Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty
Customized patient instrumentation (CPI) combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA). We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accurac...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Advances in Orthopedics |
| Online Access: | http://dx.doi.org/10.1155/2013/891210 |
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| author | William D. Bugbee Hideki Mizu-uchi Shantanu Patil Darryl D'Lima |
| author_facet | William D. Bugbee Hideki Mizu-uchi Shantanu Patil Darryl D'Lima |
| author_sort | William D. Bugbee |
| collection | DOAJ |
| description | Customized patient instrumentation (CPI) combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA). We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation. |
| format | Article |
| id | doaj-art-0db305e7825e44aa89fd52d920f9aed2 |
| institution | OA Journals |
| issn | 2090-3464 2090-3472 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Advances in Orthopedics |
| spelling | doaj-art-0db305e7825e44aa89fd52d920f9aed22025-08-20T02:02:25ZengWileyAdvances in Orthopedics2090-34642090-34722013-01-01201310.1155/2013/891210891210Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee ArthroplastyWilliam D. Bugbee0Hideki Mizu-uchi1Shantanu Patil2Darryl D'Lima3Division of Orthopaedic Surgery, Scripps Clinic, 10666 North Torrey Pines Road, MS116, La Jolla, CA 92037, USAShiley Center for Orthopaedic Research & Education at Scripps Clinic, 11025 North Torrey Pines Road, Suite 200, La Jolla, CA 92037, USAShiley Center for Orthopaedic Research & Education at Scripps Clinic, 11025 North Torrey Pines Road, Suite 200, La Jolla, CA 92037, USAShiley Center for Orthopaedic Research & Education at Scripps Clinic, 11025 North Torrey Pines Road, Suite 200, La Jolla, CA 92037, USACustomized patient instrumentation (CPI) combines preoperative planning with customized cutting jigs to position and align implants during total knee arthroplasty (TKA). We compared postoperative implant alignment of patients undergoing surgery with CPI to traditional TKA instrumentation for accuracy of implant placement. Twenty-five consecutive TKAs using CPI were analyzed. Preoperative CT scans of the lower extremities were segmented using a computer program. Limb alignment and mechanical axis were computed. Virtual implantation of computer-aided design models was done. Postoperative coronal and sagittal view radiographs were obtained. Using 3D image-matching software, relative positions of femoral and tibial implants were determined. Twenty-five TKAs implanted using traditional instrumentation were also analyzed. For CPI, difference in alignment from the preoperative plan was calculated. In the CPI group, the mean absolute difference between the planned and actual femoral placements was 0.67° in the coronal plane and 1.2° in the sagittal plane. For tibial alignment, the mean absolute difference was 0.9° in the coronal plane and 1.3° in the sagittal plane. For traditional instrumentation, difference from ideal placement for the femur was 1.5° in the coronal plane and 2.3° in the sagittal plane. For the tibia, the difference was 1.8° in the coronal plane. CPI achieved accurate implant positioning and was superior to traditional TKA instrumentation.http://dx.doi.org/10.1155/2013/891210 |
| spellingShingle | William D. Bugbee Hideki Mizu-uchi Shantanu Patil Darryl D'Lima Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty Advances in Orthopedics |
| title | Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty |
| title_full | Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty |
| title_fullStr | Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty |
| title_full_unstemmed | Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty |
| title_short | Accuracy of Implant Placement Utilizing Customized Patient Instrumentation in Total Knee Arthroplasty |
| title_sort | accuracy of implant placement utilizing customized patient instrumentation in total knee arthroplasty |
| url | http://dx.doi.org/10.1155/2013/891210 |
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