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Introduction
Computer assisted surgery (CAS) is an accurate
and reliable technique for the placement of
femoral and tibial components in total knee
arthroplasty (TKA) [1]. However, CAS needs
extra operative time, and increases costs
because of requiring buying expensive
workstation in the operating room. Patient
specific instruments (PSI) have been developed
to be as accurate as CAS without increasing
operating time and without requiring expensive
costs. We report results of a prospective and
continuous series of our first 40 cases of TKA
implanted by means of PSI. The average
follow-up was 3 year. We tried to define what
the lacks of this technique were and what could
be done in the future to improve it.
Materials and Methods
We conducted a prospective study on the first
40 cases operated on by means of PSI.
No patient selection was applied. Every patient
underwent a pre operative MRI to build the PSI
guides (fig. 1). These guides were manufactured
after manual segmentation of MRI in order to
define anatomical points (fig. 2).
All the patients were clinically followed at
2 month, 6 month, 1 year and 3 post operative
year, respectively. Maximal flexion assessment
was performed on weight bearing radiographs
(lateral view). Frontal alignment was measured
on full-leg standing X-rays.
Patient specific instruments
in total knee replacement.
Experience and limits.
A prospective studyat 3 post operative year
J. Chouteau
Fig. 1: Femoral Guide. Per operative view.