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Intra- and post-operative accuracy assessments of two different patient-specific instrumentation systems for total knee replacement

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study is to assess and compare the accuracy of two different patient-specific instrumentation (PSI) systems for total knee replacement, both intra-operatively for bone preparation and post-operatively for final component alignment.

Methods

Twenty-five patients were treated according to a computer tomography (CT)-based PSI system (group A) and 25 to a magnetic resonance imaging (MRI)/X-ray-based system (group B). Alignments on the three anatomical planes and resection thickness at the cutting blocks and at the resulting bone cuts were recorded intra-operatively by a standard surgical navigation system. Alignments of the prosthetic components and mechanical axis were also measured post-operatively on radiographs. These measurements at both the femur and tibia were compared with those of the corresponding pre-operative planning, considering discrepancies larger than 3° as outliers.

Results

In both groups, the mean absolute differences between pre-operatively planned alignments and corresponding intra- and post-operative measurements ranged from a minimum of 1.2° to a maximum of 2.9° in all three anatomical planes. In both groups and in both femur and tibia, the plane with the smallest percentage of outliers was the coronal, maximum 17 %. The comparison between two groups was statistically significant (p = 0.02) in the femoral sagittal plane, where group B showed smaller alignment discrepancies at the cutting blocks.

Conclusions

Both PSI systems showed good alignments in the coronal plane in all stages. For a few measurements, a better performance was observed in the MRI/X-ray-based system than in the CT-based system.

Level of evidence

I.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy

    Andrea Ensini, Antonio Timoncini, Francesca Fusai & Sandro Giannini

  2. Movement Analysis Laboratory, Istituto Ortopedico Rizzoli, Bologna, Italy

    Francesco Cenni, Claudio Belvedere, Alberto Leardini & Sandro Giannini

Authors
  1. Andrea Ensini
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  2. Antonio Timoncini
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  3. Francesco Cenni
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  4. Claudio Belvedere
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  5. Francesca Fusai
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  6. Alberto Leardini
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  7. Sandro Giannini
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Correspondence to Antonio Timoncini.

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Ensini, A., Timoncini, A., Cenni, F. et al. Intra- and post-operative accuracy assessments of two different patient-specific instrumentation systems for total knee replacement. Knee Surg Sports Traumatol Arthrosc 22, 621–629 (2014). https://doi.org/10.1007/s00167-013-2667-9

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  • DOI: https://doi.org/10.1007/s00167-013-2667-9

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