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Adjudication Committee
- Førsteopponent: Dr. Andrea Baldini, Instituto de Física de Cantabria
- Andreopponent: Overlege Mona Badawy, Haukeland universitetssykehus
- Chair of the Committee: Professor Tillmann Uhlig, University of Oslo
Principal supervisors
Consultant Stephan Maximillian Röhrl
Summary
Evaluation of Patient-Specific Positioning Guides in Knee Arthroplasty
Alignment in knee arthroplasty is an important factor for implant survival and clinical outcome. The use of patient-specific positioning guides (PSPGs) is a new surgical method with potential advantages with respect to achieving a more consistent alignment and better clinical outcome compared to other current operational techniques.
PSPGs are based on an MRI reconstruction of the affected knee. With the help of a software tool, a 3D virtual surgery is performed with respect to the alignment and the sizes of the implant components. Patient-specific guides are then obtained using a 3D printer. Intraoperatively, these guides match the patients’ unique anatomy and guide the placement of the implant components.
The aims of this thesis were to investigate whether the preoperative 3D planning and the use of PSPGs corresponded to the postoperative component alignment in total knee replacement (TKR) and medial unicompartmental knee arthroplasty (mUKA). Moreover, the outcome of TKR with the PSPG technique was compared to the gold standard (i.e. the conventional operation method).
The use of PSPGs in TKR and mUKA did not consistently reproduce the preoperatively planned alignment, and no advantages for TKR using PSPGs were found with respect to alignment, clinical outcome, duration of operation, and length of hospital stay when compared to the conventional operation method.
PSPGs require a preoperative MRI or CT, which entail additional diagnostic resources and costs, plus the cost of the PSPG itself. Since we did not find any proven benefit of using PSPGs, we continue to consider the conventional TKR operation technique the gold standard.
Additional information
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