Patient-Specific Instruments for Total Knee Replacement: Based on MRI and Whole-Leg Radiograms (VISIONAIRE™)

  • Carsten O. Tibesku


The VISIONAIRE™ (Smith & Nephew) patient-specific instrumentation is based on a magnetic resonance imaging (MRI) scan of the knee and a whole-leg standing radiogram for calculation of the axes. The preoperative planning is based on the surgeon’s individual preferences and can still be changed during the planning process. The surgeon can more easily control the whole-leg standing radiogram measurements than the axes that are calculated from computed tomography (CT) or MRI data. VISIONAIRETM instruments already include the cutting slots and are fully compatible with conventional instruments, in case the surgeon wishes to change any parameters during surgery.


Total Knee Arthroplasty Total Knee Replacement Tibial Slope Rotational Alignment Cutting Block 
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  1. Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D (2007) Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 89:261- 269PubMedCrossRefGoogle Scholar
  2. Cheng T, Zhang G, Zhang X (2011) Imageless navigation system does not improve component rotational alignment in total knee arthroplasty. J Surg Res 171:590–600PubMedCrossRefGoogle Scholar
  3. Daniilidis K, Tibesku CO (2013) Frontal plane alignment after total knee arthroplasty using patient-specific instruments. Int Orthop 37:45–50PubMedCrossRefGoogle Scholar
  4. Dattani R, Patnaik S, Kantak A, Tselentakis G (2009) Navigation knee replacement. Int Orthop 33:7–10PubMedCrossRefGoogle Scholar
  5. Heyse TJ, Tibesku CO (2012) Improved femoral component rotation in TKA using patient-specific instrumentation. Knee [Epub ahead of print]Google Scholar
  6. Iorio R, Bolle G, Conteduca F, Valeo L, Conteduca J, Mazza D, Ferretti A (2012) Accuracy of manual instrumentation of tibial cutting guide in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc [Epub ahead of print]Google Scholar
  7. Jerosch J, Peuker E, Philipps B, Filler T (2002) Interindividual reproducibility in perioperative rotational alignment of femoral components in knee prosthetic surgery using the transepicondylar axis. Knee Surg Sports Traumatol Arthrosc 10:194–197PubMedCrossRefGoogle Scholar
  8. Lombardi AV Jr, Berend KR, Ng VY (2011) Neutral mechanical alignment: a requirement for successful TKA: affirms. Orthopedics 34:e504–506PubMedGoogle Scholar
  9. Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C (2007) A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg Am 89:236–243PubMedCrossRefGoogle Scholar
  10. Ng VY, DeClaire JH, Berend KR, Gulick BC, Lombardi AV Jr (2012) Improved accuracy of alignment with patient-specific positioning guides compared with manual instrumentation in TKA. Clin Orthop Rel Res 470:99–107CrossRefGoogle Scholar
  11. Noble JW, Jr, Moore CA, Liu N (2012) The value of patientmatched instrumentation in total knee arthroplasty. J Arthrop 27:153–155CrossRefGoogle Scholar
  12. Nunley RM, Ellison BS, Ruh EL, Williams BM, Foreman K, Ford AD, Barrack RL (2012a) Are patient-specific cutting blocks cost-effective for total knee arthroplasty? Clin Orthop Rel Res 470:889–894CrossRefGoogle Scholar
  13. Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL (2012b) Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Rel Res 470:895–902CrossRefGoogle Scholar
  14. Slover JD, Rubash HE, Malchau H, Bosco JA (2012) Cost-effectiveness analysis of custom total knee cutting blocks. J Arthrop 27:180–185CrossRefGoogle Scholar
  15. Tibesku CO, Hofer P, Ruys CJM, Portegies W, Fennema P (2012a) Benefits of using customized intrumentation in total knee arthroplasty: results from an activity based costing model. Arch Orthop Trauma Surg [Epub ahead of print]Google Scholar
  16. Tibesku CO, Innocenti B, Wong P, Salehi A, Labey L (2012b) Can CT-based patient-matched instrumentation achieve consistent rotational alignment in knee arthroplasty? Arch Orthop Trauma Surg 132:171–177CrossRefGoogle Scholar
  17. Watters TS, Mather RC 3rd, Browne JA, Berend KR, Lombardi AV Jr, Bolognesi MP (2011) Analysis of procedure-related costs and proposed benefits of using patient-specific approach in total knee arthroplasty. J Surg Orthop Adv 20:112–126PubMedGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Carsten O. Tibesku
    • 1
  1. 1.Sporthopaedicum StraubingStraubing

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