Patient-specific instrumentation in total knee arthroplasty: a review.
Recently, patient-specific approaches to total knee arthroplasty (TKA) have been introduced, in which preoperative imaging (plain radiographs, computed tomography, and magnetic resonance imaging) are used to manufacture cutting blocks specific to a patient's anatomy. Proposed benefits of patient-matched cutting blocks include a decrease in operative time, instrument trays required, and the ability to preoperatively plan a patient's component size, position, and alignment. In addition, an improvement in postoperative mechanical alignment is expected, without violation of the intramedullary canal. However, questions remain regarding patient outcomes and the cost-effectiveness associated with patient-specific cutting block technology. This article will review the evolution of surgical techniques in TKA, the development of patient-specific cutting blocks, surgical considerations, and the literature associated with this new technology.
Department of Orthopaedic Surgery, Adult Reconstruction and Joint Replacement Service, Hospital for Special Surgery, 535 E. 70th Street, New York 10021, NY, USA. NamD@hss.edu
Denis
D
Nam
Benjamin A
BA
McArthur
Michael B
MB
Cross
Andrew D
AD
Pearle
David J
DJ
Mayman
Steven B
SB
Haas
D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*