Patient specific implants: scope for the future

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Medical technology assessment

Background:

• Patient-specific instrumentation (PSI) emerged recently, gaining traction in total knee arthroplasty (TKA).
• Comparative studies between PSI and conventional jigs in TKA have yielded mixed results, often showing no significant advantages for PSI.
• The clinical application and cost-effectiveness of PSI require further investigation.

Purpose of the Study:

• To review the intraoperative and postoperative advantages and disadvantages of patient-specific instruments in total knee arthroplasty.
• To evaluate the cost-effectiveness of patient-specific instrumentation compared to conventional methods.
• To provide a synopsis of current literature regarding the clinical utility of patient-specific instruments and implants.

Main Methods:

• Systematic literature review of studies comparing patient-specific instruments with conventional jigs in total knee arthroplasty.
• Analysis of reported intraoperative and postoperative outcomes, including benefits and drawbacks.
• Assessment of cost-effectiveness data and current availability of patient-specific implants.

Main Results:

• Existing literature suggests patient-specific instruments offer no clear additional benefits over conventional jigs in total knee arthroplasty.
• Data on the intraoperative and postoperative advantages/disadvantages and cost-effectiveness of PSI are limited and inconclusive.
• Patient-specific implants are not yet widely available, and clinical practice data is scarce.

Conclusions:

• The current evidence does not strongly support the routine use of patient-specific instruments in total knee arthroplasty due to a lack of demonstrated benefits.
• Further research is needed to clarify the role and cost-effectiveness of PSI, especially concerning patient-specific implants.
• The clinical impact of patient-specific technology in knee replacement surgery remains uncertain.