Clinical, functional, and radiographic outcomes following total knee arthroplasty with patient-specific instrumentation, computer-assisted surgery, and manual instrumentation: a short-term follow-up study

• Published in: International journal for computer assisted radiology and surgery 2014-09, Vol.9 (5), p.837-844
• Main Authors: Yaffe, Mark, Luo, Michael, Goyal, Nitin, Chan, Philip, Patel, Anay, Cayo, Max, Stulberg, S. David
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Knee - instrumentation; Computer Imaging; Computer Science; Equipment Design; Female; Follow-Up Studies; Health Informatics; Humans; Imaging; Knee Joint - diagnostic imaging; Knee Joint - physiopathology; Knee Joint - surgery; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Patient Positioning; Pattern Recognition and Graphics; Radiology; Range of Motion, Articular; Surgery; Surgery, Computer-Assisted - instrumentation; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Vision
• ISSN: 1861-6410; 1861-6429
• DOI: 10.1007/s11548-013-0968-6

Purpose    The purpose of this study was to evaluate clinical, functional, and radiographic outcomes following total knee arthroplasty (TKA) performed with patient-specific instrumentation (PSI), computer-assisted surgery (CAS), and manual instruments at short-term follow-up. Methods    122 TKAs were performed by a single surgeon: 42 with PSI, 38 with CAS, and 40 with manual instrumentation. Preoperative, 1-month, and 6-month clinical and functional outcomes were measured using the Knee Society scoring system (knee score, function score, range of motion, and pain score). Improvements in clinical and functional outcomes from the preoperative to postoperative period were analyzed. Preoperative and postoperative radiographs were measured to evaluate limb and component alignment. Results    Preoperative, 1-month postoperative, and 6-month postoperative knee scores, function scores, range of motion, and pain scores were highest in the PSI group compared to CAS and manual instrumentation. At 6-month follow-up, PSI TKA was associated with a statistically significant improvement in functional score when compared to manual TKA. Otherwise, there were no statistically significant differences in improvements among PSI, CAS, and manual TKA groups. Conclusion    The higher preoperative scores in the PSI group limits the ability to draw definitive conclusions from the raw postoperative scores, but analyzing the changes in scores revealed that PSI was associated with a statistically significant improvement in Knee Society Functional score at 6-month post-TKA as compared to CAS or manual TKA. This may be attributable to improvements in component rotation and positioning, improved component size accuracy, or other factors that are not discernible on plain radiograph.