Patient-Specific Versus Conventional Instrumentation for Total Knee Arthroplasty: Peri-Operative and Cost Differences

被引:54
作者
DeHaan, Alexander M. [1 ]
Adams, Jacob R. [1 ]
DeHart, Matthew L. [1 ]
Huff, Thomas W. [1 ]
机构
[1] Oregon Hlth & Sci Univ, Dept Orthopaed & Rehabil, Portland, OR 97239 USA
关键词
total knee arthroplasty; custom cutting blocks; patient-specific instrumentation; patient-specific total knee arthroplasty; cost-effectiveness; INITIAL-EXPERIENCE; CUTTING BLOCKS; ROTATION; SURGERY;
D O I
10.1016/j.arth.2014.06.019
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
The role of patient-specific instrumentation in total knee arthroplasty (TKA) is yet to be clearly defined. Current evidence evaluating peri-operative and cost differences against conventional TKA is unclear. We reviewed 356 TKAs between July 2008 and April 2013; 306 TKAs used patient-specific instrumentation while 50 had conventional instrumentation. The patient-specific instrumentation cohort averaged 20.4 min less surgical time (P < 0.01) and had a 42% decrease in operating room turnover time (P = 0.022). At our institution, the money saved through increased operating room efficiency offset the cost of the custom cutting blocks and pre-operative advanced imaging. Routine use of patient-specific TKA can be performed with less surgical time, no increase in peri-operative morbidity, and at no increased cost when compared to conventional TKA. (C) 2014 Elsevier Inc. All rights reserved.
引用
收藏
页码:2065 / 2069
页数:5
相关论文
共 31 条
[11]   Reliability of Templating with Patient-Specific Instrumentation in Total Knee Arthroplasty [J].
Issa, Kimona ;
Rifai, Aiman ;
McGrath, Mike S. ;
Callaghan, John J. ;
Wright, Craig ;
Malkani, Arthur L. ;
Mont, Michael A. ;
McInerney, Vincent K. .
JOURNAL OF KNEE SURGERY, 2013, 26 (06) :429-433
[12]   Are systemic emboli reduced in computer-assisted knee surgery? A prospective, randomised, clinical trial [J].
Kalairajah, Y ;
Cossey, AJ ;
Verrall, GM ;
Ludbrook, G ;
Spriggins, AJ .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2006, 88B (02) :198-202
[13]   Blood loss after total knee replacement - Effects of computer-assisted surgery [J].
Kalairajah, Y ;
Simpson, D ;
Cossey, AJ ;
Verrall, GM ;
Spriggins, AJ .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2005, 87B (11) :1480-1482
[14]   Custom-fit total knee arthroplasty (OtisKnee) results in malalignment [J].
Klatt, Brian A. ;
Goyal, Nitin ;
Austin, Matthew S. ;
Hozack, William J. .
JOURNAL OF ARTHROPLASTY, 2008, 23 (01) :26-29
[15]   Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030 [J].
Kurtz, Steven ;
Ong, Kevin ;
Lau, Edmund ;
Mowat, Fionna ;
Halpern, Michael .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2007, 89A (04) :780-785
[16]   ON A TEST OF WHETHER ONE OF 2 RANDOM VARIABLES IS STOCHASTICALLY LARGER THAN THE OTHER [J].
MANN, HB ;
WHITNEY, DR .
ANNALS OF MATHEMATICAL STATISTICS, 1947, 18 (01) :50-60
[17]  
Michiel Hazewinkel:., 2001, Encyclopedia of Mathematics
[18]   Improved Accuracy of Alignment With Patient-specific Positioning Guides Compared With Manual Instrumentation in TKA [J].
Ng, Vincent Y. ;
DeClaire, Jeffrey H. ;
Berend, Keith R. ;
Gulick, Bethany C. ;
Lombardi, Adolph V., Jr. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2012, 470 (01) :99-107
[19]   The Value of Patient-Matched Instrumentation in Total Knee Arthroplasty [J].
Noble, John W., Jr. ;
Moore, Chris A. ;
Liu, Ning .
JOURNAL OF ARTHROPLASTY, 2012, 27 (01) :153-155
[20]   Are Patient-specific Cutting Blocks Cost-effective for Total Knee Arthroplasty? [J].
Nunley, Ryan M. ;
Ellison, Bradley S. ;
Ruh, Erin L. ;
Williams, Brandon M. ;
Foreman, Keith ;
Ford, Adrienne D. ;
Barrack, Robert L. .
CLINICAL ORTHOPAEDICS AND RELATED RESEARCH, 2012, 470 (03) :889-894