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Patient-specific instrumentation may not improve femoral component rotation in TKA
Use of patient-specific instrumentation during total knee arthroplasty did not improve the accuracy of femoral component rotation compared with conventional instrumentation, according to results.
Researchers randomly assigned 69 patients undergoing TKA to either Trumatch patient-specific instrumentation (DePuy Orthopaedics Inc.) or conventional instrumentation. Researchers recorded surgical times, calculated total blood volume loss and estimated red blood cell during hospital stay. They obtained a CT of the knee 2 months after surgery to measure femoral component rotation to the transepicondylar axis and tibial component slope.
Compared with conventional instrumentation, results showed patients in the patient-specific instrumentation group did not have significant improvements in femoral component rotator or reduction of outliers. Tibial slope, blood loss, total surgical time and ischemia time did not show significant improvements in the patient-specific instrumentation group, according to results. Researchers found a significantly greater number of tibial re-cuts were required in the patient-specific instrumentation group vs. the control group.
“Recognizing that [patient-specific instrumentation] PSI could be an extremely valid tool in specific conditions, such as severe extra-articular deformity, presence of intramedullary or peri-articular retained hardware, the results of this study do not support its routine use during standard TKA,” the authors wrote. – by Casey Tingle
Disclosures: Cucchi reports he is on the research committee for the Società Italiana del Ginocchio, Artoscopia, Sport, Cartilagine e Technologie Ortopediche. Please see the full study for a list of all other authors’ relevant financial disclosures.