PMID- 29713783
OWN - NLM
STAT- MEDLINE
DCOM- 20190208
LR  - 20190215
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 26
IP  - 11
DP  - 2018 Nov
TI  - A high rate of tibial plateau fractures after early experience with 
      patient-specific instrumentation for unicompartmental knee arthroplasties.
PG  - 3491-3498
LID - 10.1007/s00167-018-4956-9 [doi]
AB  - PURPOSE: Patient-specific instrumentation (PSI) for unicompartmental knee 
      arthroplasty (UKA) has been available for a few years. However, limited 
      literature is available on this subject. Hence, the aim of this cohort study is 
      to evaluate the 2 years' results of our first experiences with the use of PSI in 
      UKA. It is hypothesised that there is no advantage in rate of adverse events and 
      in radiological and functional outcomes in comparison to literature on the 
      conventional method. METHODS: This cohort included 129 knees of 122 patients, 
      operated by one surgeon. Outcome measures were the rate of adverse events (AEs); 
      implant position as determined on radiographs; the accuracy of the default and 
      approved planning of the implant sizes and the patient-reported outcome measures 
      (PROMs) preoperatively, and at 3, 12 and 24 months, postoperatively. RESULTS: A 
      total of 6 (4.9%) AEs were observed in this study, with 4 (3.3%) tibial fractures 
      being the main complication. The mean postoperative biomechanical axis was 176.4 degrees  
      and in the majority of cases, the radiographic criteria, as determined by the 
      manufacturer, were met. The tibial component showed 20 (16.4%) outliers in the 
      sagittal and 3 (2.5%) outliers in the frontal plane. There were no outliers of 
      the femoral component. For the femoral and tibial components, respectively, in 
      125 (96.9%) and 79 (61.7%) cases, there was an agreement between approved 
      planning and implanted component size. All PROMs improved significantly after 
      surgery. CONCLUSION: Tibial fracture was the most common AE, probably related to 
      the transition from cemented to uncemented UKA. Perioperative modifications to 
      the surgical technique were made in order to prevent this AE. Improvements should 
      be made to the operation technique of the uncemented tibial plateau to obtain an 
      adequate placement and at the same time reduce the risk for tibial fracture. The 
      PSI technique was a reliable tool for the placement of the femoral component. 
      Functional outcome was in line with literature on the conventional method. It is 
      strongly recommended that the surgeon approves every preoperative plan, in order 
      to optimise the accuracy during the PSI surgery. LEVEL OF EVIDENCE: III.
FAU - Leenders, A M
AU  - Leenders AM
AD  - Orthopedic Resident at Maastricht University Medical Centre, P. Debyelaan 25, 
      6229 HX, Maastricht, The Netherlands.
FAU - Schotanus, M G M
AU  - Schotanus MGM
AUID- ORCID: 0000-0002-3975-6337
AD  - Orthopedic Research Manager at Zuyderland Medical Centre, Dr H vd Hoffplein 1, 
      6162 AG, Sittard-Geleen, The Netherlands. martijnschotanus@hotmail.com.
FAU - Wind, R J P
AU  - Wind RJP
AD  - Orthopedic Resident at Sint Maartenskliniek, Hengstdal 3, 6574 NA, Ubbergen, The 
      Netherlands.
FAU - Borghans, R A P
AU  - Borghans RAP
AD  - Radiologist at Zuyderland Medical Centre, Dr. H. van der Hoffplein 1, 6162 AG, 
      Sittard-Geleen, The Netherlands.
FAU - Kort, N P
AU  - Kort NP
AD  - Orthopaedic Surgeon at ACIBADEM International Medical Center, Arlandaweg 100, 
      1043 HP, Amsterdam, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20180430
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Arthroplasty, Replacement, Knee/*adverse effects/instrumentation
MH  - Cohort Studies
MH  - Female
MH  - Humans
MH  - Knee Prosthesis
MH  - Male
MH  - Middle Aged
MH  - Postoperative Complications
MH  - Preoperative Care
MH  - *Surgery, Computer-Assisted
MH  - Tibial Fractures/*etiology/prevention & control
OTO - NOTNLM
OT  - Custom fit
OT  - Instruments
OT  - PSG
OT  - PSI
OT  - Patient specific
OT  - Patient-specific guides
OT  - Patient-specific matched instruments
OT  - Templating
OT  - UKA
OT  - Unicompartmental knee arthroplasty
OT  - Unicondylar knee arthroplasty
EDAT- 2018/05/02 06:00
MHDA- 2019/02/09 06:00
CRDT- 2018/05/02 06:00
PHST- 2017/07/26 00:00 [received]
PHST- 2018/04/23 00:00 [accepted]
PHST- 2018/05/02 06:00 [pubmed]
PHST- 2019/02/09 06:00 [medline]
PHST- 2018/05/02 06:00 [entrez]
AID - 10.1007/s00167-018-4956-9 [pii]
AID - 10.1007/s00167-018-4956-9 [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2018 Nov;26(11):3491-3498. doi: 
      10.1007/s00167-018-4956-9. Epub 2018 Apr 30.