title: Total knee arthroplasty using patient-specific guides: Is there a learning curve?
abstract: BACKGROUND
  Patient specific guides (PSG) have been reported to improve overall component alignment in total knee arthroplasty (TKA). With more surgeons likely to consider this method of TKA in the future, this study was performed to establish whether there is a learning curve with use of PSG in TKA.
  
  
  METHODS
  Eighty-six consecutive PSG TKAs performed by one surgeon were retrospectively analyzed in two groups. The first 30 patients were compared to the second 56 patients with regards to their operative times and post-operative multi-planar alignments on computed tomography (CT) scan.
  
  
  RESULTS
  Mean operative time was higher in the initial 30 cases compared to the second 56 cases (85 min vs. 78 min; p=0.001). No statistically significant differences were found in post-operative TKA alignment between the two groups.
  
  
  CONCLUSIONS
  This study suggests that there is a minimal learning curve with operative time associated with use of PSG in TKA. This study was unable to detect a significant learning curve with regards to restoration of mechanical knee alignment with the use of PSG in TKA.
authors.affiliation: Department of Orthopaedic Surgery, The Canterbury Hospital, Canterbury, NSW, Australia.
authors.forename: Jason
authors.initials: J
authors.lastname: Chinnappa
authors.affiliation: Department of Orthopaedic Surgery, The Canterbury Hospital, Canterbury, NSW, Australia; Sydney Knee Specialists, St George Private Hospital, Sydney, NSW, Australia.
authors.forename: Darren B
authors.initials: DB
authors.lastname: Chen
authors.affiliation: South Western Sydney Clinical School, University of NSW, Australia.
authors.forename: Ian A
authors.initials: IA
authors.lastname: Harris
authors.affiliation: Department of Orthopaedic Surgery, The Canterbury Hospital, Canterbury, NSW, Australia; Sydney Knee Specialists, St George Private Hospital, Sydney, NSW, Australia. Electronic address: samuelmacdessi@sydneyknee.com.au.
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: MacDessi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000193:education / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000193:education / Q000379:methods*; D014057:Tomography, X-Ray Computed
keywords: Alignment; Knee arthroplasty; Learning curve; Patient-specific guides; Surgery