Journal of Bone and Joint Surgery - British Volume · 2012 · 164 citations · 7 references
MedicineOrthopaedic SurgeryOrthopedic SurgeryBiomedical ImagingDiagnostic ImagingOrthopedicsKnee ArthroplastyLower Limb AlignmentMinimally Invasive SurgeryOrthopedic Surgical InstrumentsPatient-specific InstrumentationSurgical ApproachesCoronal AlignmentInstrument Processing WorkflowInstrumentation EfficiencyKnee Alignment AdjustmentOperative TechniquePostoperative Alignment EvaluationSurgical Workflow Efficiency
Patient specific cutting guides generated by preoperative Magnetic Resonance Imaging (MRI) of the patient's extremity have been proposed as a method of improving the consistency of Total Knee Arthroplasty (TKA) alignment and adding efficiency to the operative procedure. The cost of this option was evaluated by quantifying the savings from decreased operative time and instrument processing costs compared to the additional cost of the MRI and the guide. Coronal plane alignment was measured in an unselected consecutive series of 200 TKAs, 100 with standard instrumentation and 100 with custom cutting guides. While the cutting guides had significantly lower total operative time and instrument processing time, the estimated $322 savings was overwhelmed by the $1,500 additional cost of the MRI and the cutting guide. All measures of coronal plane alignment were equivalent between the two groups. The data does not currently support the proposition that patient specific guides add value to TKA.
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