Patient-specific imaging and missed tumors: a catastrophic outcome.
Patient-specific instrumentation (PSI) is a relatively new technology aimed at increasing the accuracy and efficiency of total knee arthroplasty (TKA). Its premise is reliant upon preoperative imaging techniques to acquire detailed measurements of a patient's distal femur and proximal tibia. Although a limited number of studies in the current literature have begun to critically evaluate this promising technology, a number of potential controversies exist. We present 2 patients with radiographic evidence of musculoskeletal neoplasms present on initial preoperative imaging that were not recognized prior to placement of patient-specific total knees. The expanding role of non-diagnostic imaging in TKA is examined, and we suggest guidelines for prevention of further devastating outcomes.
Vanderbilt University Medical Center, Nashville, TN. Travis.Menge@Vanderbilt.edu.
Travis J
TJ
Menge
Katherine G
KG
Hartley
Ginger E
GE
Holt
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D005266:Femoral Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D012516:Osteosarcoma / Q000000981:diagnostic imaging* / Q000601:surgery; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome