Evidence map›Paper›PMID 29713783›Full record

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

A high rate of tibial plateau fractures after early experience with patient-specific instrumentation for unicompartmental knee arthroplasties.

A M Leenders, M G M Schotanus, R J P Wind, R A P Borghans, N P Kort

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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 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 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

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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  8. What future in the treatment of osteochondral knee defects?Annals of translational medicine · 2018
    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

5 authors.

A M LeendersOrthopedic Resident at Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX, Maastricht, The Netherlands.
M G M SchotanusOrthopedic Research Manager at Zuyderland Medical Centre, Dr H vd Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands. martijnschotanus@hotmail.com.ORCID http://orcid.org/0000-0002-3975-6337
R J P WindOrthopedic Resident at Sint Maartenskliniek, Hengstdal 3, 6574 NA, Ubbergen, The Netherlands.
R A P BorghansRadiologist at Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 AG, Sittard-Geleen, The Netherlands.
N P KortOrthopaedic Surgeon at ACIBADEM International Medical Center, Arlandaweg 100, 1043 HP, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatient-specific instrumentation (PSI) for unicompartmental knee arthroplasty (UKA) has been available for a few years. However, limited literature is available on this subject. Hence, the aim of this cohort study is to evaluate the 2 years' results of our first experiences with the use of PSI in UKA. It is hypothesised that there is no advantage in rate of adverse events and in radiological and functional outcomes in comparison to literature on the conventional method.

methodsThis cohort included 129 knees of 122 patients, operated by one surgeon. Outcome measures were the rate of adverse events (AEs); implant position as determined on radiographs; the accuracy of the default and approved planning of the implant sizes and the patient-reported outcome measures (PROMs) preoperatively, and at 3, 12 and 24 months, postoperatively.

resultsA total of 6 (4.9%) AEs were observed in this study, with 4 (3.3%) tibial fractures being the main complication. The mean postoperative biomechanical axis was 176.4° and in the majority of cases, the radiographic criteria, as determined by the manufacturer, were met. The tibial component showed 20 (16.4%) outliers in the sagittal and 3 (2.5%) outliers in the frontal plane. There were no outliers of the femoral component. For the femoral and tibial components, respectively, in 125 (96.9%) and 79 (61.7%) cases, there was an agreement between approved planning and implanted component size. All PROMs improved significantly after surgery.

conclusionTibial fracture was the most common AE, probably related to the transition from cemented to uncemented UKA. Perioperative modifications to the surgical technique were made in order to prevent this AE. Improvements should be made to the operation technique of the uncemented tibial plateau to obtain an adequate placement and at the same time reduce the risk for tibial fracture. The PSI technique was a reliable tool for the placement of the femoral component. Functional outcome was in line with literature on the conventional method. It is strongly recommended that the surgeon approves every preoperative plan, in order to optimise the accuracy during the PSI surgery. LEVEL OF EVIDENCE: III.

Indexed as

Surgery, Computer-AssistedArthroplasty, Replacement, KneeCohort StudiesFemaleHumansKnee ProsthesisMaleMiddle AgedPostoperative ComplicationsPreoperative CareTibial FracturesCustom fitInstrumentsPatient specificPatient-specific guidesPatient-specific matched instrumentsPSGPSITemplatingUKAUnicompartmental knee arthroplastyUnicondylar knee arthroplasty

Identifiers

PMID29713783

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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.