PMID- 33570699
OWN - NLM
STAT- MEDLINE
DCOM- 20220309
LR  - 20220309
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 30
IP  - 3
DP  - 2022 Mar
TI  - Patient-specific instruments do not show advantage over conventional instruments 
      in unicompartmental knee arthroplasty at 2 year follow-up: a prospective, 
      two-centre, randomised, double-blind, controlled trial.
PG  - 918-927
LID - 10.1007/s00167-021-06471-5 [doi]
AB  - PURPOSE: The aim of this two-centre RCT was to compare pre- and post-operative 
      radiological, clinical and functional outcomes between patient-specific 
      instrumentation (PSI) and conventional instrumented (CI) unicompartmental knee 
      arthroplasty (UKA). It was hypothesised that both alignment methods would have 
      comparable post-operative radiological, clinical and functional outcomes. 
      METHODS: One hundred and twenty patients were included, and randomly allocated to 
      the PSI or the CI group. Outcome measures were peri-operative outcomes (operation 
      time, length of hospital stay and intra-operative changes of implant size) and 
      post-operative radiological outcomes including the alignment of the tibial and 
      femoral component in the sagittal and frontal plane and the hip-knee-ankle-axis 
      (HKA-axis), rate of adverse events (AEs) and patient-reported outcome measures 
      (PROMs) pre-operatively and at 3, 12 and 24 months post-operatively. RESULTS: 
      There was a statistically significant difference (p < 0.05) in alignment of the 
      femoral component in the frontal plane in favour of the CI method. No 
      statistically significant differences were found for the peri-operative data or 
      in the functional outcome at 2-year follow-up. In the PSI group, the approved 
      implant size of the femoral component was correct in 98.2% of the cases and the 
      tibial component was correct in 60.7% of the cases. There was a comparable rate 
      of AEs: 5.1% in the CI and 5.4% in the PSI group. CONCLUSION: The PSI method did 
      not show an advantage over CI in regard of positioning of the components, nor did 
      it show an improvement in clinical or functional outcome. We conclude that the 
      possible advantages of PSI do not outweigh the costs of the MRI scan and the 
      manufacturing of the PSI. LEVEL OF EVIDENCE: Randomised controlled trial, level 
      I.
CI  - (c) 2021. European Society of Sports Traumatology, Knee Surgery, Arthroscopy 
      (ESSKA).
FAU - Leenders, Alexandra M
AU  - Leenders AM
AUID- ORCID: 0000-0003-0852-9294
AD  - Department of Orthopaedics, Zuyderland Medical Centre, Dr. H. van der Hoffplein 
      1, 6162 BG, Sittard-Geleen, The Netherlands. alexandraleenders@hotmail.com.
AD  - Department of Orthopaedics, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, 
      Venlo, The Netherlands. alexandraleenders@hotmail.com.
FAU - Kort, Nanne P
AU  - Kort NP
AD  - CortoClinics, Steeg 6E, 5482 WN, Schijndel, The Netherlands.
FAU - Koenraadt, Koen L M
AU  - Koenraadt KLM
AD  - Department of Orthopaedics, Amphia Hospital, Molengracht 21, 4814 CK, Breda, The 
      Netherlands.
FAU - van Geenen, Rutger C I
AU  - van Geenen RCI
AD  - Department of Orthopaedics, Amphia Hospital, Molengracht 21, 4814 CK, Breda, The 
      Netherlands.
FAU - Most, Jasper
AU  - Most J
AD  - Department of Orthopaedics, Zuyderland Medical Centre, Dr. H. van der Hoffplein 
      1, 6162 BG, Sittard-Geleen, The Netherlands.
FAU - Kerens, Bart
AU  - Kerens B
AD  - Department of Orthopaedics, AZ Sint-Maarten, Liersesteenweg 435, 2800, Mechelen, 
      Belgium.
FAU - Boonen, Bert
AU  - Boonen B
AD  - Department of Orthopaedics, Zuyderland Medical Centre, Dr. H. van der Hoffplein 
      1, 6162 BG, Sittard-Geleen, The Netherlands.
FAU - Schotanus, Martijn G M
AU  - Schotanus MGM
AD  - Department of Orthopaedics, Zuyderland Medical Centre, Dr. H. van der Hoffplein 
      1, 6162 BG, Sittard-Geleen, The Netherlands.
AD  - School of Care and Public Health Research Institute, Faculty of Health, Medicine 
      and Life Sciences, Maastricht University Medical Centre, Universiteitssingel 40, 
      6229 ER, Maastricht, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20210211
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/methods
MH  - Humans
MH  - Knee Joint/surgery
MH  - *Knee Prosthesis
MH  - *Osteoarthritis, Knee/etiology/surgery
MH  - Prospective Studies
MH  - *Surgery, Computer-Assisted
OTO - NOTNLM
OT  - Alignment
OT  - Arthroplasty
OT  - Knee
OT  - Knee arthroplasty
OT  - MRI
OT  - Patient-specific instrumentation
OT  - Radiography
OT  - Replacement
OT  - Unicompartmental knee arthroplasty
EDAT- 2021/02/12 06:00
MHDA- 2022/03/11 06:00
CRDT- 2021/02/11 12:11
PHST- 2020/08/31 00:00 [received]
PHST- 2021/01/21 00:00 [accepted]
PHST- 2021/02/12 06:00 [pubmed]
PHST- 2022/03/11 06:00 [medline]
PHST- 2021/02/11 12:11 [entrez]
AID - 10.1007/s00167-021-06471-5 [pii]
AID - 10.1007/s00167-021-06471-5 [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2022 Mar;30(3):918-927. doi: 
      10.1007/s00167-021-06471-5. Epub 2021 Feb 11.