Evidence map›Paper›PMID 28785788›Full record

ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2018

Revision of partial knee to total knee arthroplasty with use of patient-specific instruments results in acceptable femoral rotation.

Martijn G M Schotanus, Elke Thijs, B Boonen, B Kerens, B Jong, Nanne P Kort

Abstract read
PubMed Publisher
In one paragraph

Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Clinical Outcome of Total Knee Arthroplasty Performed Using Patient-Specific Cutting Guides.Medical science monitor : international medical journal of experimental and clinical research · 2017
    Article
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

6 authors at 1 institution in 1 country.

Martijn G M SchotanusDepartment of Orthopedic Surgery and Traumatology Zuyderland Medical Center, Dr H vd Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands. martijnschotanus@hotmail.com.ORCID http://orcid.org/0000-0002-3975-6337
Elke ThijsDepartment of Orthopedic Surgery and Traumatology Zuyderland Medical Center, Dr H vd Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands.
B BoonenDepartment of Orthopedic Surgery and Traumatology Zuyderland Medical Center, Dr H vd Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands.
B KerensAZ St Maarten, Mechelen, Belgium.
B JongDepartment of Radiology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
Nanne P KortDepartment of Orthopedic Surgery and Traumatology Zuyderland Medical Center, Dr H vd Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands.
Zuyderland Medisch Centrum · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatient-specific instruments (PSI) were initially developed for the alignment of both total knee- (TKA) and partial knee arthroplasty (PKA). We hypothesize that CT-based PSI for PKA-to-TKA revision surgery can restore biomechanical limb alignment and prosthetic component positioning in vivo as calculated pre-operatively, resulting in a limited percentages of outliers.

methodsAn imaging analysis was performed using CT-based 3D measurement methods based on a pre- and post-revision CT scan. Imaging data were gathered on 10 patients who were operated for PKA-to-TKA revision with the use of PSI based on CT imaging. The planned femur and tibia component position in vivo were compared with the pre-revision planned component position. Outliers were defined as deviations >3.0° from pre-revision planned position for the individual implant components. Adjustments (e.g. resection level and implant size) during surgery were recorded.

resultsThe HKA axis was restored accurately in all patients with a mean post-operative HKA axis of 178.1° (1.4°). Five femoral (2 varus, 2 internal rotation and 1 extension) and 14 tibial guides (2 varus, 6 anterior slope, 3 internal rotation and 3 external rotation) on a total of 60 outcome measures were identified as outliers. During surgery, an intraoperative tibial resection of 2 mm extra was performed in three patients. In 80 and 70% for, respectively, the femur and tibia, the surgeon-planned size was implanted during surgery. All patient-specific guides fitted well in all patients. No intraoperative or post-operative complications related to surgery were registered.

conclusionsThis study introduced a unique new concept regarding PSI, PKA-to-TKA revision surgery. Based on the results, we were unable to fully confirm our hypothesis. PSI as a "new" tool for PKA-to-TKA revision surgery appears to be an accurate tool for the alignment of the TKA femur component. The tibial guide seems more susceptible to errors, resulting in a substantial percentage of outliers. LEVEL OF EVIDENCE: Prospective cohort study, Level II.

Indexed as

AgedArthroplasty, Replacement, KneeBiomechanical PhenomenaBone MalalignmentFemaleFemurHumansJoint DiseasesKnee JointKnee ProsthesisMaleMiddle AgedPatient-Specific ModelingProspective StudiesReoperationRotationAlignmentCT-basedOutliersPartial knee arthroplastyPatient-specific instrumentsPKAPlanningPSIRevisionTKATotal knee arthroplastyUKAUnicompartmental knee arthroplasty

Identifiers

PMID28785788
OpenAlexW2744974262

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.