PURPOSE: Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) uses individually designed disposable guides to determine intraoperative bone cuts. The manufacturer provides the surgeon with proposed planning which can be modified and should be approved by the surgeon before the guides are produced. This study aims to assess the intra- and inter-observer reliability among preoperative planning by orthopaedic surgeons using PSI. The authors hypothesize a high intra- and inter-observer reliability in planning TKA using PSI. METHODS: Four orthopaedic surgeons modified and approved 40 preoperative MRI-based PSI plannings three times. The surgeons were blinded to their own and each other's results. Intra- and inter-observer reliability was obtained for planned implant size, resection, and position of the implant. RESULTS: Intra-observer reliability Intraclass Correlation Coefficients (ICC) were excellent for femoral and tibial implant size with a range of 0.948-0.995 and 0.919-0.988, respectively. Inter-observer reliability for femoral and tibial implant size showed an ICC range of 0.953-0.982 and 0.839-0.951, respectively. Next to implant size, intra- and inter-observer reliability demonstrated good to an excellent agreement (ICC > 0.75) for 7 out of 12 remaining parameters and 6 out of 12 remaining parameters, respectively. CONCLUSION: Preoperative planning of TKA implant size using MRI-based PSI showed excellent intra- and inter-observer reliability. Further research on the comparison of predicted implant size preoperatively to intraoperative results is needed.
PURPOSE:Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) uses individually designed disposable guides to determine intraoperative bone cuts. The manufacturer provides the surgeon with proposed planning which can be modified and should be approved by the surgeon before the guides are produced. This study aims to assess the intra- and inter-observer reliability among preoperative planning by orthopaedic surgeons using PSI. The authors hypothesize a high intra- and inter-observer reliability in planning TKA using PSI. METHODS: Four orthopaedic surgeons modified and approved 40 preoperative MRI-based PSI plannings three times. The surgeons were blinded to their own and each other's results. Intra- and inter-observer reliability was obtained for planned implant size, resection, and position of the implant. RESULTS: Intra-observer reliability Intraclass Correlation Coefficients (ICC) were excellent for femoral and tibial implant size with a range of 0.948-0.995 and 0.919-0.988, respectively. Inter-observer reliability for femoral and tibial implant size showed an ICC range of 0.953-0.982 and 0.839-0.951, respectively. Next to implant size, intra- and inter-observer reliability demonstrated good to an excellent agreement (ICC > 0.75) for 7 out of 12 remaining parameters and 6 out of 12 remaining parameters, respectively. CONCLUSION: Preoperative planning of TKA implant size using MRI-based PSI showed excellent intra- and inter-observer reliability. Further research on the comparison of predicted implant size preoperatively to intraoperative results is needed.
Authors: Etienne Cavaignac; Regis Pailhé; Gregoire Laumond; Jérôme Murgier; Nicolas Reina; Jean Michel Laffosse; Emilie Bérard; Philippe Chiron Journal: Int Orthop Date: 2014-10-10 Impact factor: 3.075
Authors: Vincent V G An; Brahman S Sivakumar; Kevin Phan; Yadin David Levy; Warwick J M Bruce Journal: J Orthop Sci Date: 2016-11-04 Impact factor: 1.601
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
Authors: Kimona Issa; Aiman Rifai; Mike S McGrath; John J Callaghan; Craig Wright; Arthur L Malkani; Michael A Mont; Vincent K McInerney Journal: J Knee Surg Date: 2013-04-10 Impact factor: 2.757