title: Does Implant Design Influence the Accuracy of Patient Specific Instrumentation in Total Knee Arthroplasty?
abstract: PSI software adjusts preoperative planning to accommodate differences in implant design. Such adjustments may influence the accuracy of intraoperative jig placement, bone resection, or component placement. Our purpose was to determine whether implant design influences PSI accuracy. 96 and 123 PSI TKA were performed by a single surgeon using two different implant systems and identical PSI software. Femoral coronal alignment outliers were greater for Implant 1 (23.9% Implant 1 vs. 13.4% Implant 2; P=0.050). Tibial coronal alignment outliers were greater for Implant 2 (10.9% Implant 1 vs. 22.7% Implant 2; P=0.025). There was no difference in overall mechanical axes. Differences in implant design can influence bone resection and component alignment. PSI software rationale must align with surgeons' intraoperative goals.
authors: Northwestern Feinberg School of Medicine Department of Orthopaedic Surgery, Chicago, Illinois.
authors: Nitin
authors: N
authors: Goyal
authors: Northwestern Feinberg School of Medicine Department of Orthopaedic Surgery, Chicago, Illinois.
authors: Anay R
authors: AR
authors: Patel
authors: Northwestern Feinberg School of Medicine Department of Orthopaedic Surgery, Chicago, Illinois.
authors: Mark A
authors: MA
authors: Yaffe
authors: Northwestern Feinberg School of Medicine Department of Orthopaedic Surgery, Chicago, Illinois.
authors: Michael Y
authors: MY
authors: Luo
authors: Northwestern Feinberg School of Medicine Department of Orthopaedic Surgery, Chicago, Illinois; Northshore Orthopaedics, Chicago, Illinois.
authors: S David
authors: SD
authors: Stulberg
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D012984:Software; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery
keywords: alignment; implant design; patient specific instrumentation; preoperative planning; total knee arthroplasty