Revision of total knee arthroplasty with the use of patient-specific instruments: an alternative surgical technique

Abstract

Introduction: Accuracy in the placement of components in revision total knee arthroplasty (R-TKA) surgery is sometimes challenging. The applicability of patient-specific instruments (PSI) in knee surgery has progressively expanded to types of surgery other than primary arthroplasty. Could this assistive technology be used to facilitate accurate R-TKA surgery? The aim of the current manuscript is to describe this new application of PSI for revision of TKA-to-TKA and to provide a step-by-step technical guideline for use. Areas covered: We will describe the application and a detailed description of PSI technology to TKA revision surgery, step-by-step, from CT images acquisition for preoperative planning and PSI blocks production to the surgery. Expert commentary: The system can facilitate the accomplishment of the bony cuts for optimal implant placement and that can be useful in minimally altering the femoral and the tibial joint line. It is obvious that technology alone will not replace surgical skill and that accuracy of the system will also depend on the quality of the CT images and the ability of the software to prevent metal artifacts. Despite that, our initial results are promising and prove that the concept of applying PSI technology to the R-TKA surgery is feasible.