The Effect Of Articular Cartilage In Patient-specific Intrumentations Total Knee Arthroplasty

Objective:The patient-specific intrumentation total knee arthroplasty(PSI-TKA)is gradually applied in the treatment of severe knee osteoarthritis(KOA).The preoperative plan of patient-specific intrumentation total knee arthroplasty is gradually performed by computed tomography,which is the more accurate than conventional intrumentation total knee arth-roplasty(CI-TKA)in terms of theory.But the effect of residual articular cartilage has not been specifically studied in previous studies.The ultimate aim of the study was to identify the more accuracy of osteotomy and lower postoperative infection rate in the treatment of severe knee osteoarthritis between patient-specific intrumentation total knee arth-roplasty with cartilage removal and conventional intrumentation total knee arthroplasty.The better technical option was provided for surgeons.Mathods:In this randomized controlled,single blind trial,66 patients with severe knee osteoarthritis received either Smith&Nephew’s Genisis or Legion CR prosthesis,which were osteotomized using conventional and patient-specific intrumentation.The information was collected preop-erative and postoperative after 20 days and 3 months.The characteristics of all patients were collected preoperatively.Twenty days and three months post-operative,infection rate of incision and prosthesis was reported.The accuracy of femoral and tibial cut bone and implant alignment was assessed by X-ray of length of lower limbs and lateral X-ray 3 months postoperative.The outliers were defined as a deviation of more than 3°from the preoperative target angle.Meanwhile,the satisfaction was evaluated.The differences of continuous variables were calculated using the independent samples t-test.Dichotomous variables were analysed with the chi-squared test.Results:In three months follow-up,The differences were not found in characteristics of PSI-TKA group and CI-TKA group(P=0.04).There were only one HKA outlier(12%)in the PSI-TKA group and seven HKA outliers in CI-TKA group(33%).The accuracy in the coronal and axial planes and the proportion of outliers was different in two groups(P<0.05).The more accuracy of femoral and tibial component was found in PSI-TKA group.The more proportion of incision inflammation was observed in CI-TKA group compared to PSI-TKA group(P=0.005)(6%VS 27%).Meanwhile,there were two patients who underwent revision surgery dut to prosthesis infection in CI-TKA group.A 40%decline in the satisfication of patients was reported for CI-TKA group.There was more significant different between two groups(P=0.01).Conclusion:The accuracy of patient-specific intrumentation total knee arth-roplasty can be changed,and different infection rate was found in two groups either.Meanwhile,the satisfaction of patient-specific intrumentation is obviously better than conventional intrumentation.