A novel patient-specific instrument design can deliver robotic level accuracy in unicompartmental knee arthroplasty

In suitable patients, unicompartmental knee arthroplasty (UKA) offers a number of advantages compared with total knee arthroplasty. However, the procedure is technically demanding, with a small tolerance for error. Assistive technology has the potential to improve the accuracy of implant positioning. This review paper describes the concept of detailed UKA planning in 3D, and the 3D printing technology that enables a plan to be delivered intraoperatively using patient-specific instrumentation (PSI). The varying guide designs that enable accurate registration are discussed and described. The system accuracy is reported. Future studies need to ascertain whether accuracy for low-volume surgeons can be delivered in the operating theatre using PSI, and reflected in improved patient reported outcome measures, and lower revision rates.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180001

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Patient-Specific Instrument Can Improve Functional and Radiographic Results during Learning Curve for Oxford Unicompartmental Knee Arthroplasty

The Journal of Knee Surgery ◽

10.1055/s-0038-1636837 ◽

2018 ◽

Vol 32 (02) ◽

pp. 180-185 ◽

Cited By ~ 5

Author(s):

Jose Matas-Diez ◽

Esther Carbo-Laso ◽

Ruben Perez-Mañanes ◽

Javier Vaquero-Martín ◽

Pablo Sanz-Ruiz

Keyword(s):

Learning Curve ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Short Form ◽

Patient Specific ◽

Radiographic Outcome ◽

Conventional Procedure ◽

True Value ◽

Unicompartmental Knee ◽

Patient Specific Instrumentation

AbstractThe true value of use of patient-specific instrumentation (PSI) systems by inexperienced surgeons during their learning curve to improve the clinical and radiographic outcome of unicompartmental knee arthroplasty (UKA) has not been previously studied. Fifty patients with a mean age of 64.3 years undergoing surgery for Oxford UKA were prospectively divided into two groups. Twenty-five patients were operated on by a surgeon with no prior experience in UKA using a PSI system and the other 25 patients by an experienced surgeon using a conventional procedure. Patients were scored using joint range of motion (ROM), the Knee Society Score (KSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the 12-item Short-Form (SF-12) before and 3 months and 2 years after surgery. Impact of use of PSI was measured by comparing clinical and radiographic outcome, complications, and implant survival. No evidence of poorer clinical outcome was seen in any subscale of KSS, KOOS, and SF-12 for inexperienced surgeons using PSI (p = 0.45, p = 0.32, and p = 0.61, respectively). No difference was found between the two procedures in precision of radiographic alignment of components (p = 0.53). No complication occurred in any group. PSI may improve precision of component alignment during the learning curve of surgeons, thus achieving functional results similar to those of more experienced surgeons using a conventional procedure.

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