title: No difference in mechanical alignment and femoral component placement between patient-specific instrumentation and conventional instrumentation in TKA.
abstract: OBJECTIVE
  There is a rising interest in the use of patient-specific instrumentation (PSI) during total knee arthroplasty (TKA). The goal of this meta-analysis was to compare PSI with conventional instrumentation (CI) in patients undergoing TKA.
  
  
  METHODS
  A literature search was performed in PubMed, Embase, Springer, Ovid, China National Knowledge Infrastructure, and the Cochrane Library. A total of 10 randomized controlled studies involving 837 knees comparing outcomes of PSI TKAs with CI TKAs were included in the present analysis. Outcomes of interest included component alignment, surgical time, blood loss, and hospital stay.
  
  
  RESULTS
  The results presented no significant differences between the two instrumentations in terms of restoring a neutral mechanical axis and femoral component placement. However, their differences have been noted regarding the alignment of the tibial component in coronal and sagittal planes. Also, 3 min less surgical time was used in PSI patients.
  
  
  CONCLUSIONS
  Based on these findings, PSI appeared not to be superior to CI in terms of the post-operative mechanical axis of the limb or femoral component placement. Despite a statistical difference for operative duration, the benefit of a small reduction in surgical time with PSI is clinically irrelevant.
  
  
  METHODS
  Therapeutic study (systematic review and meta-analysis), Level I.
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Huichao
authors.initials: H
authors.lastname: Fu
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Jiaxing
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Shenyuan
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Tao
authors.initials: T
authors.lastname: Cheng
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, School of Medicine, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, People's Republic of China. zxl201450@hotmail.com.
authors.forename: Xianlong
authors.initials: X
authors.lastname: Zhang
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D005269:Femur / Q000601:surgery*; D006801:Humans; D007720:Knee Prosthesis; D066230:Patient-Specific Modeling; D016032:Randomized Controlled Trials as Topic; D025321:Surgery, Computer-Assisted
keywords: Conventional instrumentation; PSI; Patient-specific instrumentation; TKA; Total knee arthroplasty