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Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet!
Patient-specific Instrumentation (PSI) is an innovative technique aiding the precise implementation of the preoperative plan during total knee arthroplasty (TKA) by using patient-specific guides and cutting blocks. Despite of the theoretical advantages, studies have reported contradictory results, t...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386088/ https://www.ncbi.nlm.nih.gov/pubmed/34429099 http://dx.doi.org/10.1186/s12891-021-04581-2 |
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author | Török, László Jávor, Péter Hartmann, Petra Bánki, László Varga, Endre |
author_facet | Török, László Jávor, Péter Hartmann, Petra Bánki, László Varga, Endre |
author_sort | Török, László |
collection | PubMed |
description | Patient-specific Instrumentation (PSI) is an innovative technique aiding the precise implementation of the preoperative plan during total knee arthroplasty (TKA) by using patient-specific guides and cutting blocks. Despite of the theoretical advantages, studies have reported contradictory results, thus there is no consensus regarding the overall effectiveness of PSI. Through the critical assessment of a meta-analysis published lately, this correspondence aims to highlight the complexity of comparing the efficacy of PSI to standard instrumentation (SI). The accuracy of component alignment, patient-reported outcome measures (PROMs), surgery time, blood loss, transfusion rate, and postoperative complications are commonly used outcomes for investigating the efficacy of PSI-aided TKA. By assessing component alignment, the expertise of the surgeon(s) should be taken into consideration, since PSI may not provide benefits for expert surgeons but might improve accuracy and patient safety during the learning curve of novice surgeons. With respect to PROMs and postoperative complications, PSI may not improve short-term results; however, long-term follow up data is missing. Regarding transfusion rates, favorable trends can be observed, but further studies utilizing recent data are needed for a clear conclusion. When assessing surgery time, we suggest focusing on operating room turnover instead of procedure time. |
format | Online Article Text |
id | pubmed-8386088 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-83860882021-08-26 Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! Török, László Jávor, Péter Hartmann, Petra Bánki, László Varga, Endre BMC Musculoskelet Disord Correspondence Patient-specific Instrumentation (PSI) is an innovative technique aiding the precise implementation of the preoperative plan during total knee arthroplasty (TKA) by using patient-specific guides and cutting blocks. Despite of the theoretical advantages, studies have reported contradictory results, thus there is no consensus regarding the overall effectiveness of PSI. Through the critical assessment of a meta-analysis published lately, this correspondence aims to highlight the complexity of comparing the efficacy of PSI to standard instrumentation (SI). The accuracy of component alignment, patient-reported outcome measures (PROMs), surgery time, blood loss, transfusion rate, and postoperative complications are commonly used outcomes for investigating the efficacy of PSI-aided TKA. By assessing component alignment, the expertise of the surgeon(s) should be taken into consideration, since PSI may not provide benefits for expert surgeons but might improve accuracy and patient safety during the learning curve of novice surgeons. With respect to PROMs and postoperative complications, PSI may not improve short-term results; however, long-term follow up data is missing. Regarding transfusion rates, favorable trends can be observed, but further studies utilizing recent data are needed for a clear conclusion. When assessing surgery time, we suggest focusing on operating room turnover instead of procedure time. BioMed Central 2021-08-24 /pmc/articles/PMC8386088/ /pubmed/34429099 http://dx.doi.org/10.1186/s12891-021-04581-2 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Correspondence Török, László Jávor, Péter Hartmann, Petra Bánki, László Varga, Endre Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title | Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title_full | Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title_fullStr | Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title_full_unstemmed | Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title_short | Should we abandon the patient-specific instrumentation ship in total knee arthroplasty? Not quite yet! |
title_sort | should we abandon the patient-specific instrumentation ship in total knee arthroplasty? not quite yet! |
topic | Correspondence |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386088/ https://www.ncbi.nlm.nih.gov/pubmed/34429099 http://dx.doi.org/10.1186/s12891-021-04581-2 |
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