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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-10-2013 | Knee

Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation

Authors: Sébastien Parratte, Guillaume Blanc, Thomas Boussemart, Matthieu Ollivier, Thomas Le Corroller, Jean-Noël Argenson

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2013

Abstract

Purpose

It was our hypothesis that patient-specific instrumentation (PSI) can improve the accuracy of the rotational alignment in TKA based on the concept of the system and on the potential to clearly identify pre-operatively during planning the classical anatomical landmarks that serve as references to set-up the rotation both for the femur and tibia.

Materials and methods

In this prospective comparative randomized study, 40 patients (20 in each group) operated in our institution between September 2012 and January 2013 by the 2 senior authors were included. Randomization of patients into one of the two groups was done by the Hospital Informatics Department with the use of a systematic sampling method. All patients received the same cemented high-flex mobile bearing TKA. In the PSI group, implant position was compared to the planed position using previously validated dedicated software. The position of the implants (frontal and sagittal) was compared in the 2 groups on standard X-rays, and the rotational position was analysed on post-operative CT-scan.

Results

90 % of the patients add <2° or mm of difference between the planned position of the implants and the obtained position, except for the tibial rotation where the variations were much higher. Mean HKA was 179° (171–185) in the PSI group with 4 outliers (2 varus: 171° and 172°:184° and 185°) and 178.3° with 2 outliers (171° and 176°) in the control group. No difference was observed between the two groups concerning the frontal and sagittal position of the implants on the ML and AP X-rays. No significant difference of femoral rotation was observed between the two groups with a mean of 0.4° in the PSI group and 0.2° in the control group (p: n.s). Mean tibial rotation was 8° of internal rotation in the PSI group and 15° of internal rotation in the standard group (p: n.s).

Conclusion

Based on our results, we were unable to confirm our hypothesis as PSI cannot improve rotation in TKA. More work needs to be done to more clearly define the place of PSI in TKA, to keep on improving the accuracy of the system and to better define the individual targets in TKA in terms of frontal, sagittal and rotational positioning of the implant for each patient.

Level of evidence

Prospective comparative randomized study, Level II.

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Title: Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation
Authors: Sébastien Parratte
Guillaume Blanc
Thomas Boussemart
Matthieu Ollivier
Thomas Le Corroller
Jean-Noël Argenson
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-013-2623-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Rotation in total knee arthroplasty: no difference between patient-specific and conventional instrumentation

Abstract

Purpose

Materials and methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and methods

Results

Conclusion

Level of evidence

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