costs were similar between standard and custom guide TKA, but surgical time of the latter was, on average, 28 minutes shorter. PubMed
6.
Zurück zum Zitat JFK Memorial Hospital Working Group internal data. JFK Memorial Hospital Working Group internal data.
7.
Zurück zum Zitat Spencer BA, Mont MA, McGrath MS, Boyd B, Mitrick MF. Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment. Int Orthop. 2009;33:1571–5.PubMedCrossRef Spencer BA, Mont MA, McGrath MS, Boyd B, Mitrick MF. Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment. Int Orthop. 2009;33:1571–5.PubMedCrossRef
8.
Zurück zum Zitat • Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL. Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res. 2012;470:895–902. This study compared conventional instruments, patient specific guides targeting the mechanical axis, and patient specific guides targeting the kinematic axis. Overall percentages of outliers vis-à-vis the mechanical axis were similar between the first 2, although conventional guides tended to produce more overall varus. Kinematic axis guides produced more valgus outliers. PubMedCrossRef • Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL. Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res. 2012;470:895–902. This study compared conventional instruments, patient specific guides targeting the mechanical axis, and patient specific guides targeting the kinematic axis. Overall percentages of outliers vis-à-vis the mechanical axis were similar between the first 2, although conventional guides tended to produce more overall varus. Kinematic axis guides produced more valgus outliers. PubMedCrossRef
Metadaten
Titel
The use of customized TKA implants for increased efficiency in the OR
verfasst von
Raj K. Sinha
Publikationsdatum
01.12.2012
Verlag
Current Science Inc.
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 4/2012
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-012-9140-0

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