Purpose: Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) may improve component sizing. Little has been reported about accuracy of the default plan created by the manufacturer, especially for CT-based PSI. The goal of this study was to evaluate the reliability of this plan and the impact of the surgeonâs changes on the final accuracy of the guide sizes. Methods: Forty-five patients eligible for primary TKA were prospectively enrolled. The planned implant sizes were prospectively recorded from the initial manufacturerâs proposal and from the final plan adjusted in light of the surgeonâs evaluation; these two sizes where then compared to the actually implanted sizes. Fisherâs exact test was used to test differences for categorical variables. Agreement between pre-operative plans and final implant was evaluated with the BlandâAltman method. Results: The manufacturerâs proposal differed from the final implant in 9 (20.0%) femoral and 23 (51.1%) tibial components, while the surgeonâs plan in 6 (13.3%, femoral) and 12 (26.7%, tibial). Modifications in the pre-operative plan were carried out for five (11.1%) femoral and 23 (51.1%) tibial components (p = 0.03). Appropriate modification occurred in 22 (88.0%) and 19 (76.0%) cases of femoral and tibial changes. The agreement between the manufacturerâs and the surgeonâs pre-operative plans was poor, especially with regard to tibial components. Conclusion: The surgeonâs accuracy in predicting the final component size was significantly different from that of the manufacturer and changes in the initial manufacturerâs plan were necessary to get an accurate pre-operative plan of the implant sizes. Clinical relevance: Careful evaluation of the initial manufacturerâs plan by an experienced knee surgeon is mandatory when planning TKA with CT-based PSI. Level of evidence: II.
Significant differences between manufacturer and surgeon in the accuracy of final component size prediction with CT-based patient-specific instrumentation for total knee arthroplasty / D. Cucchi, A. Menon, R. Compagnoni, P. Ferrua, C. Fossati, P. Randelli. - In: KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY. - ISSN 0942-2056. - (2018). [Epub ahead of print] [10.1007/s00167-018-4876-8]
Significant differences between manufacturer and surgeon in the accuracy of final component size prediction with CT-based patient-specific instrumentation for total knee arthroplasty
D. Cucchi;A. MenonCo-primo
;R. Compagnoni;P. Ferrua;C. FossatiPenultimo
;P. Randelli
2018
Abstract
Purpose: Patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) may improve component sizing. Little has been reported about accuracy of the default plan created by the manufacturer, especially for CT-based PSI. The goal of this study was to evaluate the reliability of this plan and the impact of the surgeonâs changes on the final accuracy of the guide sizes. Methods: Forty-five patients eligible for primary TKA were prospectively enrolled. The planned implant sizes were prospectively recorded from the initial manufacturerâs proposal and from the final plan adjusted in light of the surgeonâs evaluation; these two sizes where then compared to the actually implanted sizes. Fisherâs exact test was used to test differences for categorical variables. Agreement between pre-operative plans and final implant was evaluated with the BlandâAltman method. Results: The manufacturerâs proposal differed from the final implant in 9 (20.0%) femoral and 23 (51.1%) tibial components, while the surgeonâs plan in 6 (13.3%, femoral) and 12 (26.7%, tibial). Modifications in the pre-operative plan were carried out for five (11.1%) femoral and 23 (51.1%) tibial components (p = 0.03). Appropriate modification occurred in 22 (88.0%) and 19 (76.0%) cases of femoral and tibial changes. The agreement between the manufacturerâs and the surgeonâs pre-operative plans was poor, especially with regard to tibial components. Conclusion: The surgeonâs accuracy in predicting the final component size was significantly different from that of the manufacturer and changes in the initial manufacturerâs plan were necessary to get an accurate pre-operative plan of the implant sizes. Clinical relevance: Careful evaluation of the initial manufacturerâs plan by an experienced knee surgeon is mandatory when planning TKA with CT-based PSI. Level of evidence: II.File | Dimensione | Formato | |
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