Abstract
The true value of use of patient-specific instrumentation (PSI) systems by inexperienced
surgeons during their learning curve to improve the clinical and radiographic outcome
of unicompartmental knee arthroplasty (UKA) has not been previously studied. Fifty
patients with a mean age of 64.3 years undergoing surgery for Oxford UKA were prospectively
divided into two groups. Twenty-five patients were operated on by a surgeon with no
prior experience in UKA using a PSI system and the other 25 patients by an experienced
surgeon using a conventional procedure. Patients were scored using joint range of
motion (ROM), the Knee Society Score (KSS), the Knee Injury and Osteoarthritis Outcome
Score (KOOS), and the 12-item Short-Form (SF-12) before and 3 months and 2 years after
surgery. Impact of use of PSI was measured by comparing clinical and radiographic
outcome, complications, and implant survival. No evidence of poorer clinical outcome
was seen in any subscale of KSS, KOOS, and SF-12 for inexperienced surgeons using
PSI (p = 0.45, p = 0.32, and p = 0.61, respectively). No difference was found between the two procedures in precision
of radiographic alignment of components (p = 0.53). No complication occurred in any group. PSI may improve precision of component
alignment during the learning curve of surgeons, thus achieving functional results
similar to those of more experienced surgeons using a conventional procedure.
Keywords
patient-specific instrument - Oxford Knee - unicompartmental knee arthroplasty - learning
curve
