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Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning

PURPOSE: To evaluate the accuracy and reproducibility of a patient-specific, customized individually made (CIM) total knee replacement (TKR) using the ORIGIN® prosthesis. METHODS: This was a prospective study conducted at a University Hospital from January 15, 2019, to April 30, 2021. The study incl...

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Autores principales: Sajan, Martin, Moussa, Mohamad K., Lefèvre, Nicolas, Payan, Charles, Valentin, Eugénie, Meyer, Alain, Bohu, Yoann, Khalaf, Zeinab, Grimaud, Olivier, Gerometta, Antoinne, Hardy, Alexandre, Khiami, Frédéric
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684845/
https://www.ncbi.nlm.nih.gov/pubmed/38015319
http://dx.doi.org/10.1186/s40634-023-00706-9
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author Sajan, Martin
Moussa, Mohamad K.
Lefèvre, Nicolas
Payan, Charles
Valentin, Eugénie
Meyer, Alain
Bohu, Yoann
Khalaf, Zeinab
Grimaud, Olivier
Gerometta, Antoinne
Hardy, Alexandre
Khiami, Frédéric
author_facet Sajan, Martin
Moussa, Mohamad K.
Lefèvre, Nicolas
Payan, Charles
Valentin, Eugénie
Meyer, Alain
Bohu, Yoann
Khalaf, Zeinab
Grimaud, Olivier
Gerometta, Antoinne
Hardy, Alexandre
Khiami, Frédéric
author_sort Sajan, Martin
collection PubMed
description PURPOSE: To evaluate the accuracy and reproducibility of a patient-specific, customized individually made (CIM) total knee replacement (TKR) using the ORIGIN® prosthesis. METHODS: This was a prospective study conducted at a University Hospital from January 15, 2019, to April 30, 2021. The study included patients planned for an ORIGIN® CIM TKR procedure. Exclusion criteria included revision surgery, severe deformity, stiffness, or laxity. Evaluations were carried out using computed tomography scans performed 8 weeks preoperatively and 6 weeks postoperatively. The primary outcome measurements were the preoperative, planned, and postoperative CT scan alignment measurements including the Hip-Knee-Ankle (HKA) angle, mechanical Medial Distal Femoral articular surface Angle (mMDFA, distal alpha angle), Posterior Distal femoral articular surface angle (PDFA, posterior alpha angle), mechanical Medial Proximal Tibial articular surface Angle (mMPTA, beta angle) and posterior proximal tibial angle (PPTA). Secondary outcomes included the accuracy of implant positioning with percentage of outliers at 2° and 3° RESULTS: The study encompassed 51 knees from 50 patients with mean age of 68.1 (SD = 8.89). The overall HKA angle deviated by -0.93° [95% CI: -1.45; -0.43], and the PDFA angle by -0.61° [95% CI: -1.07; -0.15], while the mMPTA exceeded planned values by 1.00° [95% CI: 0.57; 1.43]. The 3° outliers rate ranged from 3.9% for the mMPTA to 7.8% for the HKA alignment, with no outliers in mMDFA and PPTA. Similarly, the 2° outliers rate ranged from 15.7% for both the PDFA angle and mMPTA to 19.6% for the HKA alignment. The Bland–Altman plots further emphasized the precision of planned and post-operative angles across all measurements. CONCLUSION: The CIM TKR showed high accuracy and reproducibility, closely matching preoperative planning. The weakest accuracy at 3°-outliers is in the reproduction of the HKA alignment at 92.2% (range for all angle: 92.2–100%). Similarly, the weakest accuracy at 2°-outliers is in the reproduction of the HKA alignment at 80.4% (range for all angles: 80.4–92.2%). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40634-023-00706-9.
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spelling pubmed-106848452023-11-30 Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning Sajan, Martin Moussa, Mohamad K. Lefèvre, Nicolas Payan, Charles Valentin, Eugénie Meyer, Alain Bohu, Yoann Khalaf, Zeinab Grimaud, Olivier Gerometta, Antoinne Hardy, Alexandre Khiami, Frédéric J Exp Orthop Original Paper PURPOSE: To evaluate the accuracy and reproducibility of a patient-specific, customized individually made (CIM) total knee replacement (TKR) using the ORIGIN® prosthesis. METHODS: This was a prospective study conducted at a University Hospital from January 15, 2019, to April 30, 2021. The study included patients planned for an ORIGIN® CIM TKR procedure. Exclusion criteria included revision surgery, severe deformity, stiffness, or laxity. Evaluations were carried out using computed tomography scans performed 8 weeks preoperatively and 6 weeks postoperatively. The primary outcome measurements were the preoperative, planned, and postoperative CT scan alignment measurements including the Hip-Knee-Ankle (HKA) angle, mechanical Medial Distal Femoral articular surface Angle (mMDFA, distal alpha angle), Posterior Distal femoral articular surface angle (PDFA, posterior alpha angle), mechanical Medial Proximal Tibial articular surface Angle (mMPTA, beta angle) and posterior proximal tibial angle (PPTA). Secondary outcomes included the accuracy of implant positioning with percentage of outliers at 2° and 3° RESULTS: The study encompassed 51 knees from 50 patients with mean age of 68.1 (SD = 8.89). The overall HKA angle deviated by -0.93° [95% CI: -1.45; -0.43], and the PDFA angle by -0.61° [95% CI: -1.07; -0.15], while the mMPTA exceeded planned values by 1.00° [95% CI: 0.57; 1.43]. The 3° outliers rate ranged from 3.9% for the mMPTA to 7.8% for the HKA alignment, with no outliers in mMDFA and PPTA. Similarly, the 2° outliers rate ranged from 15.7% for both the PDFA angle and mMPTA to 19.6% for the HKA alignment. The Bland–Altman plots further emphasized the precision of planned and post-operative angles across all measurements. CONCLUSION: The CIM TKR showed high accuracy and reproducibility, closely matching preoperative planning. The weakest accuracy at 3°-outliers is in the reproduction of the HKA alignment at 92.2% (range for all angle: 92.2–100%). Similarly, the weakest accuracy at 2°-outliers is in the reproduction of the HKA alignment at 80.4% (range for all angles: 80.4–92.2%). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40634-023-00706-9. Springer Berlin Heidelberg 2023-11-28 /pmc/articles/PMC10684845/ /pubmed/38015319 http://dx.doi.org/10.1186/s40634-023-00706-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Paper
Sajan, Martin
Moussa, Mohamad K.
Lefèvre, Nicolas
Payan, Charles
Valentin, Eugénie
Meyer, Alain
Bohu, Yoann
Khalaf, Zeinab
Grimaud, Olivier
Gerometta, Antoinne
Hardy, Alexandre
Khiami, Frédéric
Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title_full Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title_fullStr Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title_full_unstemmed Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title_short Customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
title_sort customized-individually-made origin® implants in total knee arthroplasty allow a reliable solution for accurate reproduction of planned implant positioning
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10684845/
https://www.ncbi.nlm.nih.gov/pubmed/38015319
http://dx.doi.org/10.1186/s40634-023-00706-9
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