“Are Patient Specific Cutting Guides Better Alternative to Conventional Instrumentation in Primary Total Knee Arthroplasty? “-Prospective Randomized Comparative Study”
Om Baghele, Nishant D Goyal*, Navroze Kapil, Nikhil Verma, Anuj Jain and Simon Thomas
Background: Patient specificicuttingiguides (PSCGs)iisirelativelyinewitechnology utilized in TKA having benefits of accurate image-guided preoperative, fewer-operative steps, less soft tissue trauma, lesser component mal-alignment, and operating time. Toidate, studies in the literature oniPSCGs have been limited and without comparative control groups. At the same time the effectiveness of PSCGs is also unclear.
Material and Method: This prospective randomized comparative study was icarried out on 70 randomly selected patients divided into two groups of 35 patients each at a tertiary care centre.iPatients with varus, intra-articular deformity were included in the study. Demographics, radiological parameters, iimplantation time,itourniquet time, post op VAS score and complications were studied in both the groups.
Observation and Results: Both the groups were statistically similar and comparable and there was no selection bias with regard to age, side, bilaterally, gender, BMI and comorbidity. The differences between mean pre-operative Femoral Mechanical Anatomical angle, Postop Lower limb alignment, VAS score, mean fall of haemoglobin were statistically insignificant whereas the difference between implantation time, tourniquet time were statistically significant.
Conclusion: PSCGs can achieve more close to neutral lower limb alignment with less number of outliers in primary TKA. It does not give any added advantage with regard to component placement. PSCGs can help to reduce the postoperative blood loss, implantation time and operative time thus can be abeneficial alternative in patients with high risk of anaesthesia.