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Master Thesis

Perfection and evaluation of patient specific guides for total knee arthroplasty : a cadaveric study : review of literature since 2006 = Mise au point et évaluation des guides de coupe patient spécifique pour la mise en place des prothèses de genou : étude cadavérique : revue de la littérature depuis 2006

Abstract : Coronal alignment in total knee arthroplasty (TKA), seems to be a major factor in the survivorship of the components and in the functional outcome. The Patient Specific Guides (PSG), based on 3 D imaging, had been introduced in surgical process in order to improve accuracy in TKA, and to reach post operative neutral mechanical alignment. Compared with standard instrumentation (SI), PSG can improve the coronal alignment of the TKA and decrease the operative time. Thirty-three lower limbs have been taken from seventeen cadavers. A pre operative CT scan of each lower limb has been realized in order to measure: HKA angle, MFA and MTA, and to plan the TKA for shaping the PSG. 17 TKAs have been implanted with PSG, 16 with SI. Post operatively, a further CT scan has been used to make the measures to compare the two groups. Per operatively, operative time and positioning of PSG have been reported. Pre operatively, 66,7% (22/33) of the lower limbs were in varus, 27,3% (9/33) were in valgus and 6% (2/33) were in neutral alignment, there was no significant difference between the groups. Post operatively, the overall mechanical alignment was between 177° and 183° for 81,25% (13/16) in SI group, and 76,47% (13/17) in PSG group. The mean HKA in SI was 179,1° (±2,45), and 178° (±2,18) in PSG group, there was no significant difference between the group (p-Value: 0,17). Only the operative time was significantly lower in PSG group with a median of 43 minutes [35-47] for 50 minutes [43-62,5] in SI group. In our study, PSG did not demonstrate a superiority regarding the coronal mechanical alignment comparing with SI in TKA. But the use of PSG process can reduce the operative time.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-00865644
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Submitted on : Wednesday, September 25, 2013 - 1:31:56 PM
Last modification on : Wednesday, July 15, 2020 - 8:58:04 AM
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  • HAL Id : dumas-00865644, version 1

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Séverine Dao Lena. Perfection and evaluation of patient specific guides for total knee arthroplasty : a cadaveric study : review of literature since 2006 = Mise au point et évaluation des guides de coupe patient spécifique pour la mise en place des prothèses de genou : étude cadavérique : revue de la littérature depuis 2006. Médecine humaine et pathologie. 2013. ⟨dumas-00865644⟩

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