Patient-specific instrumentation in total ankle arthroplasty.

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Abstract

Conflict of interest statement: Conflict-of-interest statement: The authors declare that they have no competing interests. 6. Expert Rev Med Devices. 2019 Jul;16(7):555-567. doi: 10.1080/17434440.2019.1627197. Epub 2019 Jun 10. Patient-specific instrumentation in total knee arthroplasty. León-Muñoz VJ(1), Martínez-Martínez F(1)(2), López-López M(3), Santonja-Medina F(1)(2). Author information: (1)a Orthopaedic Surgery and Traumatology Department , Hospital Clínico Universitario Virgen de la Arrixaca , Murcia , Spain. (2)b Faculty of Medicine , University of Murcia , Murcia , Spain. (3)c Subdirección General de Tecnologías de la Información. Servicio Murciano de Salud , Murcia , Spain. INTRODUCTION: Total knee arthroplasty (TKA) is one of the most commonly performed orthopedic procedures. During the past decade, patient-specific instrumentation (PSI) has been commercially introduced in order to simplify and make TKA surgery more effective, precise and efficient than conventional mechanical instrumentation (CI) and computer-assisted surgery (CAS). Nevertheless, there are critical arguments against PSI for routine use. The aim of the current manuscript is to describe advantages and limitations of PSI for primary TKA. AREAS COVERED: By means of a description of the available literature different aspects are discussed (accuracy, clinical and functional outcomes, operative time, blood loss, efficiency and costs). EXPERT OPINION: Most publications do not claim a significant increase in PSI accuracy over CI, but they also do not postulate PSIs accuracy is worse either. Regarding clinical aspects, PSI did not appear to give any advantage over standard techniques although, equally, it did not appear to show any disadvantages. PSI seems to reduce operative time, could reduce perioperative blood loss and provides logistical benefits in the operation room. Further studies will be required to more thoroughly assess all the advantages and disadvantages of this promising technology as an alternative to CI and CAS. DOI: 10.1080/17434440.2019.1627197