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Patient-specific positioning guides do not consistently achieve the planned implant position in UKA

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To investigate whether the intended preoperative planning corresponded with the postoperative component position after medial UKA using patient-specific positioning guides (PSPGs).

Methods

Twenty-five consecutive UKAs performed with the PSPG technique (Signature™) were included. Two independent observers performed postoperative CT measurements. The preoperative angles for the femoral component were defined in the frontal plane as 0°. In the first eight cases, a femoral component with single peg was inserted, and the flexion of the femoral component was set to 5°. In the last 17 cases, a twin-peg component was used and flexion set to 10°. In the axial plane, the femoral component was on average set at 2.5° internal rotation. The preoperative tibial component angles in the frontal and axial plane were defined as 0° and in the sagittal plane as 4° in flexion.

Results

The postoperative femoral component angles were on average 0.8° of valgus (SD 3.2, range 12.2° valgus to 5.1° varus, n.s., CI −2.1 to 0.6), 5.0° of flexion (SD 3.9, range 10.2° flexion to 6.0° extension, p = 0.001, CI −5.3 to −1.5) and 4.0° of internal rotation (SD 1.7, range 1.4° to 6.9° int.rot., p < 0.001, CI −4.7 to −3.4). The tibial component angles were on average 3.0° of varus (SD 1.9, range 1.3° valgus to 6.8° varus, p < 0.001, CI 2.2 to 3.8), 3.2° of flexion (SD 2.4°, 6.7° flex to 1.8° ext, n.s., CI −0.2 to 1.7) and 2.7° of internal rotation (SD 7.0, range 16.6° int.rot. to 10.7° ext.rot., n.s., CI −5.6 to 0.2).

Conclusion

This study showed no agreement between preoperative planning and postoperative component alignment (p < 0.05) for the femoral component angle in sagittal and axial plane and for the tibial component angle in the coronal plane. Although the results did not show significant difference for the tibial component angle in the axial plane, a considerable range of the component angles was found varying from 17° internal to 11° external rotation. This study suggests that the use of PSPGs for UKA does not lead to consistent component position.

Level of evidence

IV.

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Fig. 1
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Acknowledgments

We would like to thank Mona Risdal and Silje Klausen, radiographers at the Center of Implant and Radiostereometric Research, Oslo for performing the postoperative CT measurements, Anette Simonsen, nurse at Betanien Hospital, for her contribution in collecting data and Ingri Ekrol, consultant orthopaedic surgeon at Betanien Hospital, for critical reading and linguistic support.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Betanien Hospital, Skien, Norway

    Justin A. M. J. van Leeuwen

  2. Department of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway

    Stephan M. Röhrl

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  1. Justin A. M. J. van Leeuwen
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Corresponding author

Correspondence to Justin A. M. J. van Leeuwen.

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Conflict of interest statement

No financial funding or other support from companies has been received for this study. One author worked as a consultant for Biomet (participated in evaluation of the first Signatures for Biomet).

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van Leeuwen, J.A.M.J., Röhrl, S.M. Patient-specific positioning guides do not consistently achieve the planned implant position in UKA. Knee Surg Sports Traumatol Arthrosc 25, 752–758 (2017). https://doi.org/10.1007/s00167-016-4268-x

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  • DOI: https://doi.org/10.1007/s00167-016-4268-x

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