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Accuracy of Individualized Custom Tibial Cutting Guides in UKA

  • Original Article
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HSS Journal ®

Abstract

Background

Component malposition is one of the major reasons for early failure of unicompartmental knee arthroplasty (UKA).

Questions/Purposes

It was investigated how reproducibly patient-specific instrumentation (PSI) achieved preoperatively planned placement of the tibial component in UKA specifically assessing coronal alignment, slope and flexion of the components and axial rotation.

Patients and Methods

Based on computer tomography models of ten cadaver legs, PSI jigs were generated to guide cuts perpendicular to the tibial axis in the coronal and sagittal planes and in neutral axial rotation. Deviation ≥3° from the designed orientation in a postoperative CT was defined as outside the range of acceptable alignment.

Results

Mean coronal alignment was 0.4 ± 3.2° varus with two outliers. Mean slope was 2.8 ± 3.9° with six components in excessive flexion. It was noted that the implants were put in a mean of 1.7 ± 8.0° of external rotation with seven outliers

Conclusions

PSI helped achieve the planned coronal orientation of the component. The guides were less accurate in setting optimal tray rotation and slope.

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Disclosures

Conflict of Interest: Thomas J. Heyse, MD, PhD received grant funding from Marmor ARJR and research support from Stryker for the study; payment for lectures from Smith & Nephew and Biomet and other from Smith and Nephew, outside the work. Joseph D. Lipman, MS received Marmor ARJR Grant and research support from Stryker for the study; paid consultant for Ivy Sports Medicine; received royalties from Orthodevelopment Corporation and Mathys Medical, outside the work. Carl W. Imhauser, PhD received grant funding from Marmor ARJR for the study. Scott M. Tucker, MS received grant funding from Marmor ARJR and research support from Stryker for the study. Yogesh Rajak, received grant funding from Marmor ARJR and research support from Stryker for the study. Geoffrey H. Westrich, MD received grant funding from Marmor ARJR and research support from Stryker for the study; board member of Knee Society and EOA; paid consultant for Exactech, Stryker and DJO; grants from Exactech and Stryker; payments for lectures including service on speakers bureaus from Exactech, Stryker and DJO; royalties from Orthodevelopment Corporation and Mathys Medical, outside the work.

Human/Animal Rights: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent: N/A

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Authors and Affiliations

  1. Department of Orthopedics and Rheumatology, University Hospital Marburg, Baldingerstrasse, 35043, Marburg, Germany

    Thomas J. Heyse MD, PhD

  2. Department of Biomechanics, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA

    Joseph D. Lipman MS, Carl W. Imhauser PhD, Scott M. Tucker MS & Yogesh Rajak

  3. Adult Reconstruction & Joint Replacement Division, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA

    Geoffrey H. Westrich MD

Authors
  1. Thomas J. Heyse MD, PhD
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  2. Joseph D. Lipman MS
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Correspondence to Thomas J. Heyse MD, PhD.

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Heyse, T.J., Lipman, J.D., Imhauser, C.W. et al. Accuracy of Individualized Custom Tibial Cutting Guides in UKA. HSS Jrnl 10, 260–265 (2014). https://doi.org/10.1007/s11420-014-9410-z

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  • DOI: https://doi.org/10.1007/s11420-014-9410-z

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