Custom-Fit Total Knee Arthroplasty: Our Initial Experience in 32 Knees

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Abstract

We share our initial experience of total knee arthroplasty (TKA) using customized cutting block technology in 32 TKAs from May 2010 to March 2011. Ten of these patients had prior TKA done on the other side using conventional or navigation-assisted TKA. Customized cutting blocks were generated for each of the knee using preoperative magnetic resonance imaging of knee and long-leg weight-bearing radiographs. At 6 weeks, long-leg radiographs were obtained to evaluate the coronal alignment. There were no adverse intraoperative events. Twenty-nine of the 32 knees had a mechanical axis restored to within 3°° of neutral. Of 10 patients with prior TKA without custom-fit technology, the mean blood loss and the mean skin-to-skin time was found to be lower in knees that had undergone custom-fit TKA. We conclude that this technology can be safely used in most of the cases of osteoarthritis.

Section snippets

Materials and Methods

This prospective study included 29 patients (16 were male and 13 were female) who had 32 knee arthroplasties done using custom-fit technique between May 2010 and March 2011. A written informed consent was taken from all the patients. The inclusion criterion was patients undergoing TKA for the diagnosis of primary osteoarthritis. Patients with history of trauma, malaligned femoral/tibial shafts, or prior history of surgery on the knee were also included as long as they did not have any form of

Results

Table 1 summarizes the demographic profile of the patients. The mean age of the patients was 64.1 years (range, 47-100 years). The mean BMI was 31 kg/m2 (range, 20-45 kg/m2). None of the patients had neutral preoperative alignment. Preoperative varus/valgus deformities at the time of surgery included 19 patients with varus alignment (−6.6° ± 2.6°; maximum, −14.0°) and 13 with valgus alignment (7.1° ± 3.6°; maximum, 16.0°). There were only 4 patients with a deformity greater or equal to 10° (2

Discussion

The purposes of the study were to share our initial experience with custom-fit TKA and to see if such a technique restored mechanical axis as accurately as the standard techniques. Various studies have cited the importance of proper coronal alignment for a successful TKA, concluding that alignment outside 3° leads to decreased survivorship 3, 4, 5, 6, 7. As such, the implantation technique should minimize or eliminate postoperative mechanical axis malalignment. Our results showed that the

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    The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.12.006.

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