Three-dimensional analysis of accuracy of component positioning in total knee arthroplasty with patient specific and conventional instruments: A randomized controlled trial

Autor: Raf De Vloo, Aad Dhollander, Jos Vander Sloten, Pim Pellikaan
Rok vydání: 2017
Předmět:
Male
Patient-Specific Modeling
Knee Joint
Total knee arthroplasty
law.invention
0302 clinical medicine
Randomized controlled trial
law
Orthopedics and Sports Medicine
Femur
Postoperative Period
Prospective Studies
Range of Motion
Articular
Arthroplasty
Replacement
Knee
Orthodontics
030222 orthopedics
biology
Middle Aged
Magnetic Resonance Imaging
medicine.anatomical_structure
Surgery
Computer-Assisted
Female
Knee Prosthesis
Patient specific guides
psychological phenomena and processes
medicine.medical_specialty
3D analysis
Patient specific instrumentation
Prosthesis Design
03 medical and health sciences
Imaging
Three-Dimensional
Component (UML)
mental disorders
medicine
Humans
Component placement
Aged
Alignment
Tibia
business.industry
030229 sport sciences
biology.organism_classification
Sagittal plane
respiratory tract diseases
Surgery
Valgus
Coronal plane
Implant
Tomography
X-Ray Computed
business
Zdroj: The Knee. 24:1469-1477
ISSN: 0968-0160
1469-1477
DOI: 10.1016/j.knee.2017.08.059
Popis: BACKGROUND: Component malalignment remains a major concern in total knee arthroplasty (TKA). Patient-specific guides (PSG) were developed to increase accuracy of bone resections and component placement, but available evidence is contradictory. We assessed the accuracy of 3D component placement in TKA with PSG compared to conventional surgery using virtual 3D bone models. METHODS: Fifty patients were randomly assigned to the PSG or conventional instrumentation group, 44 were finally analyzed. Preoperatively, MRI and CT scans were converted into virtual 3D models and a surgical plan was developed. Surgery was performed and changes in component sizing were recorded. Postoperative CT images were converted to 3D models and aligned to the planned, preoperative models and implant orientation. Differences between planned and postoperative implant orientations were calculated in 3D. RESULTS: PSG allowed significantly more accurate varus/valgus placement for the femoral component (PSG: 0.14±1.47; control: 1.40±1.99; p
Databáze: OpenAIRE
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