Patient-matched total knee arthroplasty: does it offer any clinical advantages?

This study aimed to assess if patient-matched cutting blocks reduce operating time, blood loss and length of stay on top of improving implant alignment and offer operational or economic benefits, as claimed by manufacturers. We retrospectively reviewed patients undergoing TKA using patient matched technology and compared them with patients undergoing TKA using standard instrumentation; all were operated on between September 2010 and June 2012. All procedures were performed by a single surgeon at a single centre using the same implants. We collected data on operating time, length of stay and blood loss and also measured component alignment. Thirty-nine patients underwent TKA using patient-matched technology during the study period. Data was compared with that from 50 patients undergoing TKA using standard instrumentation during the same period. We found no significant difference in operating time, length of stay or blood loss between the two groups. There was also no difference in femoral or tibial component alignment although we did observe that the femorotibial angle of TKAs using patient-matched technology was 0.9 degrees more valgus (183.5 degrees versus 182.6 degrees, p = 0.035). In this study, patient-matched technology did not appear to give any clinical advantages over standard techniques although, equally, it did not appear to show any disadvantages. Further studies are needed to evaluate whether operational or economic benefits may be achieved by adoption of patient matched instrumentation.