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J Knee Surg 2014; 27(03): 177-184
DOI: 10.1055/s-0034-1374813
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Patient-Specific Instrumentation in Total Knee Arthroplasty

Authors

  • Julio J. Jauregui

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

  • Jeffrey J. Cherian

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

  • Bhaveen H. Kapadia

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

  • Samik Banerjee

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

  • Kimona Issa

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland

  • Steven F. Harwin

    2   Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York

  • Michael A. Mont

    1   Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Baltimore, Maryland
Further Information

Publication History

19 February 2014

16 March 2014

Publication Date:
24 April 2014 (online)

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Abstract

Patient-specific instrumentation (PSI) is a technology that allows the surgeon to perform a total knee arthroplasty (TKA) potentially more easily with preformed cutting blocks and jigs, which are developed from preoperative computed tomographic or magnetic resonance image scans of the knee. It was introduced with the goal of reducing surgical time, minimizing costs, improving alignment, and reducing radiographic outliers when performing a TKA. Although multiple reports have demonstrated that PSI can reduce the amount of trays and instrumentation required, operative time, and turnover rates, this has not been extrapolated to an overall cost reduction. This is potentially related to the costs of preoperative imaging and the intrinsic costs of production of the patient-specific guides. With the present technology, it is also controversial whether improvements in alignment can be achieved. In addition, it remains to be seen whether this will lead to a reduction in costs and improvements in clinical, radiographic, and functional outcomes. As PSI is relatively new, there is a paucity of long-term studies, which makes it difficult to predict whether long-term improvements in implant survivorship will lead to substantial improvements in patient function, overall outcomes, or cost benefits.

Keywords

patient-specific instrumentation - total knee arthroplasty - preoperative templating