Related Experiment Video
Updated: May 17, 2026
Three-Dimensional Preoperative Virtual Planning in Derotational Proximal Femoral Osteotomy
Published on: February 17, 2023
Improved femoral component rotation in TKA using patient-specific instrumentation
Thomas J Heyse1, Carsten O Tibesku2
1Department of Orthopedics and Rheumatology, University Hospital Marburg, Germany.
Background:
Patient-specific instrumentation (PSI) was introduced in an attempt to reduce positional outliers of components in total knee arthroplasty (TKA). It was hypothesized that PSI could help with the positioning of femoral components in optimal rotational alignment.
Methods:
A magnetic resonance imaging (MRI) analysis of 94 patients following TKA was conducted. Of these, 46 operations were performed using PSI and 48 using conventional instrumentation. The rotation of the femoral components was determined in the MRI and deviations>3° were considered outliers. Data were analyzed for positional outliers, observer reliability, and a variance comparison between implant groups.
Results:
There was excellent inter- and intraobserver reliability with low standard deviations for the determination of femoral component rotation. There were significantly more outliers in the conventional (22.9%) group than in the PSI group (2.2%, p=0.003).
Conclusion:
In this setup, PSI was effective in significantly reducing outliers of optimal rotational femoral component alignment during TKA.
