title: [Total knee arthroplasty. Patient-specific instruments and implants].
abstract: This article describes the concept and surgical technique of patient-specific total knee arthroplasty. Patient-specific implants and instruments are designed and fabricated based on computed tomography (CT) data of the leg. The disposable patient-specific drill guides and cutting-jigs are manufactured taking into consideration the anatomical and biomechanical axes of the knee joint and mediating the efficient pre-navigation of the osseous saw-cuts, without the need for additional navigation or balancing aids. The surgical plan is made on the basis of the CT data. The implantation technique comprises the following steps: distal femoral resection, tibial resection, balancing and femur preparation, tibia preparation, optional patellar resurfacing, trialling of the test components, and implantation of the final components. By using this patient-specific implant system, which includes not only personalized, single-use instruments, but also individualized implants, the surgeon is able to provide endoprosthetic treatment that broadly restores the patient's own knee anatomy and knee kinematics. Preliminary studies have proven the concept and data on this technology are promising so far; however, like a new implant, they are usually limited. In particular, comparative long-term clinical data are still to come.
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland. a-steinert.klh@uni-wuerzburg.de.
authors.forename: Andre F
authors.initials: AF
authors.lastname: Steinert
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.
authors.forename: Boris M
authors.initials: BM
authors.lastname: Holzapfel
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.
authors.forename: Lukas
authors.initials: L
authors.lastname: Sefrin
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.
authors.forename: Jörg
authors.initials: J
authors.lastname: Arnholdt
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.
authors.forename: Maik
authors.initials: M
authors.lastname: Hoberg
authors.affiliation: Orthopädische Klinik, König-Ludwig-Haus, Lehrstuhl für Orthopädie, Julius-Maximilians-Universität, Brettreichstr. 11, 97074, Würzburg, Deutschland.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Rudert
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D019544:Equipment Failure Analysis; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D007720:Knee Prosthesis; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000601:surgery*; D018579:Patient Selection; D057285:Precision Medicine / Q000295:instrumentation / Q000379:methods; D066330:Printing, Three-Dimensional / Q000295:instrumentation; D011474:Prosthesis Design; D017755:Prosthesis Fitting / Q000295:instrumentation* / Q000379:methods; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome
keywords: Bone malalignment; Computer-aided design; Osteoarthritis; Precision medicine; Prosthesis fitting