Accuracy of tibial cuts with patient-specific instrumentation is not influenced by the surgeon's level of experience.

Antoniadis, Alexander; Camenzind, Roland S; Schär, Michael; Bergadano, Dario; Helmy, Näder (2019). Accuracy of tibial cuts with patient-specific instrumentation is not influenced by the surgeon's level of experience. Knee surgery, sports traumatology, arthroscopy, 27(5), pp. 1535-1543. Springer-Verlag 10.1007/s00167-018-4992-5

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PURPOSE It was hypothesized that surgeon's experience as well as bone density play a significant role in achieving accurate cuts with patient-specific instrumentation (PSI). The aim of this study was to compare the accuracy of the tibial cuts in different bone densities made by a highly experienced orthopedic surgeon on one hand and a less experienced orthopedic surgeon on the other. METHODS Tibial models from three different sawbone densities were developed for this study. Each surgeon performed 21 cuts. A coordinate measuring machine was used to analyse the cuts. The K-Cohen test was performed to evaluate the results. The analyzed parameters were guide positioning and deviation from the guide cut to the tibial cut, including varus/valgus angle, the tibial slope, cut height, planarity (mm), and rugosity (mm). RESULTS There was a significant difference in the positioning of the tibial cut guide between the two surgeons for the tibial slope (p < 0.05), while no difference was observed for the varus/valgus angle (n.s.) and the cut height (n.s.). No significant difference in the tibial cut was observed between the surgeons for the tibial slope angle (n.s.), varus/valgus angle (n.s.), planarity (n.s.), and rugosity (n.s.). In the different bone types, no significant difference was observed for the tibial slope (n.s.) and varus/valgus angle (n.s.), while planarity and rugosity showed significant differences (p < 0.05). Our study showed no significant difference in the tibial cuts for the tibial slope, varus/valgus angle, planarity, and rugosity between the two surgeons. CONCLUSIONS In the present study, it could be demonstrated that accuracy of the cuts is ensured by PSI not depending on the surgeon's experience and the bone mineral density. This speaks to its clinical significance: PSI might be suited for less experienced surgeons to reduce outliers in total knee arthroplasty (TKA).

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery

UniBE Contributor:

Schär, Michael

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0942-2056

Publisher:

Springer-Verlag

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

12 Aug 2019 12:19

Last Modified:

22 Oct 2019 18:08

Publisher DOI:

10.1007/s00167-018-4992-5

PubMed ID:

29872869

Uncontrolled Keywords:

Patient-specific instrumentation Tibial cut accuracy Total knee arthroplasty

BORIS DOI:

10.7892/boris.132053

URI:

https://boris.unibe.ch/id/eprint/132053

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