ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016
Patient-specific instrumentation improved mechanical alignment, while early clinical outcome was comparable to conventional instrumentation in TKA.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 47 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
47 citing papers in PubMed, 3 syntheses or guidelines pooled it, 87 citations in OpenAlex.
- Functional outcomes in patient specific instrumentation vs. conventional instrumentation for total knee arthroplasty; a systematic review and meta-analysis of prospective studies.BMC musculoskeletal disorders · 2022Pooled it
- Total knee arthroplasty using patient-specific instrumentation for osteoarthritis of the knee: a meta-analysis.BMC musculoskeletal disorders · 2019Pooled it
- Patient-specific instrumentation improved axial alignment of the femoral component, operative time and perioperative blood loss after total knee arthroplasty.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Pooled it
- Effect of patient specific instruments compared with conventional instruments in total knee arthroplasty : a randomized controlled trial.Acta orthopaedica · 2025Trial
- Efficiency assessment of intelligent patient-specific instrumentation in total knee arthroplasty: a prospective randomized controlled trial.Journal of orthopaedic surgery and research · 2024Trial
- A double-blind randomized controlled trial of total knee replacement using patient-specific cutting block instrumentation versus standard instrumentationCanadian journal of surgery. Journal canadien de chirurgie · 2019Trial
- Comparison of custom cutting guides based on three-dimensional computerized CT-scan planning and a conventional ancillary system based on two-dimensional planning in total knee arthroplasty: a randomized controlled trial.International orthopaedics · 2019Trial
- Patient-specific Instrumentation Affects Rotational Alignment of the Femoral Component in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial.Orthopaedic surgery · 2019Trial
- No improvement in reducing outliers in coronal axis alignment with patient-specific instrumentation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Trial
- Stability and alignment do not improve by using patient-specific instrumentation in total knee arthroplasty: a randomized controlled trial.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2018Trial
- Review
- [Patient-specific instrumentation in total knee arthroplasty - current concepts and clinical implications].Orthopadie (Heidelberg, Germany) · 2025Article
- Complex primary total knee arthroplasty with constrained condylar knee in post-traumatic arthritis: a retrospective comparison between 3D-printed patient-specific instrumentation and conventional instrumentation.Journal of orthopaedic surgery and research · 2025Article
- [New technologies in total knee arthroplasty : Current concepts and personalized treatment strategies].Orthopadie (Heidelberg, Germany) · 2025Review
- The CPAK classification in three-dimensional measurements is consistent with those in two-dimensional measurements.Archives of orthopaedic and trauma surgery · 2025Article
- Comparison of the accuracy and efficacy of different assistive techniques in primary total knee arthroplasty: A network meta-analysis.Journal of experimental orthopaedics · 2024Article
- A Retrospective Study to Compare Patient Outcomes from Standard Total Knee Arthroplasty (TKA) versus Navigation-Guided Arthroplasty Using the Brainlab Software-Guided Surgical System at a Center in Hebei Province January 2021 to July 2023.Medical science monitor : international medical journal of experimental and clinical research · 2024Article
- The coronal alignment differs between two-dimensional weight-bearing and three-dimensional nonweight bearing planning in total knee arthroplasty.Journal of experimental orthopaedics · 2024Article
- Combined Edge Loss UNet for Optimized Segmentation in Total Knee Arthroplasty Preoperative Planning.Bioengineering (Basel, Switzerland) · 2023Article
- Patient specific implants versus conventional implants in primary total knee arthroplasty: No significant difference in patient reported outcomes at 5 years.Journal of orthopaedics · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this prospective study was to compare early clinical outcome, radiological limb alignment, and three-dimensional (3D)-component positioning between conventional and computed tomography (CT)-based patient-specific instrumentation (PSI) in primary mobile-bearing total knee arthroplasty (TKA).
methodsTwo hundred ninety consecutive patients (300 knees) with severe, debilitating osteoarthritis scheduled for TKA were included in this study using either conventional instrumentation (CVI, n = 150) or PSI (n = 150). Patients were clinically assessed before and 2 years after surgery according to the Knee-Society-Score (KSS) and the visual-analog-scale for pain (VAS). Additionally, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and the Oxford-Knee-Score (OKS) were collected at follow-up. To evaluate accuracy of CVI and PSI, hip-knee-ankle angle (HKA) and 3D-component positioning were assessed on postoperative radiographs and CT.
resultsData of 222 knees (CVI: n = 108, PSI: n = 114) were available for analysis after a mean follow-up of 28.6 ± 5.2 months. At the early follow-up, clinical outcome (KSS, VAS, WOMAC, OKS) was comparable between the two groups. Mean HKA-deviation from the targeted neutral mechanical axis (CVI: 2.2° ± 1.7°; PSI: 1.5° ± 1.4°; p < 0.001), rates of outliers (CVI: 22.2%; PSI: 9.6%; p = 0.016), and 3D-component positioning outliers were significantly lower in the PSI group. Non-outliers (HKA: 180° ± 3°) showed better clinical results than outliers at the 2-year follow-up.
conclusionsCT-based PSI compared with CVI improves accuracy of mechanical alignment restoration and 3D-component positioning in primary TKA. While clinical outcome was comparable between the two instrumentation groups at early follow-up, significantly inferior outcome was detected in the subgroup of HKA-outliers. LEVEL OF EVIDENCE: Prospective comparative study, Level II.
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Registered trials
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.