Stability and alignment do not improve by using patient-specific instrumentation in total knee arthroplasty: a randomized controlled trial

Purpose The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperati...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2018-06, Vol.26 (6), p.1792-1799
Main Authors: Kosse, Nienke M., Heesterbeek, Petra J. C., Schimmel, Janneke J. P., van Hellemondt, Gijs G., Wymenga, Ate B., Defoort, Koen C.
Format: Article
Language:English
Subjects:
Aged
Alignment
Ankle
Arthritis
Arthroplasty (knee)
Arthroplasty, Replacement, Knee - instrumentation
Arthroplasty, Replacement, Knee - methods
Biocompatibility
Biomedical materials
Bone Malalignment - surgery
Clinical outcomes
Clinical trials
Complications
Computed tomography
Control equipment
Female
Femur
Hip
Humans
Instrumentation
Instruments
Joint Instability - surgery
Joint surgery
Knee
Knee Joint - surgery
Knee Prosthesis
Male
Medicine
Medicine & Public Health
Middle Aged
Orthopedics
Osteoarthritis
Osteoarthritis, Knee - surgery
Pain
Patient-Specific Modeling
Patients
Prospective Studies
Prostheses
Radiographs
Radiography
Randomization
Range of Motion, Articular
Single-Blind Method
Stability analysis
Surgery, Computer-Assisted
Surgical implants
Tibia
Variance analysis
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Summary:Purpose The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperatively. The secondary aim included the evaluation of clinical outcomes after TKA. Methods In this prospective randomized controlled trial, 42 patients with knee osteoarthritis received a Genesis II PS prosthesis with either PSI or CI. Patients visited the hospital preoperatively and postoperatively after 6 weeks and 3 and 12 months. To evaluate stability, varus–valgus laxity was determined in extension and flexion using stress radiographs 12 months postoperatively. Three months postoperatively, a long-leg radiograph and CT scan were obtained to measure hip–knee–ankle (HKA) alignment and component rotation. Furthermore, frontal and sagittal alignment of the components, the Knee Society Score, VAS Pain, VAS Satisfaction, Knee injury and Osteoarthritis Outcome score, Patella score (Kujala), University of California Los Angeles activity score, anterior–posterior laxity, (serious) adverse device-related events, and intraoperative complications were reported. The clinical outcomes were compared using independent t tests or non-parametric alternatives, and repeated measurements ANOVA with a significance level of p  
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-017-4792-3