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Patient-specific instrumentation in total knee arthroplasty
Julio J Jauregui1, Jeffrey J Cherian1, Bhaveen H Kapadia1
1Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland.
The Journal of Knee Surgery
|April 26, 2014
Summary
Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) may simplify surgery but has not yet proven cost-effectiveness or improved long-term outcomes. Further long-term studies are needed to assess benefits.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Medical Technology
Background:
- Patient-specific instrumentation (PSI) utilizes preoperative imaging (CT/MRI) for custom surgical guides in total knee arthroplasty (TKA).
- PSI was developed to enhance surgical efficiency, reduce costs, improve joint alignment, and minimize radiographic outliers during TKA procedures.
Purpose of the Study:
- To evaluate the efficacy and cost-effectiveness of patient-specific instrumentation in total knee arthroplasty.
- To assess whether PSI leads to improved alignment, clinical, radiographic, and functional outcomes compared to traditional methods.
Main Methods:
- Review of existing literature and data on the application of PSI in TKA.
- Analysis of reported reductions in instrumentation, operative time, and turnover rates associated with PSI.
Main Results:
- While PSI can reduce instrumentation, operative time, and turnover, overall cost reduction remains unproven due to imaging and guide production expenses.
- Current evidence is controversial regarding improvements in alignment and long-term clinical, radiographic, or functional benefits.
Conclusions:
- The long-term benefits of PSI for total knee arthroplasty, including implant survivorship and patient outcomes, require further investigation.
- Paucity of long-term studies makes it difficult to ascertain substantial improvements in patient function, overall outcomes, or cost-effectiveness.
