ArticleJournal of orthopaedic surgery and research2019
Patient-specific instrumentation improved three-dimensional accuracy in total knee arthroplasty: a comparative radiographic analysis of 1257 total knee arthroplasties.
Article in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Evaluating the clinical outcomes of computer-assisted surgery and patient-specific instrumentation compared to conventional instrumentation in total knee arthroplasty, a randomised controlled trial.BMC musculoskeletal disorders · 2025Trial
- From data to decisions: machine learning in predicting outcomes of robotic-assisted total knee arthroplasty.Frontiers in surgery · 2026Review
- Review
- Preoperative difference between 2D and 3D planning correlates with difference between planned and achieved surgical correction in patient-specific instrumented total knee arthroplasty.Journal of experimental orthopaedics · 2025Article
- Total Knee Arthroplasty in Paget's Disease using 3D-Printed Patient-Specific Femoral Jig - A Case Report.Journal of orthopaedic case reports · 2023Article
- A new robotically assisted technique can improve outcomes of total knee arthroplasty comparing to an imageless navigation system.Archives of orthopaedic and trauma surgery · 2023Article
- Closed-leg standing long leg radiographs can be a useful tool to assess whether the joint line is parallel to the ground in restricted kinematic alignment total knee arthroplasty.Journal of experimental orthopaedics · 2023Article
- Research Advances in the Application of AI for Preoperative Measurements in Total Knee Arthroplasty.Life (Basel, Switzerland) · 2023Review
- Trends in Computer-Assisted Surgery for Total Knee Arthroplasty in Germany: An Analysis Based on the Operative Procedure Classification System between 2010 to 2021.Journal of clinical medicine · 2023Article
- Accuracy of a Three-Dimensional (3D)-Printed Patient-Specific (PS) Femoral Osteotomy Guide: A Computed Tomography (CT) Study.Bioengineering (Basel, Switzerland) · 2022Article
- Patient-specific instrumentation for total knee arthroplasty improves reproducibility in the planned rotational positioning of the tibial component.Journal of orthopaedic surgery and research · 2022Article
- Surgeon Dominated Design Can Improve the Accuracy of Patient-Specific Instruments in Kinematically Aligned TKA.Journal of personalized medicine · 2022Article
- Extreme Hinge Axis Positions Are Necessary to Achieve Posterior Tibial Slope Reduction With Small Coronal-Plane Corrections in Medial Opening Wedge High Tibial Osteotomy.Orthopaedic journal of sports medicine · 2022Article
- Patient-Specific Instrumentation Accuracy Evaluated with 3D Virtual Models.Journal of clinical medicine · 2021Article
- Complex Primary Total Knee Arthroplasty in a Patient with Achondroplasia, Osteoarthritis, and Severe Coronal Instability.Arthroplasty today · 2021Article
- [Clinical application of distal femoral patient-specific cutting guide based on knee CT and full-length X-ray film of lower extremities].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe purpose of this study was to compare restoration of mechanical limb alignment and three-dimensional component-positioning between conventional and patient-specific instrumentation in total knee arthroplasty.
methodsRadiographic data of patients undergoing mobile-bearing total knee arthroplasty (n = 1257), using either conventional (n = 442) or patient-specific instrumentation (n = 812), were analyzed. To evaluate accuracy of axis restoration and 3D-component-positioning between conventional and patient-specific instrumentation, absolute deviations from the targeted neutral mechanical limb alignment and planned implant positions were determined. Measurements were performed on standardized coronal long-leg and sagittal knee radiographs. CT-scans were evaluated for accuracy of axial femoral implant rotation. Outliers were defined as deviations from the targeted neutral mechanical axis of > ± 3° or from the intraoperative component-positioning goals of > ± 2°. Deviations greater than ± 5° from set targets were considered to be severe outliers.
resultsDeviations from a neutral mechanical axis (conventional instrumentation: 2.3°± 1.7° vs. patient-specific instrumentation: 1.7°± 1.2°; p < 0.001) and numbers of outliers (conventional instrumentation: 25.8% vs. patient-specific instrumentation: 10.1%; p < 0.001) were significantly lower in the patient-specific instrumentation group. Significantly lower mean deviations and less outliers were detected regarding 3D-component-positioning in the patient-specific instrumentation compared to the conventional instrumentation group (all p < 0.05).
conclusionsPatient-specific instrumentation prevented from severe limb malalignment and component-positioning outliers (> ± 5° deviation). Use of patient-specific instrumentation proved to be superior to conventional instrumentation in achieving more accurate limb alignment and 3D-component positioning, particularly regarding femoral component rotation. Furthermore, the use of patient-specific instrumentation successfully prevented severe (> 5° deviation) outliers.
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