Department of Trauma and Orthopaedic Surgery, Hospital Wittmund, Wittmund, Germany.
Department of Trauma, Orthopaedic Surgery and Sports Medicine, Klinikum Agnes Karll Laatzen, Laatzen, Germany.
Technol Health Care. 2022;30(6):1397-1406. doi: 10.3233/THC-213507.
Patient-individualised anatomic alignment in total knee arthroplasty (TKA) requires exact positioning of the tibial and femoral components. Patient-specific instrumentation (PSI) may be advantageous for implantation. However, the role of PSI in the instrumentation of such knee designs has not been investigated.
The aim of this study was to investigate the accuracy of a PSI system designed for patient-individualised anatomic alignment.
Fifty-four patients from a single centre were consecutively enrolled in this study. Patient-specific femoral and tibial cutting guides were manufactured using 3D models from computed tomography (CT) scans. All patients received an anatomic TKA implant design through an extension gap first technique. Postoperative radiography was taken, and implant component alignment and leg alignment were compared to the preoperative planning.
Thirty-four patients were evaluable. Mean differences between planned angles values obtained from CT scans and the measured radiographic values were small and not significantly different from zero.
Implantation of an anatomic knee design that allows individual component alignment using PSI is feasible. The percentage of component misalignment in the coronal plane was remarkably low. Whether this leads to clinical benefits requires further verification.
全膝关节置换术（TKA）中患者个体化解剖对线需要精确定位胫骨和股骨组件。患者特异性器械（PSI）可能有利于植入。然而，PSI 在这种膝关节设计中的器械应用的作用尚未得到研究。
本研究旨在探讨专为患者个体化解剖对线设计的 PSI 系统的准确性。
本研究连续纳入了来自一家中心的 54 名患者。使用来自 CT 扫描的 3D 模型制造了患者特异性股骨和胫骨切割导向器。所有患者均通过延长间隙初次技术接受解剖 TKA 植入物设计。术后进行放射摄影，将植入物组件的对线和腿部对线与术前规划进行比较。
34 名患者可评估。从 CT 扫描获得的计划角度值与测量的放射学值之间的平均差异较小，且与零值无显著差异。
使用 PSI 实现个体化组件对线的解剖型膝关节设计的植入是可行的。冠状面上组件对线不良的比例显著较低。这是否会带来临床获益还需要进一步验证。
