title: Patient specific cutting blocks are currently of no proven value.
abstract: Patient specific cutting guides generated by   preoperative Magnetic Resonance Imaging (MRI) of the patient's extremity   have been proposed as a method of improving the consistency of Total   Knee Arthroplasty (TKA) alignment and adding efficiency to the operative   procedure. The cost of this option was evaluated by quantifying the   savings from decreased operative time and instrument processing   costs compared to the additional cost of the MRI and the guide.   Coronal plane alignment was measured in an unselected consecutive   series of 200 TKAs, 100 with standard instrumentation and 100 with   custom cutting guides. While the cutting guides had significantly lower   total operative time and instrument processing time, the estimated   $322 savings was overwhelmed by the $1,500 additional cost of the   MRI and the cutting guide. All measures of coronal plane alignment   were equivalent between the two groups. The data does not currently   support the proposition that patient specific guides add value to   TKA.
authors.affiliation: Washington University School of Medicine, Department of Orthopaedic Surgery, One Barnes-Jewish Hospital Plaza, 11300 West Pavilion, Campus Box 8233, St Louis, Missouri 63110, USA. barrackr@wustl.edu
authors.forename: R L
authors.initials: RL
authors.lastname: Barrack
authors.forename: E L
authors.initials: EL
authors.lastname: Ruh
authors.forename: B M
authors.initials: BM
authors.lastname: Williams
authors.forename: A D
authors.initials: AD
authors.lastname: Ford
authors.forename: K
authors.initials: K
authors.lastname: Foreman
authors.forename: R M
authors.initials: RM
authors.lastname: Nunley
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D017046:Cost Savings / Q000706:statistics & numerical data*; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007720:Knee Prosthesis; D008279:Magnetic Resonance Imaging / Q000191:economics*; D008297:Male; D008875:Middle Aged; D008923:Missouri; D008953:Models, Anatomic; D061646:Operative Time; D010043:Outcome and Process Assessment, Health Care; D011300:Preoperative Care / Q000191:economics / Q000379:methods*