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Radiographic accuracy in TKA with a CT-based patient-specific cutting block technique

Koch, P. ; Müller, D. ; Pisan, M. ; Fucentese, S.

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2013, vol. 21, no. 10, p. 2200-2205

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    Titre
    • Radiographic accuracy in TKA with a CT-based patient-specific cutting block technique
    Auteur
    • Koch, P.. Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
    • Müller, D.. Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
    • Pisan, M.. Clinic of Orthopaedic Surgery, Kantonsspital Winterthur, Brauerstrasse 15, 8401, Winterthur, Switzerland
    • Fucentese, S.. Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstrasse 340, 8008, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Knee Surgery, Sports Traumatology, Arthroscopy, 2013, vol. 21, no. 10, p. 2200-2205. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:316126
    Summary
    Purpose: Patient-specific instrumentation (PSI) technology for the implantation of total knee arthroplasty (TKA) has a rising interest in the orthopaedic community. Data of PSI are controversially discussed. The hypothesis of this paper is that the radiological accuracy of CT-based PSI is similar to the one of navigated TKA published in the literature. Methods: Since 2010, all 301 consecutively performed PSI TKAs (GMK MyKnee©) were included in this study. The radiological assessment consisted in a preoperative and postoperative standard X-ray and long-standing X-ray. Changes from the planned to the definitively implanted component size were documented. Postoperative analysis included limb alignment and position of femoral and tibial components (for varus/valgus and flexion or tibial slope). Results: The postoperative average hip-knee-ankle angle was 180.1°±2.0°. In the frontal plane a total of 12.4% of outliers >3°, for the tibial components 4.1% of outliers >3° and for the femoral components 4.8% of outliers >3° were measured. A total of 12.3% of outliers for posterior tibial slope and 9% of outliers >3° for the femoral flexion were noted. 10.8% of the 602 planned size components were adapted intraoperatively. Conclusion: Although it is still unknown which limb axis is the correct one for the best clinical result, a technology providing the aimed axis in a most precise way should be chosen. Comparing the outcome of the current study with the data from the literature, there does not seem to be any difference compared to computer-assisted surgery. Level of evidence: IV