Martijn Gm Schotanus1, Bert Boonen1, Nanne P Kort1. 1. Martijn GM Schotanus, Bert Boonen, Nanne P Kort, Department of Orthopaedic Surgery, Zuyderland Medical Centre, 6162 BG Sittard-Geleen, The Netherlands.
Abstract
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.
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.
Entities:
Keywords:
Alignment; Conventional instruments; Cutting guides; Patient matched instruments; Patient specific matched guides; Pin guides; Single surgeon; Total knee arthroplasty
Authors: Vincent Y Ng; Jeffrey H DeClaire; Keith R Berend; Bethany C Gulick; Adolph V Lombardi Journal: Clin Orthop Relat Res Date: 2012-01 Impact factor: 4.176
Authors: J Duryea; G Neumann; M H Brem; W Koh; F Noorbakhsh; R D Jackson; J Yu; C B Eaton; P Lang Journal: Osteoarthritis Cartilage Date: 2006-12-22 Impact factor: 6.576
Authors: Vincent Y Ng; Lindsay Arnott; Jia Li; Ronald Hopkins; Jamie Lewis; Sean Sutphen; Lisa Nicholson; Douglas Reader; Michael A McShane Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-08-25 Impact factor: 4.342
Authors: Martijn G M Schotanus; Elke Thijs; Marion Heijmans; Rein Vos; Nanne P Kort Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-07-11 Impact factor: 4.342