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Comparison of Customized Cutting Block and Conventional Cutting Instrument in Total Knee Arthroplasty: A Randomized Controlled Trial.
Tammachote, Nattapol; Panichkul, Phonthakorn; Kanitnate, Supakit.
Afiliación
  • Tammachote N; Department of Orthopaedics, Thammasat University, Khlong Luang, Pathum Thani, Thailand.
  • Panichkul P; Department of Orthopaedics, Thammasat University, Khlong Luang, Pathum Thani, Thailand.
  • Kanitnate S; Department of Orthopaedics, Thammasat University, Khlong Luang, Pathum Thani, Thailand.
J Arthroplasty ; 33(3): 746-751.e3, 2018 03.
Article en En | MEDLINE | ID: mdl-29108794
BACKGROUND: Customized cutting block (CCB) was designed to ensure the accurate alignment of knee prostheses during total knee arthroplasty. Given the paucity of CCB efficacy data, we compare CCB with conventional cutting guide using a randomized controlled trial. METHODS: One hundred eight osteoarthritic knee patients underwent total knee arthroplasty by one experienced surgeon were randomized to receive CCB (n = 54) or conventional cutting instrument (CCI) surgery (n = 54). The primary outcomes were limb alignment, prostheses position, and operative time. The secondary outcomes were hemodynamic alteration after surgery, functional outcomes (modified Western Ontario and McMaster University Osteoarthritis Index) and range of motion at 2 years after surgery. RESULTS: Mean hip-knee-ankle angle in the CCB group was 179.4° ± 1.8° vs 179.1° ± 2.4° in the CCI group, Δ = 0 (95% confidence interval [CI] -0.6 to 1.1, P = .55). Mean operative time was faster in the CCB arm: 93 ± 12 vs 104 ± 12 minutes, Δ = 11 (95% CI -16.7 to -7.2, P < .0001). There were no differences in hemodynamic parameters, mean blood loss (446 [CCB] vs 514 mL [CCI], Δ = -68 [95% CI -138 to 31 mL, P = .21]), postoperative hemoglobin changes, incidence of hypotension (systolic <90 mm Hg), oliguria, and rates of blood transfusion. Functional outcomes and range of motion were also similar. CONCLUSION: There was no improvement in alignment, hemodynamic changes, blood loss, and knee functional outcomes. CCB reduced surgical time by 11 minutes in our population. CCB cost-effectiveness should be further investigated.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Articulación de la Rodilla / Prótesis de la Rodilla Tipo de estudio: Clinical_trials / Observational_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Artroplastia de Reemplazo de Rodilla / Articulación de la Rodilla / Prótesis de la Rodilla Tipo de estudio: Clinical_trials / Observational_studies Límite: Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Arthroplasty Asunto de la revista: ORTOPEDIA Año: 2018 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Estados Unidos