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Current Reviews in Musculoskeletal Medicine

Erschienen in:

01.06.2014 | TKA Symposium (P Sancheti, Section Editor)

Patient specific implants: scope for the future

verfasst von: Rajesh N. Maniar, Tushar Singhi

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 2/2014

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Abstract

“Patient Specific” technology introduced in last 5 years, slowly gained popularity but has currently plateaued. We have a number of studies on patient specific instruments where they have been compared with conventional jigs in total knee arthroplasty and reported to have no clear additional benefits. This review discusses their intraoperative and postoperative advantages/disadvantages and cost effectiveness and provides a synopsis in light of current literature. Patient specific implants are not freely available yet, and there is no scientific literature reporting on their use in clinical practice.

Noble WJ, Moore CA, Ning L. The value of patient-matched instrumentation in total knee arthroplasty. J Arthroplasty. 2012;27:153–6.PubMedCrossRef

Barrett W, Hoeffel D, Dalury D, Bohannon Mason J., Murphy J, Himden S. In-vivo alignment comparing patient specific instrumentation with both conventional and computer assisted surgery (CAS) instrumentation in total knee arthroplasty. J Arthroplasty. 2013. Available at: doi: 10.1016/j.arth.2013.06.029.

Nunley RM, Ellison BS, Ruh EL, Williams BM, Foreman K, Ford AD, et al. Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Relat Res. 2012;470:889–94.PubMedCentralPubMedCrossRef

Stronach BM, Pelt CE, Erickson J, Peters CL. Patient-specific total knee arthroplasty required frequent surgeon-directed changes. Clin Orthop Relat Res. 2013;471:169–74.PubMedCentralPubMedCrossRef

5.•

Hamilton GW, Parks NL, Saxena A. Patient-specific instrumentation does not shorten surgical time: a prospective, randomized trial. J Arthroplasty. 2013;28(96). A prospective randomized study (level 1 study) of the comparison of 26 PSI and 26 conventional TKA; where the time period of 15 surgical steps was compared between the groups. This comparison of time, required for surgical steps, is the most detailed of all the studies.

Roh YW, Kim TW, Lee S, Seong SC, Lee MC. Is TKA using patient-specific instruments comparable to conventional TKA? A randomized controlled study of 1 system. Clin Orthop Relat Res. 2013;471:3988–95.PubMedCrossRef

Lustig S, Scholes CJ, Oussedik SI, Kinzel V, Coolican MRJ, Parker DA. Unsatisfactory accuracy as determined by computer navigation of Visionaire patient-specific instrumentation for total knee arthroplasty. J Arthroplasty. 2013;28:469–73.PubMedCrossRef

Spencer BA, Mont MA, McGrath MS, Boyd B, Mitrick MF. Initial experience with custom-fit total knee replacement: intraoperative events and long leg coronal alignment. Int Orthop. 2009;33:1571–5.PubMedCentralPubMedCrossRef

Bali K, Walker P, Bruce W. Custom-fit total knee arthroplasty: our initial experience in 32 knees. J Arthroplasty. 2012;27:1149–54.PubMedCrossRef

10.•

Vundelinckx BJ, Bruckers L, Mulder KD, Schepper JD, Van Esbroeck G. Functional and radiographic short-term outcome evaluation of the Visionaire system, a patient-matched instrumentation system for total knee arthroplasty. J Arthroplasty. 2013;28:964–70. This is the only study comparing the postoperative functional recovery of PSI TKA with conventional TKA.PubMedCrossRef

11.

Ng VY, DeClaire JH, Berend KR, et al. Improved accuracy of alignment with patient specific positioning guides compared with manual instrumentation in TKA. Clin Orthop Relat Res. 2012;470:99.PubMedCentralPubMedCrossRef

12.••

Victor J, Dujardin J, Vandenneucker H, Arnout N, Bellemans J. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial. Clin Orthop Relat Res. 2013;472:263–71. This is the only study reporting that individual femoral and tibial component alignment was worse with PSI compared with conventional TKA.CrossRef

13.

Barrack RL, Ruh EL, Williams BM, Ford AD, Foreman K, Nunley RM. Patient specific cutting blocks are currently of no proven value. J Bone Joint Surg Br. 2012;94-B(Suppl A):95–9.CrossRef

14.

Nogler M, Hozack W, Collopy D, Mayr E, Deirmengian G, Sekyra K. Alignment for total knee replacement: a comparison of kinematic axis vs mechanical axis techniques. A cadaver study. Int Orthop. 2012;36:2249–53.PubMedCentralPubMedCrossRef

15.

Dossett HG, Swartz GJ, Estrada NA, LeFevre GW, Kwasman BG. Kinematically vs mechanically aligned total knee arthroplasty. Orthopedics. 2012;35:e160–9.PubMed

16.

Howell SM, Howell SJ, Kuznik KT, Cohen J, Hull ML. Does a kinematically aligned total knee arthroplasty restore function without failure regardless of alignment category? Clin Orthop Relat Res. 2013;471:1000–7.PubMedCentralPubMedCrossRef

17.••

Slover JD, Rubash HE, Malchau H, et al. Cost-effectiveness analysis of custom total knee cutting blocks. J Arthroplasty. 2012;27:180. This is the most important study for cost benefit analysis of PSI TKA.PubMedCrossRef

18.

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;20:112–6.PubMed

Titel: Patient specific implants: scope for the future
verfasst von: Rajesh N. Maniar
Tushar Singhi
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Current Reviews in Musculoskeletal Medicine / Ausgabe 2/2014
Elektronische ISSN: 1935-9748
DOI: https://doi.org/10.1007/s12178-014-9214-2

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