A comparison of short term radiological alignment outcomes of the patient speciŞc and standard instrumentation for primary total knee arthroplasty: A systematic review and meta-analysis

Abstract

Objective: The aim of this study was to review the radiological alignment outcomes of patient SpeciŞc(PS) cutting blocks and Standard Instrumentation in Primary Total Knee Arthroplasty.Methods: We hypothesized that the use of PS techniques would signiŞcantly improve sagittal, coronaland rotational alignment of the prosthesis on short term. We performed a systematic review and a metaanalysis including all the randomised controlled trials (RCT) using PS and standard (ST) total kneearthroplasty to date.Results: A total of 538 PS TKA and 549 ST TKA were included in the study. Statistical analysis of theoutliers for femoral component sagittal, coronal and rotational positioning, tibial component sagittal andcoronal positioning and the overall mechanical axis were assessed. We found that there was no significant beneŞt from using PS instrumentation in primary knee arthroplasty to aid in the positioning ofeither the tibial or femoral components. Furthermore sagittal plane tibial component positioning wasworse in the PS than the traditional ST group.Conclusion: Our results suggest that at present PS instrumentation is not superior to ST instrumentationin primary total knee arthroplasty.Level of evidence: Level 1, Systematic review of therapeutic studies.© 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)