Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc.. Patient-specific instruments for total knee arthroplasty: a review of reviews. Lansdale: HAYES, Inc.. Directory Publication. 2016 Authors' objectives Patient-specific instruments (PSI) for total knee arthroplasty (TKA) are custom-made bone-cutting guides for use during TKA surgical implantation that are manufactured for each patient based on analysis of presurgical magnetic resonance imaging or computed tomography.
Controversy:
Although many factors may contribute to poor TKA outcomes, malalignment of the implant in particular has been associated with poor clinical outcomes, early implant loosening, premature implant wear, and arthroplasty failure. PSI are intended to improve alignment compared with conventional instruments (CI). While the proposed benefits of PSI are appealing, the superiority of PSI compared with CI has not been established, and PSI cost more than CI. There are also questions related to whether alignment outcomes are an appropriate surrogate for revision/reoperation rates, which are patient-important outcomes.
Relevant Questions: Do PSI lower surgical revision rates? Do PSI lead to lower proportion of postoperative knee alignment outliers? Do PSI lead to reduction in surgical time or length of hospital stay? Is there greater
improvement in function with use of PSI? What are the harms or complications, including intraoperative abandonment of use of PSI? Have definitive patient selection criteria been established for the use of PSI? Indexing Status Subject indexing assigned by CRD MeSH Arthroplasty, Replacement, Knee; Humans; Knee Prosthesis Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: hayesinfo@hayesinc.com AccessionNumber 32017000030 Date abstract record published 04/01/2017 |