- 作者：Zahra Jaffry ; Milad Masjedi ; m.masjedi@imperial.ac.uk" class="auth_mail ; Susannah Clarke ; Simon Harris ; Monil Karia ; Barry Andrews ; Justin Cobb
- 关键词：Osteoarthritis ; Unicompartmental knee replacement ; Surgical technique ; Surgical accuracy ; Three dimensional analysis
- 刊名：The Knee
- 出版年：March, 2014
- 年：2014
- 卷：21
- 期：2
- 页码：428-434
- 全文大小：961 K
Background
The technical reliability demonstrated by semi active robots in implant placement could render unicompartmental knee arthroplasties (UKAs) more favourable than they are currently. The relatively untested method using patient specific instrumentation (PSI), however, has the potential to match the accuracy produced by robots but without the barriers that have prevented them from being used more widely in clinical practice, namely operative time. Therefore this study took a step towards comparing the accuracy and time taken between the two technologies.Methods
Thirty-six UKAs were carried out on identical knee models, 12 with the Sculptor, 12 with PSI and 12 conventionally under timed conditions. Implant placement in these knees was then judged against that in a pre-operative plan.
Results
Tibial implant orientations and femoral implant positions and orientations were significantly more accurate in the PSI group with mean errors of 6掳, 2 mm and 4掳 respectively, than the conventional group which had means of 9掳, 4 mm and 10掳. There was no significant difference between the robot and PSI generally except in tibial implant orientation (mean robotic error 3掳) and tibial implant position did not vary significantly across all three groups. It was also found that use of PSI and conventional methods took half the time taken by the robot (p < 0.001).
Conclusions
With further development, PSI can match and possibly surpass the accuracy of the robot, as it does with the conventional method, and achieve planned surgery in less time.
Clinical relevance
This work sets the foundation for clinical trials involving PSI.