Total knee arthroplasty using patient-specific guides: Is there a learning curve?

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Surgical technique innovation

Background:

• Patient-specific guides (PSG) are increasingly considered for total knee arthroplasty (TKA) to enhance component alignment.
• Understanding the learning curve associated with PSG in TKA is crucial for widespread adoption.

Purpose of the Study:

• To investigate the learning curve associated with the use of patient-specific guides in total knee arthroplasty.
• To evaluate the impact of surgeon experience with PSG on operative time and post-operative knee alignment.

Main Methods:

• Retrospective analysis of 86 consecutive total knee arthroplasties using patient-specific guides performed by a single surgeon.
• Comparison of the first 30 cases (Group 1) with the subsequent 56 cases (Group 2).
• Evaluation of operative times and post-operative multi-planar alignments via computed tomography (CT) scans.

Main Results:

• Mean operative time was significantly higher in the initial 30 cases (85 minutes) compared to the subsequent 56 cases (78 minutes) (p=0.001).
• No statistically significant differences were observed in post-operative total knee arthroplasty alignment between the two groups.

Conclusions:

• A minimal learning curve exists concerning operative time when utilizing patient-specific guides for total knee arthroplasty.
• The study did not detect a significant learning curve related to the restoration of mechanical knee alignment using patient-specific guides.