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Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty
BACKGROUND: In kinematically aligned total knee arthroplasty (KA-TKA), the cylindrical axis (CA) is very important in restoring the native joint line and kinematics of the pre-arthritic knee. This study aimed to determine the accuracy of patient-specific instrument (PSI) for restoring the CA for fem...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Orthopaedic Association
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10551691/ https://www.ncbi.nlm.nih.gov/pubmed/37811500 http://dx.doi.org/10.4055/cios22147 |
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author | Kim, Kwang-Kyoun Song, Jaehwang |
author_facet | Kim, Kwang-Kyoun Song, Jaehwang |
author_sort | Kim, Kwang-Kyoun |
collection | PubMed |
description | BACKGROUND: In kinematically aligned total knee arthroplasty (KA-TKA), the cylindrical axis (CA) is very important in restoring the native joint line and kinematics of the pre-arthritic knee. This study aimed to determine the accuracy of patient-specific instrument (PSI) for restoring the CA for femoral bone resection in KA-TKA. METHODS: Thirty KA-TKAs were performed using a computed tomography (CT)-based PSI system. Data from preoperative CT were reconstructed into three-dimensional (3D) models using 3D-planning software. The CA was created by connecting the centers of each virtual sphere to the medial and lateral femoral condyles using computer software. Femoral bone resection of the distal and posterior condyles was performed parallel to the sagittal planes of the CA. The thickness of the CA-referenced bone resection was determined based on the thickness necessary for the respective regions of the femoral component. The PSI was manufactured to locate the guide pin for a conventional cutting block. The accuracy of PSI for KA-TKA was evaluated as the absolute error between the preoperatively predicted thickness and the intraoperative measurements in each of the four regions, as well as the difference in error between distal-medial (DM) and posterior-medial (PM) and between distal-lateral (DL) and posterior-lateral (PL). RESULTS: The differences in thickness of bone cut in the DM, DL, PM, and PL were 0.79 ± 0.39 mm (range, –1.20 to 1.50), 0.70 ± 0.42 mm (range, –1.50 to 1.50), 0.80 ± 0.46 mm (range, –0.80 to 1.50), and 0.75 ± 0.47 mm (range, –2.10 to 1.40), respectively. There was no significant difference in the thickness error between DM and PM (p = 0.959) and between DL and PL (p = 0.812). CONCLUSIONS: In KA-TKA, PSI was effective for accurate femoral bone resection based on virtually planned thickness. |
format | Online Article Text |
id | pubmed-10551691 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Korean Orthopaedic Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-105516912023-10-06 Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty Kim, Kwang-Kyoun Song, Jaehwang Clin Orthop Surg Original Article BACKGROUND: In kinematically aligned total knee arthroplasty (KA-TKA), the cylindrical axis (CA) is very important in restoring the native joint line and kinematics of the pre-arthritic knee. This study aimed to determine the accuracy of patient-specific instrument (PSI) for restoring the CA for femoral bone resection in KA-TKA. METHODS: Thirty KA-TKAs were performed using a computed tomography (CT)-based PSI system. Data from preoperative CT were reconstructed into three-dimensional (3D) models using 3D-planning software. The CA was created by connecting the centers of each virtual sphere to the medial and lateral femoral condyles using computer software. Femoral bone resection of the distal and posterior condyles was performed parallel to the sagittal planes of the CA. The thickness of the CA-referenced bone resection was determined based on the thickness necessary for the respective regions of the femoral component. The PSI was manufactured to locate the guide pin for a conventional cutting block. The accuracy of PSI for KA-TKA was evaluated as the absolute error between the preoperatively predicted thickness and the intraoperative measurements in each of the four regions, as well as the difference in error between distal-medial (DM) and posterior-medial (PM) and between distal-lateral (DL) and posterior-lateral (PL). RESULTS: The differences in thickness of bone cut in the DM, DL, PM, and PL were 0.79 ± 0.39 mm (range, –1.20 to 1.50), 0.70 ± 0.42 mm (range, –1.50 to 1.50), 0.80 ± 0.46 mm (range, –0.80 to 1.50), and 0.75 ± 0.47 mm (range, –2.10 to 1.40), respectively. There was no significant difference in the thickness error between DM and PM (p = 0.959) and between DL and PL (p = 0.812). CONCLUSIONS: In KA-TKA, PSI was effective for accurate femoral bone resection based on virtually planned thickness. The Korean Orthopaedic Association 2023-10 2022-11-21 /pmc/articles/PMC10551691/ /pubmed/37811500 http://dx.doi.org/10.4055/cios22147 Text en Copyright © 2023 by The Korean Orthopaedic Association https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kim, Kwang-Kyoun Song, Jaehwang Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title | Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title_full | Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title_fullStr | Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title_full_unstemmed | Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title_short | Accuracy of Patient-Specific Instrument for Cylindrical Axis Implementation in Kinematically Aligned Total Knee Arthroplasty |
title_sort | accuracy of patient-specific instrument for cylindrical axis implementation in kinematically aligned total knee arthroplasty |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10551691/ https://www.ncbi.nlm.nih.gov/pubmed/37811500 http://dx.doi.org/10.4055/cios22147 |
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