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Verification of in vivo accuracy of Trumatch™ patient-specific instrumentation in total knee replacement using pin-less computer navigation

  • Original Article • KNEE - ARTHOPLASTY
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Accurate component alignment in total knee replacement (TKR) is one of the important factors in determining long-term survivorship. This has been achieved by conventional jigs, computer-assisted technology (CAS) and more recently patient-specific instrumentation (PSI). The purpose of the current study was to investigate the in vivo accuracy of Trumatch™ PSI using validated pin-less computer navigation system.

Method

Twenty consecutive selected patients that fulfilled our inclusion/exclusion criteria underwent TKR using PSI. Coronal alignment, posterior slope, resection thickness and femoral sagittal alignment were recorded using pin-less navigation. The position of the actual cutting block was appropriately adjusted prior to proceeding to definitive resections.

Results

The coronal alignment using PSI without the assistance of navigation would have resulted in 14 (70 %) within ±3°, 11 (55 %) within ±2° and 6 (30 %) outside acceptable alignment. Thirty-five percentage of proposed femur sagittal alignment and 55 % of posterior tibial slope were achieved within ±3°. Components size was accurately predicted in 95 % of femurs and 90 % of tibia.

Conclusion

The purported advantages in restoring alignments using Trumatch™ PSI alone over standard equipment are debatable. However, it predicts sizing well, and femoral coronal alignment is reasonable. Combining Trumatch™ PSI with CAS will allow in vivo verification and necessary corrections.

Level of evidence

IV.

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Authors and Affiliations

  1. The South West London Elective Orthopaedic Centre, Dorking Road, Epsom, London, KT18 7EG, UK

    Nikolai Briffa, Mohamed A. Imam, Ravi Mallina & Ajeya Adhikari

  2. Orthopaedic Surgery and Traumatology Department, Faculty of Medicine, Suez Canal University, Circular Road, Ismailia, 41522, Egypt

    Mohamed A. Imam & Ashraf Abdelkafy

Authors
  1. Nikolai Briffa
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  2. Mohamed A. Imam
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  3. Ravi Mallina
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  4. Ashraf Abdelkafy
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  5. Ajeya Adhikari
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Corresponding author

Correspondence to Ashraf Abdelkafy.

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Conflict of interest

The authors declare that they have no conflict of interest. Also, they have not received any payment or services from any third party for any aspect of the submitted work. Also, they have no financial relationships with any of the entities described in the instructions. Also, the authors have no patents whether planned, pending or issued.

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Authors certify that their institution has approved the conduction of and their participation in this study and that all investigations were conducted in conformity with ethical principles of research and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Briffa, N., Imam, M.A., Mallina, R. et al. Verification of in vivo accuracy of Trumatch™ patient-specific instrumentation in total knee replacement using pin-less computer navigation. Eur J Orthop Surg Traumatol 27, 125–132 (2017). https://doi.org/10.1007/s00590-016-1849-9

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  • DOI: https://doi.org/10.1007/s00590-016-1849-9

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