Abdel et al.
4
4 Abdel MP, Parratte S, Blanc G, Ollivier M, Pomero V, Viehweger E, et al. No benefit of patient-specific instrumentation in TKA on functional and gait outcomes: a randomized clinical trial. Clin Orthop Relat Res. 2014;472(8):2468-76.
|
RCT |
|
20 PSI |
No difference in early functional, quality-of-life or gait outcomes. |
Functional evaluation |
|
|
|
20 SI |
|
|
Barke et al.
22
22 Barke S, Musanhu E, Busch C, Stafford G, Field R. Patient- matched total knee arthroplasty: does it offer any clinical advantages? Acta Orthop Belg. 2013;79(3):307-11.
|
Retrospective |
Visionaire® (Smith & Nephew) |
39 PSI |
SI achieved a MA closer to neutral. OT was equivalent. |
MA, OT |
|
|
|
50 SI |
|
|
Barrack et al.
17
17 Barrack RL, Ruh EL, Williams BM, Ford AD, Foreman K, Nunley RM. Patient specific cutting blocks are currently of no proven value. J Bone Joint Surg Br. 2012;94 11 (Suppl. A):95-9.
|
Retrospective |
Signature® (Biomet) |
100 PSI |
Equivalent MA accuracy, decreased OT and reduced number of instrument trays with PSI. |
MA, OT, number of instrument trays |
|
|
|
100 SI |
|
|
Barret et al.
23
23 Barrett W, Hoeffel D, Dalury D, Mason JBB, Murphy J, Himden S. In- vivo alignment comparing patient specific instrumentation with both conventional and computer assisted surgery (CAS) instrumentation in total knee arthroplasty. J Arthroplasty. 2014;29(2):343-7.
|
Prospective non-RCT |
TruMatch® (DePuy) |
66 PSI |
Comparable MA and OT between groups. |
MA, OT |
|
|
|
86 SI |
|
|
Boonen et al.
14
14 Boonen B, Schotanus MG, Kerens B, van der Weegen W, van Drumpt RA, Kort NP. Intra- operative results and radiological outcome of conventional and patient-specific surgery in total knee arthroplasty: a multicentre, randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2013;21(10):2206-12.
|
RCT |
Signature® (Biomet) |
90 PSI |
Equivalent MA, sagittal and coronal alignment of femur and tibia. PSI decreased OT by 5 min. |
MA, CFC, CTC, SFC, STC, OT |
|
|
|
90 SI |
|
|
Chareancholvanich et al.
11
11 Chareancholvanich K, Narkbunnam R, Pornrattanamaneewong C. A prospective randomised controlled study of patient-specific cutting guides compared with conventional instrumentation in total knee replacement. Bone Joint J. 2013;95-B(3):354-9.
|
RCT |
Patient-Specific Instruments® (Zimmer) |
40 PSI |
No difference in MA. Improved accuracy in CTC (89.8 ± 1.2 vs 90.5 ± 1.9, p = 0.030) and fewer outliers in SFC with PSI (p = 0.012). PSI decreased OT by 5 min. |
MA, CFC, CTC, SFC, OT |
|
|
|
40 SI |
|
|
Daniilidis et al.
6
6 Daniilidis K, Tibesku CO. A comparison of conventional and patient-specific instruments in total knee arthroplasty. Int Orthop. 2014;38(3):503-8.
|
Retrospective |
Visionaire® (Smith & Nephew) |
150 PSI |
MA equivalent, with fewer outliers with PSI (9.3% vs. 21.2%). |
MA |
|
|
|
156 SI |
|
|
Hamilton et al.
15
15 Hamilton WG, Parks NL. Patient-specific instrumentation does not shorten surgical time: a prospective, randomized trial. J Arthroplasty. 2014;29(7):1508-9.
|
RCT |
TruMatch® (DePuy) |
26 PSI |
No difference in MA, CFC, CTC and SFC with PSI. Increased posterior slope in SI (p < 0.001). PSI required fewer instrument trays but it was 4 min longer. |
MA, CFC, CTC, SFC, STC, OT, number of instrument trays |
|
|
|
26 SI |
|
|
Heyse et al.
7
7 Heyse TJ, Tibesku CO. Improved femoral component rotation in TKA using patient-specific instrumentation. Knee. 2014;21(1):268-71.
|
Retrospective |
Visionaire® (Smith & Nephew) |
46 PSI |
Reduced rate of FCR outliers in PSI group compared to SI (2.2% vs 22.9%, p = 0.003). |
FCR |
|
|
|
48 SI |
|
|
Ivie et al.
