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CT-based TruMatch® Personal Solutions for knee replacement Surgery … Does it really match?
Amila N Silva1, You Wei Adriel Tay1, Sharon Tan Si Heng2
1Singapore General Hospital, Department of Orthopaedic Surgery, 20 College Road, Academia, Level 4, 169856, Singapore.
Objective:
Patient-specific templates promises to be able to increase alignment while decreasing operative time, increasing patient throughput, decreasing instrumentation, reducing risk of fat embolism and intraoperative bleeding, decreasing tissue loss, shortening recovery, reducing post-operative pain and decreasing incidence of infection. However, multiple studies have shown conflicting results regarding these potential benefits. This study serves to critically evaluate the potential advantages and disadvantages of using a patient-specific templating technique through a single-surgeon study.
Methods:
All patients who underwent primary total knee arthroplasty (TKA) for osteoarthritis of the knee using TruMatch® Personal Solutions total knee replacement by a single surgeon were identified. An age-, gender-, side-, diagnosis- and surgeon-matched cohort who underwent conventional primary TKAs was randomly identified for comparison.
Results:
The average distal medial femur (p < 0.001), distal lateral femur (p < 0.001), posteromedial femur (p < 0.001), posterolateral femur (p < 0.001), medial tibial (p < 0.001) and lateral tibial (p = 0.12) predicted cuts showed significant difference from the actual corresponding cuts. Three knees also required the need to freehand. There was no significant difference in mechanical (p = 0.96) and anatomical alignments (p = 0.26), as well as the changes in mechanical (p = 0.06) and anatomical (p = 0.39) alignments between the two groups. Duration of surgery (p = 0.26), length of inpatient stay (p = 0.06) and incidence of wound infection (p = 1.00) were similar. Additionally, patients in the TruMatch® Personal Solutions group had a greater decrease drop in hemoglobin levels (p = 0.02), with five transfusions needed while only one patient in the conventional group required transfusion (p = 0.09).
Conclusion:
Our early experience and results with the CT-based TruMatch® Personal Solutions templates for TKA has not been promising. Despite promised, there were no demonstrable benefits with the technology. Moreover, the disadvantage of having increased blood loss was identified. Further studies are required to recommend the use of this technology.
