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Patient specific instrumentation
David R Lionberger1, Catherine L Crocker2, Vincent Chen3
1Suite 1020, Houston, Texas.
The Journal of Arthroplasty
|May 10, 2014
Summary
Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) is more profitable and efficient than computer-assisted surgery (CAS). While PSI improves operating room efficiency, it does not enhance surgical accuracy compared to CAS.
Area of Science:
- Orthopedic Surgery
- Medical Device Technology
- Health Economics
Background:
- Traditional instrumentation in total knee arthroplasty (TKA) is being challenged by newer technologies.
- Patient-specific instrumentation (PSI) offers a personalized approach to surgical planning and execution.
- Computer-assisted surgery (CAS) is another advanced technique used in TKA.
Purpose of the Study:
- To compare the operating room (OR) efficiency of PSI versus CAS in TKA.
- To evaluate the accuracy of PSI compared to CAS as a secondary outcome.
- To determine the economic viability of PSI through a profit ratio (PR) analysis.
Main Methods:
- A randomized controlled trial involving sixty patients undergoing TKA.
- Patients were allocated to either PSI or CAS groups.
- A profit ratio formula was developed, considering costs, revenue, and total OR time.
Main Results:
- PSI cases demonstrated a 1.45 times higher profitability compared to CAS cases.
- PSI allows for approximately 3 cases per 8-hour OR day, versus 2 CAS cases.
- No significant difference in accuracy was observed between PSI and CAS groups.
Conclusions:
- Patient-specific instrumentation (PSI) significantly enhances operating room efficiency in total knee arthroplasty (TKA).
- PSI demonstrates superior economic benefits over computer-assisted surgery (CAS).
- Current PSI methods do not provide an accuracy advantage over CAS in TKA.
