W Anderl1, L Pauzenberger2, E Schwameis2. 1. Abteilung für Orthopädie, Krankenhaus der Barmherzigen Schwestern Wien, Stumpergasse 13, 1060, Wien, Österreich. werner.anderl@bhs.at. 2. Abteilung für Orthopädie, Krankenhaus der Barmherzigen Schwestern Wien, Stumpergasse 13, 1060, Wien, Österreich.
Abstract
BACKGROUND: Adequate three-dimensional component positioning and restoration of overall limb alignment are primary goals in total knee arthroplasty. Patient-specific instrumentation (PSI) is a potential way to improve accuracy of knee reconstruction surgery. However, currently available literature regarding the reliability of PSI shows inconsistent results for limb alignment restoration and component positioning. OBJECTIVES: The purpose of this article is to illustrate the rationale for using PSI in total knee arthroplasty, to demonstrate the surgical technique, and to present our outcome with the MyKnee(®) system. METHODS: We illustrate in detail the logistics and workflow involved in PSI for total knee arthroplasty. Finally, we present clinical and radiological results of patients undergoing knee arthroplasty using the MyKnee(®) system compared to a conventional instrumentation group. RESULTS: PSI significantly improved accuracy and reduced the number of outliers regarding neutral mechanical alignment restoration as well as three-dimensional component positioning compared to conventional instrumentation. The early clinical outcome was comparable between the two instrumentation groups. However, clinical outcome in the subgroup of patients within ± 3° from neutral mechanical limb alignment was superior to limb alignment outliers. CONCLUSION: The MyKnee(®) PSI system presents a reliable way to improve the accuracy of mechanical limb alignment restoration and three-dimensional component positioning in total knee arthroplasty. Nonetheless, an adequate surgical technique remains the crucial factor for successful total knee reconstruction.
BACKGROUND: Adequate three-dimensional component positioning and restoration of overall limb alignment are primary goals in total knee arthroplasty. Patient-specific instrumentation (PSI) is a potential way to improve accuracy of knee reconstruction surgery. However, currently available literature regarding the reliability of PSI shows inconsistent results for limb alignment restoration and component positioning. OBJECTIVES: The purpose of this article is to illustrate the rationale for using PSI in total knee arthroplasty, to demonstrate the surgical technique, and to present our outcome with the MyKnee(®) system. METHODS: We illustrate in detail the logistics and workflow involved in PSI for total knee arthroplasty. Finally, we present clinical and radiological results of patients undergoing knee arthroplasty using the MyKnee(®) system compared to a conventional instrumentation group. RESULTS: PSI significantly improved accuracy and reduced the number of outliers regarding neutral mechanical alignment restoration as well as three-dimensional component positioning compared to conventional instrumentation. The early clinical outcome was comparable between the two instrumentation groups. However, clinical outcome in the subgroup of patients within ± 3° from neutral mechanical limb alignment was superior to limb alignment outliers. CONCLUSION: The MyKnee(®) PSI system presents a reliable way to improve the accuracy of mechanical limb alignment restoration and three-dimensional component positioning in total knee arthroplasty. Nonetheless, an adequate surgical technique remains the crucial factor for successful total knee reconstruction.
Entities:
Keywords:
Bone malalignment; Osteoarthritis; Patient-specific instrumentation (PSI); Prosthesis design; Total knee arthroplasty
Authors: Matthew P Abdel; Sébastien Parratte; Guillaume Blanc; Matthieu Ollivier; Vincent Pomero; Elke Viehweger; Jean-Noël A Argenson Journal: Clin Orthop Relat Res Date: 2014-03-07 Impact factor: 4.176