Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jul 18, 2015; 6(6): 446-448
Published online Jul 18, 2015. doi: 10.5312/wjo.v6.i6.446
Current concepts in total knee arthroplasty: Patient specific instrumentation
Patrick Sadoghi
Patrick Sadoghi, Department of Orthopedic Surgery, Medical University of Graz, 8036 Graz, Austria
Author contributions: Sadoghi P contributed to this paper.
Conflict-of-interest statement: I hereby declare to have no potential conflict of interest including but not limited to commercial, personal, political, intellectual, or religious interests.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Patrick Sadoghi, MD, PhD, Professor, Department of Orthopedic Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036 Graz, Austria. patricksadoghi@gmx.at
Telephone: +43-316-38580971 Fax: +43-316-38514806
Received: April 5, 2015
Peer-review started: April 6, 2015
First decision: May 13, 2015
Revised: May 23, 2015
Accepted: June 15, 2015
Article in press: June 16, 2015
Published online: July 18, 2015
Processing time: 100 Days and 17.4 Hours
Abstract

Patient specific instrumentation (PSI) in total knee arthroplasty (TKA) promises faster operation time (by using less instruments and individual cutting jigs), less blood loss, faster rehabilitation, better implant sizing and accuracy, superior overall outcome, and at the end - less costs. However, as evident for every new development, its superiority remains to be proven over the conventional systems. Whilst dissatisfaction is reported to be eminent in up to 30% of patients having undergone conventional TKA, it is unclear, whether PSI can address to these patients as a suitable option in the future. The author believes that the current evidence does not support superiority of PSI in TKA over conventional systems. However, future long-term level I and II studies might aid to show its cost-effectiveness stating same results, accuracy, and overall outcome with less operation time.

Keywords: Total knee arthroplasty; Patient specific instrumentation; Accuracy; Outcome analysis; Cost-effectiveness

Core tip: Patient specific instrumentation (PSI) in total knee arthroplasty (TKA) promises faster operation time, less blood loss, faster rehabilitation, superior implant accuracy, superior overall outcome, and less costs. However, as evident for every new development, its superiority remains to be proven over the conventional systems. Whilst dissatisfaction is reported to be eminent in up to 30% of patients having undergone conventional TKA, it is unclear, whether PSI can address to these patients as a suitable option in the future. The author believes that the current evidence does not support superiority of PSI in TKA over conventional systems.