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Knee Surgery, Sports Traumatology, Arthroscopy

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Open Access 01-09-2017 | Knee

Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation

Authors: Bert Boonen, Martijn G. M. Schotanus, Bart Kerens, Frans-Jan Hulsmans, Wim E. Tuinebreijer, Nanne P. Kort

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 9/2017

Abstract

Purpose

To assess whether there is a significant difference between the alignment of the individual femoral and tibial components (in the frontal, sagittal and horizontal planes) as calculated pre-operatively (digital plan) and the actually achieved alignment in vivo obtained with the use of patient-specific positioning guides (PSPGs) for TKA. It was hypothesised that there would be no difference between post-op implant position and pre-op digital plan.

Methods

Twenty-six patients were included in this non-inferiority trial. Software permitted matching of the pre-operative MRI scan (and therefore calculated prosthesis position) to a pre-operative CT scan and then to a post-operative full-leg CT scan to determine deviations from pre-op planning in all three anatomical planes.

Results

For the femoral component, mean absolute deviations from planning were 1.8° (SD 1.3), 2.5° (SD 1.6) and 1.6° (SD 1.4) in the frontal, sagittal and transverse planes, respectively. For the tibial component, mean absolute deviations from planning were 1.7° (SD 1.2), 1.7° (SD 1.5) and 3.2° (SD 3.6) in the frontal, sagittal and transverse planes, respectively. Absolute mean deviation from planned mechanical axis was 1.9°. The a priori specified null hypothesis for equivalence testing: the difference from planning is >3 or <−3 was rejected for all comparisons except for the tibial transverse plane.

Conclusion

PSPG was able to adequately reproduce the pre-op plan in all planes, except for the tibial rotation in the transverse plane. Possible explanations for outliers are discussed and highlight the importance for adequate training surgeons before they start using PSPG in their day-by-day practise.

Level of evidence

Prospective cohort study, Level II.

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Title: Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation
Authors: Bert Boonen
Martijn G. M. Schotanus
Bart Kerens
Frans-Jan Hulsmans
Wim E. Tuinebreijer
Nanne P. Kort
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 9/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-015-3661-1

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Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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Abstract

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