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Long term results of PSI compared to conventional arthroplasty

Description

Purpose: Patient specific instrumentation is a commonly used technique designed to improve alignment in total knee arthroplasty and was therefore believed to lead to better clinical outcome and revision rates compared to conventional arthroplasty. To date, long term result comparing these two techniques are not available. 

Methods: This study is a continuation of a previous double-blind multicenter randomized controlled trial with now presenting the results at 10-years follow-up.  Clinical outcome was assessed using Patient Reported Outcome Measures and the analysis was performed with a general linear model for repeated measurements. Descriptive data were used to compare revision rates. X-rays were obtained and examined by two individual reviewers for any signs of loosening of the components. 
Results: At a mean follow up of XX years, 129 patients (loss to follow-up 23%) were analyzed in this trial. No significant difference between the two groups were found for any of the PROMs and revision rates were comparable. 
Conclusion: PSI may lead to equal or better alignment of the prosthesis compared to CA but does not lead to better clinical outcome or survival of the prosthesis. Therefore, also taking into account the extra costs, PSI cannot be considered a good replacement for CA. 

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Author

D T

Dieuwertje Theeuwen

Resident

Zuyderland Medical Centre

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