title: Computerised tomography vs magnetic resonance imaging for modeling of patient-specific instrumentation in total knee arthroplasty.
abstract: OBJECTIVE
  To summarise and compare currently available evidence regarding accuracy of pre-operative imaging, which is one of the key choices for surgeons contemplating patient-specific instrumentation (PSI) surgery.
  
  
  METHODS
  The MEDLINE and EMBASE medical literature databases were searched, from January 1990 to December 2013, to identify relevant studies. The data from several clinical studies was assimilated to allow appreciation and comparison of the accuracy of each modality. The overall accuracy of each modality was calculated as proportion of outliers > 3% in the coronal plane of both computerised tomography (CT) or magnetic resonance imaging (MRI).
  
  
  RESULTS
  Seven clinical studies matched our inclusion criteria for comparison and were included in our study for statistical analysis. Three of these reported series using MRI and four with CT. Overall percentage of outliers > 3% in patients with CT-based PSI systems was 12.5% vs 16.9% for MRI-based systems. These results were not statistically significant.
  
  
  CONCLUSIONS
  Although many studies have been undertaken to determine the ideal pre-operative imaging modality, conclusions remain speculative in the absence of long term data. Ultimately, information regarding accuracy of CT and MRI will be the main determining factor. Increased accuracy of pre-operative imaging could result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging and revision surgery.
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Paul
authors: P
authors: Stirling
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Rejith
authors: R
authors: Valsalan Mannambeth
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Agustin
authors: A
authors: Soler
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Vineet
authors: V
authors: Batta
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Rajeev Kumar
authors: RK
authors: Malhotra
authors: Paul Stirling, Rejith Valsalan Mannambeth, Agustin Soler, Yegappan Kalairajah, Department of Orthopaedic Surgery, Luton and Dunstable University Hospital, Luton LU4 0DZ, United Kingdom.
authors: Yegappan
authors: Y
authors: Kalairajah
keywords: Accuracy; Alignment; Arthroplasty; Cost-effectiveness; Patient-specific instrumentation