Guided Personalized Surgery (GPS) in Posterostabilized Total Knee Replacement: A Radiological Study.

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering
• Medical Imaging

Background:

• Surgical accuracy in total knee replacement (TKR) can be influenced by surgeon technique, patient deformity, and instrumentation.
• Navigation systems aim to enhance intraoperative decision-making but their effectiveness and procedural complexity are debated.

Purpose of the Study:

• To compare the accuracy of the Guided Personalized Surgery (GPS) system against standard instrumentation for total knee replacement (TKR).
• To evaluate the impact of the GPS system on radiographic measurements including alignment, joint line, and patellar height.

Main Methods:

• A retrospective case-control study with prospective data collection.
• 100 consecutive TKR patients were analyzed, divided into standard technique (n=59) and GPS system (n=41) groups.
• Radiographic measurements of alignment (mLDFA, mMPTA), patellar height (Blackburne-Peel Index, Epicondylar Ratio), and joint line indices were assessed postoperatively.

Main Results:

• The GPS group demonstrated improved mechanical Lateral Distal Femoral Angle (mLDFA) alignment (p=0.003) and achieved normal patellar height in 98% of cases (p=0.002).
• Lower dispersion of postoperative measurements was observed in the GPS group across multiple indices (mMPTA, CD-Index, IS-Index, mIS-Index, BP-Index, ER), indicating higher reproducibility.
• While mLDFA showed improvement, mMPTA alignment did not significantly differ between groups (p=0.132).

Conclusions:

• The GPS system facilitates better post-surgical restoration of joint line and patellar height in TKR.
• The GPS system shows a tendency towards more accurate mechanical alignment and reduced inter-patient variability, suggesting enhanced reproducibility in TKR procedures.