Effect of patient-specific instruments compared with conventional instruments in total knee arthroplasty: a randomized controlled trial.
Background and purpose — Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) aims to improve implant alignment and clinical outcomes, but its effectiveness remains uncertain. We aimed to compare whether PSI was superior to conventional instrumentation (CVI) in TKA. The primary ou...
| Publicado en: | Acta Orthopaedica Vol. 96; pp. 875 - 885 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts randomized controlled trial Journal Article |
| Publicado: |
Medical Journals Sweden AB
2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=191461452&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 191461452 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2025 vid: 96 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 191461452 191461452 191461452 10.2340/17453674.2025.44924 191461452 ppf: 875 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Effect of patient-specific instruments compared with conventional instruments in total knee arthroplasty: a randomized controlled trial. aug: au: HERMODSSON, Jakob SAARI, Tuuli SHAREGHI, Bita MOHADDES, Maziar NILSDOTTER, Anna KÄRRHOLM, Johan affil: Department of Orthopedics, Sahlgrenska University Hospital, Mölndal. sug: subj: Osteoarthritis, Knee Surgery Arthroplasty, Replacement, Knee Methods Arthroplasty, Replacement, Knee Equipment and Supplies Surgical Instruments Treatment Outcomes Human Male Female Adult Middle Age Aged Randomized Controlled Trials Random Assignment Comparative Studies Descriptive Statistics Confidence Intervals Odds Ratio Funding Source T-Tests Pearson's Correlation Coefficient Chi Square Test Fisher's Exact Test Data Analysis Software Surgical Patients Treatment Failure After Care Tibia Physiology Patient-Reported Outcomes Range of Motion Knee Joint Physiology Questionnaires Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background and purpose — Patient-specific instrumentation (PSI) in total knee arthroplasty (TKA) aims to improve implant alignment and clinical outcomes, but its effectiveness remains uncertain. We aimed to compare whether PSI was superior to conventional instrumentation (CVI) in TKA. The primary outcome was the Oxford Knee Score (OKS) at 2 years with assessments of additional clinical outcomes up to 5 years after surgery. Methods — This study included 70 knees with primary osteoarthritis randomized (1:1) to undergo TKA using either PSI or CVI. Outcomes were evaluated using patient-reported outcome measures (PROMs), radiographic alignment, and radiostereometric analysis (RSA) of migration over the full follow-up period of 5 years. Results — 68 knees underwent surgery as per protocol. At 2 years, 29 knees in the PSI group and 36 in the CVI group were assessed with the OKS, which improved significantly by 21.2 in the PSI group and 18.2 in the CVI group (mean difference [MD] 2.1; 95% confidence interval [CI] –1.5 to 5.7). PSI resulted in slightly increased tibial varus alignment (MD –1.4°; CI –2.3° to –0.4°), migrated slightly more into varus (mean difference at 2 years: –0.28 mm, CI –0.54 to –0.03 mm), and showed higher maximum total point motion (MTPM) during the period 1 to 2 years (mean difference: 0.13 mm; CI 0.01–0.25). At 5 years, 3 knees had been revised (PSI: 2; CVI: 1). Conclusion — PSI did not demonstrate superior outcomes compared with CVI. These findings suggest that PSI may not provide significant benefits over conventional techniques in routine TKA. pubtype: Academic Journal doctype: research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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