Clinical and Economic Case for Patient-Specific Total Knee Arthroplasty: A Prospective Study

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Medical Device Technology

Background:

• Total knee arthroplasty (TKA) addresses severe knee arthritis and cartilage destruction.
• Prosthetic design and surgical technique are critical for TKA success.
• Patient-specific knee (PSK) systems offer a tailored approach compared to standard off-the-shelf (OTS) implants.

Purpose of the Study:

• To compare the clinical outcomes and cost-effectiveness of a PSK system (iTotal® Identity CR) versus an OTS system (Triathlon®).
• To evaluate operative efficiency, patient-reported outcomes, and complication rates between the two TKA systems.

Main Methods:

• A single-center, prospective study involving 188 patients (217 knees) undergoing TKA.
• Comparison between the PSK (iTotal® Identity CR) and OTS (Triathlon®) systems.
• Data collected included operative times, complications, patient-reported outcomes (KOOS-JR, KSS), and cost metrics.

Main Results:

• The PSK group showed significantly shorter average total operating room time (85.2 vs. 95.9 min, p < 0.001).
• PSK patients experienced greater postoperative improvement in KOOS-JR (37.33 vs. 24.61, p < 0.001) and KSS (113.1 vs. 98.1, p < 0.001) scores.
• PSK group had significantly reduced OR instrument setup and tear down times.

Conclusions:

• Patient-specific knee systems demonstrate superior operative efficiency compared to standard OTS systems.
• PSK implants lead to improved patient-reported outcomes at three months post-TKA.
• Further long-term studies are needed to confirm the sustained benefits of PSK in diverse populations.