title: Current data do not support routine use of patient-specific instrumentation in total knee arthroplasty.
abstract: The purpose of this systematic review and meta-analysis is to compare patient-specific instrumentation (PSI) versus standard instrumentation for total knee arthroplasty (TKA) with regard to coronal and sagittal alignment, operative time, intraoperative blood loss, and cost. A systematic query in search of relevant studies was performed, and the data published in these studies were extracted and aggregated. In regard to coronal alignment, PSI demonstrated improved accuracy in femorotibial angle (FTA) (P=0.0003), while standard instrumentation demonstrated improved accuracy in hip-knee-ankle angle (HKA) (P=0.02). Importantly, there were no differences between treatment groups in the percentages of FTA or HKA outliers (>3 degrees from target alignment) (P=0.7). Sagittal alignment, operative time, intraoperative blood loss, and cost were also similar between groups (P>0.1 for all comparisons).
authors: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Pramod B
authors: PB
authors: Voleti
authors: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Mathew J
authors: MJ
authors: Hamula
authors: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Keith D
authors: KD
authors: Baldwin
authors: Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Gwo-Chin
authors: GC
authors: Lee
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000592:standards; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D020370:Osteoarthritis, Knee / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000592:standards
keywords: custom cutting guides; patient-specific guides; patient-specific instrumentation; primary total knee arthroplasty; total knee arthroplasty instrumentation