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European Journal of Orthopaedic Surgery & Traumatology

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01-08-2019 | Original Article • KNEE - ARTHROPLASTY

Rotational component alignment in patient-specific total knee arthroplasty compared with conventional cutting instrument

Authors: Nuttawut Chanalithichai, Nattapol Tammachote, Chane Jitapunkul, Supakit Kanitnate

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 6/2019

Abstract

Background

Although many studies investigated the accuracy of customized cutting block (CCB), the data on rotational alignment are still lacking. The study aimed to assess whether CCB improved the component rotational position compared with conventional cutting instrument (CCI) using computed tomography scanning.

Methods

Eighty-six of 102 total knee arthroplasties from the previous randomized study were analyzed. The outcomes were rotational position of the femoral and tibial components, frequency of outliers and intra-class correlation coefficient.

Results

The mean femoral component rotation was not different between CCB versus CCI: 0.9° ± 0.8° versus 1.1° ± 1.1° (P = 0.29). Both groups had similar outlier frequencies: 2% (CCB) versus 2% (CCI) (P = 0.74). CCB had nearly 1° less mean tibial component deviation compared with CCI (P < 0.001): (1) dorsal tangent reference (DTR): 0.7° ± 0.8° versus 1.5° ± 1.0°, and (2) tibial trans-epicondylar reference (TTR): 0.5° ± 0.9° versus 1.4° ± 1.1°. Outlier frequencies were similar: (1) DTR: 0% CCB versus 5% CCI (P = 0.24), and (2) TTR: 5% in CCB versus 12% CCI (P = 0.20). Measurements based on tibial tubercle showed that CCB had ~ 1.4° less mean tibial component deviation compared with CCI: 0.3° ± 1.4° versus 1.7° ± 1.6° (P < 0.001) with a corresponding, less frequency of outliers: 0% versus 19% (P = 0.002). However, there was poor intra-observer reproducibility (0.61).

Conclusions

CCB did not improve femoral component rotational alignment compared with CCI nor affect outlier frequency, but it marginally improved the accuracy of tibial rotational alignment. The tibial tubercle reference point had poor intra-observer reproducibility.

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Title: Rotational component alignment in patient-specific total knee arthroplasty compared with conventional cutting instrument
Authors: Nuttawut Chanalithichai
Nattapol Tammachote
Chane Jitapunkul
Supakit Kanitnate
Publication date: 01-08-2019
Publisher: Springer Paris
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 6/2019
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-019-02423-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Rotational component alignment in patient-specific total knee arthroplasty compared with conventional cutting instrument

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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