Verification of in vivo accuracy of Trumatch™ patient-specific instrumentation in total knee replacement using pin-less computer navigation.
OBJECTIVE
Accurate component alignment in total knee replacement (TKR) is one of the important factors in determining long-term survivorship. This has been achieved by conventional jigs, computer-assisted technology (CAS) and more recently patient-specific instrumentation (PSI). The purpose of the current study was to investigate the in vivo accuracy of Trumatch™ PSI using validated pin-less computer navigation system.


METHODS
Twenty consecutive selected patients that fulfilled our inclusion/exclusion criteria underwent TKR using PSI. Coronal alignment, posterior slope, resection thickness and femoral sagittal alignment were recorded using pin-less navigation. The position of the actual cutting block was appropriately adjusted prior to proceeding to definitive resections.


RESULTS
The coronal alignment using PSI without the assistance of navigation would have resulted in 14 (70 %) within ±3°, 11 (55 %) within ±2° and 6 (30 %) outside acceptable alignment. Thirty-five percentage of proposed femur sagittal alignment and 55 % of posterior tibial slope were achieved within ±3°. Components size was accurately predicted in 95 % of femurs and 90 % of tibia.


CONCLUSIONS
The purported advantages in restoring alignments using Trumatch™ PSI alone over standard equipment are debatable. However, it predicts sizing well, and femoral coronal alignment is reasonable. Combining Trumatch™ PSI with CAS will allow in vivo verification and necessary corrections.


METHODS
IV.
The South West London Elective Orthopaedic Centre, Dorking Road, Epsom, London, KT18 7EG, UK.
Nikolai
N
Briffa
The South West London Elective Orthopaedic Centre, Dorking Road, Epsom, London, KT18 7EG, UK.|Orthopaedic Surgery and Traumatology Department, Faculty of Medicine, Suez Canal University, Circular Road, Ismailia, 41522, Egypt.
Mohamed A
MA
Imam
The South West London Elective Orthopaedic Centre, Dorking Road, Epsom, London, KT18 7EG, UK.
Ravi
R
Mallina
Orthopaedic Surgery and Traumatology Department, Faculty of Medicine, Suez Canal University, Circular Road, Ismailia, 41522, Egypt. ashraf.abdelkafy@gmail.com.
Ashraf
A
Abdelkafy
The South West London Elective Orthopaedic Centre, Dorking Road, Epsom, London, KT18 7EG, UK.
Ajeya
A
Adhikari
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods; D017760:Bone Malalignment / Q000175:diagnosis / Q000601:surgery; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery; D010347:Patient Care Planning; D011300:Preoperative Care; D011446:Prospective Studies; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery
Computer navigation; Patient-specific instrumentation; Total knee arthroplasty; Total knee replacement; Trumatch™