ArticleBMC musculoskeletal disorders2020
Accurate implant fit and leg alignment after cruciate-retaining patient-specific total knee arthroplasty.
Article in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- No clinical advantage with customized individually made implants over conventional off-the-shelf implants in total knee arthroplasty: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- A prospective study comparing sleep quality using Pittsburgh Sleep Quality Index at 8 weeks after robotic-assisted versus conventional total knee arthroplasty: a single-center study.Journal of robotic surgery · 2025Trial
- From empirical to analytical: synergizing robotic assistance with customized implants for superior TKA outcomes.Journal of orthopaedic surgery and research · 2026Article
- Robotic-assisted differential total knee arthroplasty with patient-specific implants: surgical techniques and preliminary results.Arthroplasty (London, England) · 2024Article
- A review of the design, manufacture, and outcomes of custom total joint replacement implants available in the United States.Journal of clinical orthopaedics and trauma · 2024Review
- 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
- Applying machine learning methods to enable automatic customisation of knee replacement implants from CT data.Scientific reports · 2023Article
- The Impact of Total Knee Replacement with a Customized Cruciate-Retaining Implant Design on Patient-Reported and Functional Outcomes.Journal of personalized medicine · 2022Article
- Custom TKA: what to expect and where do we stand today?Archives of orthopaedic and trauma surgery · 2021Review
- Comparison of Postoperative Coronal Leg Alignment in Customized Individually Made and Conventional Total Knee Arthroplasty.Journal of personalized medicine · 2021Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFor improved outcomes in total knee arthroplasty (TKA) correct implant fitting and positioning are crucial. In order to facilitate a best possible implant fitting and positioning patient-specific systems have been developed. However, whether or not these systems allow for better implant fitting and positioning has yet to be elucidated. For this reason, the aim was to analyse the novel patient-specific cruciate retaining knee replacement system iTotal™ CR G2 that utilizes custom-made implants and instruments for its ability to facilitate accurate implant fitting and positioning including correction of the hip-knee-ankle angle (HKA).
methodsWe assessed radiographic results of 106 patients who were treated with the second generation of a patient-specific cruciate retaining knee arthroplasty using iTotal™ CR G2 (ConforMIS Inc.) for tricompartmental knee osteoarthritis (OA) using custom-made implants and instruments. The implant fit and positioning as well as the correction of the mechanical axis (hip-knee-ankle angle, HKA) and restoration of the joint line were determined using pre- and postoperative radiographic analyses.
resultsOn average, HKA was corrected from 174.4° ± 4.6° preoperatively to 178.8° ± 2.2° postoperatively and the coronal femoro-tibial angle was adjusted on average 4.4°. The measured preoperative tibial slope was 5.3° ± 2.2° (mean +/- SD) and the average postoperative tibial slope was 4.7° ± 1.1° on lateral views. The joint line was well preserved with an average modified Insall-Salvati index of 1.66 ± 0.16 pre- and 1.67 ± 0.16 postoperatively. The overall accuracy of fit of implant components was decent with a measured medial overhang of more than 1 mm (1.33 mm ± 0.32 mm) in 4 cases only. Further, a lateral overhang of more than 1 mm (1.8 mm ± 0.63) (measured in the anterior-posterior radiographs) was observed in 11 cases, with none of the 106 patients showing femoral notching.
conclusionThe patient-specific iTotal™ CR G2 total knee replacement system facilitated a proper fitting and positioning of the implant components. Moreover, a good restoration of the leg axis towards neutral alignment was achieved as planned. Nonetheless, further clinical follow-up studies are necessary to validate our findings and to determine the long-term impact of using this patient- specific system.
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