title: Patient-Specific Instrumentation in Total Knee Arthroplasty: What Is the Evidence?
abstract: With a steady increase in the demand for primary and revision total knee arthroplasty (TKA), any potential reduction in the number of failures can be a topic of significant clinical importance. Patient-specific instrumentation (PSI) is introduced to potentially achieve more reproducible alignment with reduced outliers by creating more accurate and patient-specific femoral and tibial cuts based on neutral mechanical axis. However, there is no widely accepted consensus on the efficacy and indication of using PSI in TKA. The purpose of this review was to assess the current literature on patient-specific TKA and its effect on perioperative outcomes, including templating and preoperative planning, mechanical alignment, clinical outcomes, perioperative blood loss, and economic evaluations. Based on the current literature, more prospective studies are necessary to evaluate the routine use of PSI in TKA.
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Bartlomiej
authors.initials: B
authors.lastname: Szczech
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: James D
authors.initials: JD
authors.lastname: McDermott
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Kimona
authors.initials: K
authors.lastname: Issa
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Aiman
authors.initials: A
authors.lastname: Rifai
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Anthony
authors.initials: A
authors.lastname: Festa
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: William A
authors.initials: WA
authors.lastname: Matarese
authors.affiliation: Department of Orthopaedic Surgery, Seton Hall University School of Health and Medical Sciences, South Orange, New Jersey.
authors.forename: Vincent K
authors.initials: VK
authors.lastname: McInerney
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D017760:Bone Malalignment / Q000517:prevention & control*; D005269:Femur / Q000601:surgery; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome