Evidence map›Paper›PMID 23616267›Full record

Trial reportClinical orthopaedics and related research2014

Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial.

Jan Victor, Jan Dujardin, Hilde Vandenneucker, Nele Arnout, Johan Bellemans

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Clinical orthopaedics and related research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
82citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

82 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  6. Favourable alignment outcomes with MRI-based patient-specific instruments in total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
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  14. Accuracy of empirical distal femoral valgus cut angle of 4° to 6° in total knee arthroplasty: a randomized controlled trial.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022
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  17. Rotational component alignment in patient-specific total knee arthroplasty compared with conventional cutting instrument.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2019
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  19. No improvement in reducing outliers in coronal axis alignment with patient-specific instrumentation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018
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22 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Jan VictorGhent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium, jan.victor@ugent.be.
Jan Dujardin
Hilde Vandenneucker
Nele Arnout
Johan Bellemans

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial. QUESTIONS/PURPOSES: We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG.

methodsIn this randomized controlled trial, we enrolled 128 patients. In the PSG cohort, surgical navigation was used as an intraoperative control. When the suggested cut deviated more than 3° from target, the use of PSG was abandoned and marked as an outlier. When cranial-caudal position or size was adapted, the PSG was marked as modified. All patients underwent long-leg standing radiography and CT scan. Deviation of more than 3° from the target in any plane was defined as an outlier.

resultsThe PSG and conventional cohorts showed similar numbers of outliers in overall coronal alignment (25% versus 28%; p = 0.69), femoral coronal alignment (7% versus 14%) (p = 0.24), and femoral axial alignment (23% versus 17%; p = 0.50). There were more outliers in tibial coronal (15% versus 3%; p = 0.03) and sagittal 21% versus 3%; p = 0.002) alignment in the PSG group than in the conventional group. PSGs were abandoned in 14 patients (22%) and modified in 18 (28%).

conclusionsPSGs do not improve accuracy in TKA and, in our experience, were somewhat impractical in that the procedure needed to be either modified or abandoned with some frequency.

Indexed as

AdultArthroplasty, Replacement, KneeFemaleFemurHumansKnee JointMaleOsteoarthritis, KneePatient PositioningProspective StudiesRadiographyReproducibility of ResultsSurgery, Computer-AssistedTibiaTreatment Outcome

Identifiers

PMID23616267
PMCPMC3889461

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.