Huichao Fu1, Jiaxing Wang1, Shenyuan Zhou1, Tao Cheng1, Wen Zhang1, Qi Wang1, Xianlong Zhang2. 1. Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China. 2. Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China. zxl201450@hotmail.com.
Abstract
PURPOSE: There is a rising interest in the use of patient-specific instrumentation (PSI) during total knee arthroplasty (TKA). The goal of this meta-analysis was to compare PSI with conventional instrumentation (CI) in patients undergoing TKA. METHODS: A literature search was performed in PubMed, Embase, Springer, Ovid, China National Knowledge Infrastructure, and the Cochrane Library. A total of 10 randomized controlled studies involving 837 knees comparing outcomes of PSI TKAs with CI TKAs were included in the present analysis. Outcomes of interest included component alignment, surgical time, blood loss, and hospital stay. RESULTS: The results presented no significant differences between the two instrumentations in terms of restoring a neutral mechanical axis and femoral component placement. However, their differences have been noted regarding the alignment of the tibial component in coronal and sagittal planes. Also, 3 min less surgical time was used in PSI patients. CONCLUSIONS: Based on these findings, PSI appeared not to be superior to CI in terms of the post-operative mechanical axis of the limb or femoral component placement. Despite a statistical difference for operative duration, the benefit of a small reduction in surgical time with PSI is clinically irrelevant. LEVEL OF EVIDENCE: Therapeutic study (systematic review and meta-analysis), Level I.
PURPOSE: There is a rising interest in the use of patient-specific instrumentation (PSI) during total knee arthroplasty (TKA). The goal of this meta-analysis was to compare PSI with conventional instrumentation (CI) in patients undergoing TKA. METHODS: A literature search was performed in PubMed, Embase, Springer, Ovid, China National Knowledge Infrastructure, and the Cochrane Library. A total of 10 randomized controlled studies involving 837 knees comparing outcomes of PSI TKAs with CI TKAs were included in the present analysis. Outcomes of interest included component alignment, surgical time, blood loss, and hospital stay. RESULTS: The results presented no significant differences between the two instrumentations in terms of restoring a neutral mechanical axis and femoral component placement. However, their differences have been noted regarding the alignment of the tibial component in coronal and sagittal planes. Also, 3 min less surgical time was used in PSI patients. CONCLUSIONS: Based on these findings, PSI appeared not to be superior to CI in terms of the post-operative mechanical axis of the limb or femoral component placement. Despite a statistical difference for operative duration, the benefit of a small reduction in surgical time with PSI is clinically irrelevant. LEVEL OF EVIDENCE: Therapeutic study (systematic review and meta-analysis), Level I.
Entities:
Keywords:
Conventional instrumentation; PSI; Patient-specific instrumentation; TKA; Total knee arthroplasty
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