Patient-Specific Instrumentation Does Not Shorten Surgical Time: A Prospective, Randomized Trial
Section snippets
Methods
This level 1 prospective, randomized study compared PSI with TI. Each surgery was videotaped and the timing of each operative step as well as the overall operative time was recorded. Inclusion criteria for this study were patients with non-inflammatory osteoarthritis scheduled for unilateral TKA. Exclusion criteria included previous ipsilateral hip, knee, or ankle replacement, a body mass index greater than 41 kg/m2, or a flexion contracture greater than 20 degrees.
A power analysis was performed
Results
Of the 78 patients initially enrolled in the study, 26 were excluded from the study after randomization. Twelve patients canceled surgery (six in the traditional group and six in the PSI group) for personal or family reasons. Nine of the PSI patients were unable to get a CT scan of their leg, for reasons related to cost (4), non-compliance (4), and hardware (1). Five others withdrew for various reasons including one who expired. Ultimately 52 patients had TKA surgery, 26 with traditional
Discussion
To address the growing volume of patients that will require total knee arthroplasty in the coming years [1], manufacturers have developed patient specific instruments to simplify the process on the day of surgery. Some have argued that these instruments may reproduce the alignment seen with computer assisted surgery 3., 7., 8., 9., 10., 11. without the upfront cost of the computer or the intraoperative hassle of placing pins and utilizing a camera and tracking device. Surgeons and manufacturers
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2020, Academic RadiologyCitation Excerpt :In conclusion, the potential cost-savings for using 3D printed models and surgical guides for patients’ operative care can be substantial. The present study used previously published data (9,15–44) to illustrate the potential value 3D printing can offer in terms of reducing the number of operating room minutes, using studies published with maxillofacial and orthopedic focuses. Studies to validate these analyses using single- and multiple institutional data are needed given the heterogeneity of sources used for analysis.
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2020, Journal of OrthopaedicsCitation Excerpt :However, Ishii et al. compared TFA on short radiographs with TFA observed on long radiographs using the best correlation procedure available (r = 0.94),25 and the discrepancy between them was reported to be only 0.5° (SD 1.2°).25 Finally, unlike a previous report that measured time for each surgical step,7 the total operative duration was evaluated. Despite these limitations, the strength of this study was that less surgeon-related bias was present than in previous studies.
The Conflict of Interest statement associated with this article can be found at http://dx.doi.org/10.1016/j.arth.2013.04.049.