19
19 Ivie CB, Probst PJ, Bal AK, Stannard JT, Crist BD, Sonny Bal B. Improved radiographic outcomes with patient-specific total knee arthroplasty. J Arthroplasty. 2014;29(11):2100-3.
|
Retrospective |
iTotal® G2 (ConforMIS) |
100 PSI |
MA and CFC more accurate with PSI, with fewer outliers (p = 0.0016 and p = 0.032, respectively). No difference in CTC and in sagittal alignment between the two groups. No changes were required. |
MA, CFC, CTC, SFC, STC, need for applying changes |
|
|
|
100 SI |
|
|
Kotela et al.
24
24 Kotela A, Kotela I. Patient-specific computed tomography based instrumentation in total knee arthroplasty: a prospective randomized controlled study. Int Orthop. 2014;38(10):2099-107.
|
RCT |
Signature® (Biomet) |
49 PSI |
CTC showed more outliers in PSI group (38.78% vs 19.57%, p = 0.0458). |
MA, CFC CTC, SFC, STC |
|
|
|
46 SI |
|
|
Marimuth et al.
10
10 Marimuthu K, Chen DB, Harris IA, Wheatley E, Bryant CJ, MacDessi SJ. A multi-planar CT-based comparative analysis of patient-specific cutting guides with conventional instrumentation in total knee arthroplasty. J Arthroplasty. 2014;29(6):1138-42.
|
Retrospective |
Visionaire® (Smith & Nephew) |
115 PSI |
No differences in the evaluated parameters. Similar number of outliers. |
MA, CFC, CTC, SFC, STC, FCR |
|
|
|
185 SI |
|
|
Ng et al.
2
2 Ng VY, DeClaire JH, Berend KR, Gulick BC, Lombardi AV Jr. Improved accuracy of alignment with patient-specific positioning guides compared with manual instrumentation in TKA. Clin Orthop Relat Res. 2012;470(1):99-107.
|
Retrospective |
Signature® (Biomet) |
105 PSI |
Overall MA similar, but fewer outliers with PSI (9% vs 22%, p = 0.018); CFC (90.7 vs 91.3, p < 0.001) and CTC (89.9 vs 90.4, p = 0.005) closer to neutral in PSI group compared to SI. |
MA, CFC, CTC |
|
|
|
55 SI |
|
|
Noble et al.
12
12 Noble JW Jr, Moore CA, Liu N. The value of patient-matched instrumentation in total knee arthroplasty. J Arthroplasty. 2012;27(1):153-5.
|
RCT |
Visionaire® (Smith & Nephew) |
15 PSI |
MA closer to neutral with PSI (1.7 vs 2.8, p = 0.03). PSI showed reduction in OT (7 min) and number of instrument trays needed. |
MA, CFC, CTC, OT, number of instrument trays |
|
|
|
14 SI |
|
|
Nunley et al.
16
16 Nunley RM, Ellison BS, Ruh EL, Williams BM, Foreman K, Ford AD, et al. Are patient-specific cutting blocks cost- effective for total knee arthroplasty? Clin Orthop Relat Res. 2012;470(3):889-94.
|
Retrospective |
Signature® (Biomet) |
57 PSI |
Equivalent numbers of outliers with respect to MA. Decreased OT by 12 min after PSI. |
MA, OT |
|
|
|
57 SI |
|
|
Nunley et al.
21
21 Nunley RM, Ellison BS, Zhu J, Ruh EL, Howell SM, Barrack RL. Do patient-specific guides improve coronal alignment in total knee arthroplasty? Clin Orthop Relat Res. 2012;470(3):895-902.
|
Retrospective |
Signature® (Biomet) |
50 PSI |
Equivalent numbers of outliers with respect to MA. |
MA |
|
|
|
50 SI |
|
|
Renson et al.
20
20 Renson L, Poilvache P, Van den Wyngaert H. Improved alignment and operating room efficiency with patient-specific instrumentation for TKA. Knee. 2014;21(6):1216-20.
|
Prospective case series |
Signature® (Biomet) |
71 PSI |
Fewer outliers in MA with PSI compared to SI (13% vs 29%, p = 0.043). Decreased OT time by 9 min and the number of instrument trays by six trays with PSI. |
MA, CFC, CTC, SFC, STC, OT, number of instrument trays |
|
|
|
60 SI |
|
|
Roh et al.
9
9 Roh YW, Kim TW, Lee S, Seong SC, Lee MC. Is TKA using patient-specific instruments comparable to conventional TKA? A randomized controlled study of one system. Clin Orthop Relat Res. 2013;471(12):3988-95.
|
RCT |
Signature® (Biomet) |
42 PSI |
No difference groups with respect to all evaluated parameters. Equivalent number of outliers. OT was 13 min longer with PSI and PSI had to be aborted in 16% of knees. |
MA, CFC, CTC, SFC, STC, FCR, OT, need for applying changes |
|
|
|
48 SI |
|
|
Silva et al.
