Abstract
Objective To conduct a meta-analysis of randomized controlled trials (RCTs) to compare knee arthroplasty with patient-specific instrumentation (PSI) with the conventional instrumentation (CI). Methods RCTs were selected in PubMed and Embase from 2012 to 2018. Key data extracted included malalignment of mechanical axis, blood loss, surgical time, Oxford Knee Score (OKS), Knee Society Score (KSS), length of stay, and complications. Subgroup analysis was also performed regarding different PSI systems and different image processing methods. Results 29 RCTs with 2487 knees were eligible for the meta-analysis. Results showed that PSI did not improve the alignment of the mechanical axis compared with CI, but MRI-based PSI and Visionaire-specific PSI decrease the risk of malalignment significantly (P = 0.04 and P = 0.04 and P = 0.04 and P = 0.04 and P = 0.04 and Conclusion PSI reduced the blood loss and improved KSS. MRI-based PSI reduced operative time and risk of malalignment of mechanical axis compared with CT-based PSI. Moreover, Visionaire-specific PSI achieves better alignment result of the mechanical axis than other systems.
Highlights
Total knee arthroplasty (TKA) is the most important treatment for end-stage osteoarthritis of the knee and has been performed increasingly common in orthopedics surgery
Results showed that patient-specific instrumentation (PSI) did not improve the alignment of the mechanical axis compared with conventional instrumentation (CI), but magnetic resonance imaging (MRI)-based PSI and Visionairespecific PSI decrease the risk of malalignment significantly (P = 0:04 and P = 0:003, respectively)
The customized blocks were generated from a preoperative three-dimensional model, which was reconstructed from computed tomography (CT) or magnetic resonance imaging (MRI) [4]
Summary
To conduct a meta-analysis of randomized controlled trials (RCTs) to compare knee arthroplasty with patient-specific instrumentation (PSI) with the conventional instrumentation (CI). Key data extracted included malalignment of mechanical axis, blood loss, surgical time, Oxford Knee Score (OKS), Knee Society Score (KSS), length of stay, and complications. Results showed that PSI did not improve the alignment of the mechanical axis compared with CI, but MRI-based PSI and Visionairespecific PSI decrease the risk of malalignment significantly (P = 0:04 and P = 0:003, respectively). PSI reduced operative time (P = 0:03) and blood loss (P = 0:002) and improve the KSS (P = 0:02) compared with CI, but for CT-based PSI, the difference of operative time becomes insignificant. MRI-based PSI reduced operative time and risk of malalignment of mechanical axis compared with CT-based PSI. Visionaire-specific PSI achieves better alignment result of the mechanical axis than other systems
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
