title: Outcomes following total knee arthroplasty with CT-based patient-specific instrumentation.
abstract: OBJECTIVE
  A 24-month prospective follow-up study was carried out to compare perioperative clinical outcomes, radiographic limb alignment, component positioning, as well as functional outcomes following total knee arthroplasty (TKA) between patient-specific instrumentation (PSI) and conventional instrumentation (CI).
  
  
  METHODS
  Ninety consecutive patients, satisfying the inclusion and exclusion criteria, were scheduled to undergo TKA with either PSI or CI. A CT-based PSI was used in this study, and a senior surgeon performed all surgeries. Patients were clinically and functionally assessed preoperatively, 6 and 24 months post-operatively. Perioperative outcomes were also analysed, including operating time, haemoglobin loss, the need for blood transfusion, length of hospitalisation, and radiographic features.
  
  
  RESULTS
  At 24-month follow-up, clinical and functional outcomes were comparable between the two groups. PSI performed no better than CI in restoring lower limb mechanical alignment or improving component positioning. There were no differences in operating time, haemoglobin loss, transfusion rate, or length of hospitalisation between PSI and CI.
  
  
  CONCLUSIONS
  No significant clinical benefit could be demonstrated in using PSI over CI after 24 months, and routine use of PSI is not recommended in non-complicated TKA.
  
  
  METHODS
  II.
authors.affiliation: Duke-NUS Graduate Medical School, 8 College Road, Singapore, 169857, Singapore. meng.zhu@u.duke.nus.edu.
authors.forename: Meng
authors.initials: M
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Jerry Yongqiang
authors.initials: JY
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Hwei Chi
authors.initials: HC
authors.lastname: Chong
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Andy Khye Soon
authors.initials: AKS
authors.lastname: Yew
authors.affiliation: Island Orthopaedic Consultants, Mount Elizabeth Medical Centre, 3 Mount Elizabeth, Singapore, 228510, Singapore.
authors.forename: Leon Siang Shen
authors.initials: LSS
authors.lastname: Foo
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Shi-Lu
authors.initials: SL
authors.lastname: Chia
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Ngai Nung
authors.initials: NN
authors.lastname: Lo
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, 20 College Road, Singapore, 169865, Singapore.
authors.forename: Seng Jin
authors.initials: SJ
authors.lastname: Yeo
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D007720:Knee Prosthesis; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Clinical and functional outcomes; Patient-specific cutting block; Patient-specific instrument; Radiographic outcome; Total knee arthroplasty