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Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 21, Issue 10, pp 2227–2233 | Cite as

Patient-specific instruments: industry’s innovation with a surgeon’s interest

  • Emmanuel Thienpont
  • Johan Bellemans
  • Hendrik Delport
  • Philippe Van Overschelde
  • Bart Stuyts
  • Karl Brabants
  • Jan Victor
Knee

Abstract

Purpose

The aim of this study was (1) to survey the orthopaedic companies about the volume of patient-specific instruments (PSI) used in Europe and worldwide; (2) to survey a group of knee arthroplasty surgeons on their acceptance of PSI and finally; (3) to survey a medico-legal expert on PSI-related issues.

Methods

Seven orthopaedic implant manufacturers were contacted to obtain their sales figures (in volume) of PSI in Europe and worldwide for the 2011 and 2012 period. During the Open Meeting of the Belgian Knee Society, a survey by a direct voting system was submitted to a selection of knee surgeons. Finally, a number of medico-legal ‘PSI-related’ questions were submitted to an adult reconstruction surgeon/legal expert.

Results

The total volume, for all contacted companies, of PSI in Europe for 2012 was 17,515 total knee arthroplasty (TKA) and 82,556 TKA worldwide. Biomet (Warsaw, USA) was the number one in volume, both in Europe as worldwide with their Signature system. Biomet represented 27 % of the market share in PSI worldwide. Stryker preferred not to reply to the survey because of the FDA class 1 recall on ShapeMatch cutting guides. Eighty per cent of the Belgian knee surgeons expressed a great interest in PSI and especially, for 58 % of them, if it would increase their surgical accuracy. They valued it even more in unicompartmental arthroplasty, and 55 % was ready to use single-use instruments. Surprisingly, 47 % of surgeons thought it was the company’s responsibility if something goes wrong with a PSI-assisted case. The medico-legal expert concluded that PSI is a complex process that exposes surgeons to new risks in case of failure and stated that companies should not produce surgical guides without validation of the planning by the surgeon.

Conclusion

Patient-specific instruments is of great interest if it can proof to increase the surgical accuracy in knee arthroplasty to the level surgeons are expecting and if in the same time it would make the surgical process more efficient.

Level of evidence

V.

Keywords

Total knee arthroplasty Patient-specific instruments Accuracy Medico-legal Survey study 

Notes

Acknowledgments

The authors wish to thank Leo Beckers, Lukas Beckers, Hans Casteur, Raf Devloo, Angelique Koninckx, Peter Stuer, Luc Van Den Daele and Peter Verdonk for their contributions to the Open Meeting of the Belgian Knee Society in November 2012.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Emmanuel Thienpont
    • 1
  • Johan Bellemans
    • 2
  • Hendrik Delport
    • 3
  • Philippe Van Overschelde
    • 4
  • Bart Stuyts
    • 5
  • Karl Brabants
    • 6
  • Jan Victor
    • 7
  1. 1.University Hospital Saint LucBrusselsBelgium
  2. 2.University Hospital UZ PellenbergKU LeuvenLeuvenBelgium
  3. 3.Catholic University of LeuvenLeuvenBelgium
  4. 4.AZ Maria MiddelaresGentBelgium
  5. 5.Sint AugustinusWilrijkBelgium
  6. 6.AZ MiddelheimAntwerpenBelgium
  7. 7.University Hospital UZ GhentGentBelgium

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