18
18 Silva A, Sampaio R, Pinto E. Patient-specific instrumentation improves tibial component rotation in TKA. Knee Surg Sports Traumatol Arthrosc. 2014;22(3):636-42.
|
Prospective randomized |
Signature® (Biomet) |
23 PSI |
No significant difference in FCR and TCR between groups, but less dispersion and amplitude of TCR around the neutral position with PSI. |
FCR, TCR |
|
|
|
22 SI |
|
|
Stronach et al.
25
25 Stronach BM, Pelt CE, Erickson JA, Peters CL. Patient-specific instrumentation in total knee arthroplasty provides no improvement in component alignment. J Arthroplasty. 2014;29(9):1705-8.
|
Retrospective |
Signature® (Biomet) |
58 PSI |
No improvement in alignment with PSI. Worsening of accuracy of the tibial slope with PSI (38% vs 61%, p = 0.01). Equivalent OT. |
MA, CFC, CTC, SFC, STC, OT |
|
|
|
62 SI |
|
|
Stronach et al.
26
26 Stronach BM, Pelt CE, Erickson J, Peters CL. Patient-specific total knee arthroplasty required frequent surgeon- directed changes knee. Clin Orthop Relat Res. 2013;471(1):169-74.
|
Retrospective |
Signature® (Biomet) |
66 PSI |
Equivalent OT but multiple changes required intraoperatively with PSI (2.4 changes/knee). |
OT, need for applying changes |
|
|
|
62 SI |
|
|
Tibesku et al.
13
13 Tibesku CO, Hofer P, Portegies W, Ruys CJ, Fennema P. Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model. Arch Orthop Trauma Surg. 2013;133(3):405-11.
|
Activity-based costing model |
Visionaire® (Smith & Nephew) |
|
Increased efficacy in OT and utilization of instrument trays with PSI. PSI is economically effective. |
OT, number of instrument trays |
Victor et al.
1
1 Victor J, Dujardin J, Vandenneucker H, Arnout N, Bellemans J. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial. Clin Orthop Relat Res. 2014;472(1):263-71.
|
RCT |
Signature® (Biomet) |
61 P SI |
No significant differences between PSI and SI with respect to component alignment. PSI had more outliers than SI in CTC (14.6% vs 3.1%, p = 0.03) and STC (21.3% vs 3.1%, p = 0.002). Visionaire® subgroup had more overall coronal alignment outliers (p = 0.04) but fewer SFC outliers (p = 0.001). PSI was abandoned in 22% of patients and modified in 28% of patients. |
MA, CFC, CTC, SFC, STC, FCR, need for applying changes |
|
|
TruMatch® (DePuy) |
64 SI |
|
|
|
|
Visionaire® (Smith & Nephew) |
|
|
|
|
|
Patient-Specific Instruments® (Zimmer) |
|
|
|
Vundelinckx et al.
3
3 Vundelinckx BJ, Bruckers L, De Mulder K, De Schepper J, Van Esbroeck G. Functional and radiographic short-term outcome evaluation of the Visionaire system, a patient-matched instrumentation system for total knee arthroplasty. J Arthroplasty. 2013;28(6):964-70.
|
RCT |
Visionaire® (Smith & Nephew) |
31 PSI |
Equivalent MA. Improved STC with PSI (2.9 ± 2.39 vs 5.0 ± 2.14, p = 0.0008). No difference in pain, patient satisfaction, or functional outcomes (KOOS, Lysholm score). |
MA, STC, functional evaluation |
|
|
|
31 SI |
|
|
Woolson et al.
8
8 Woolson ST, Harris AH, Wagner DW, Giori NJ. Component alignment during total knee arthroplasty with use of standard or custom instrumentation: a randomized clinical trial using computed tomography for postoperative alignment measurement. J Bone Joint Surg Am. 2014;96(5):366-72.
|
RCT |
TruMatch® (DePuy) |
22 PSI |
Increased number of outliers in PSI group with respect to tibial slope (32% vs 8%, p = 0.032). No significant difference with regard to OT or Knee Society rating or function score. |
MA, CFC, CTC, STC, FCR, OT, functional evaluation |
|
|
|
26 SI |
|
|
Yaffe et al.
5
5 Yaffe M, Luo M, Goyal N, Chan P, Patel A, Cayo M, et al. Clinical, functional, and radiographic outcomes following total knee arthroplasty with patient-specific instrumentation, computer- assisted surgery, and manual instrumentation: a short-term follow-up study. Int J Comput Assist Radiol Surg. 2014;9(5):837-44.
|
Retrospective |
Patient-Specific Instruments® (Zimmer) |
44 PSI |
No difference in MA, SFC or STC. No difference in pain, motion, Knee Society knee scores; PSI had higher Knee Society function scores pre- and postoperatively |
MA, SFC, STC, functional evaluation |
|
|
|
40 SI |
|
|