Patient Specific Instrumentation and Total Ankle Arthroplasty
Category: Ankle Arthritis; Ankle Introduction/Purpose: Total Ankle Arthroplasty (TAA) can now be performed using Patient Specific Instrumentation (PSI). Advantages include the ability to pre-operatively plan bone resections and implant position and reduce the number of intra- operative surgical step...
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| Published in: | Foot & ankle orthopaedics Vol. 7; no. 4 |
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| Main Authors: | , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Los Angeles, CA
SAGE Publications
01-11-2022
Sage Publications Ltd SAGE Publishing |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | Category:
Ankle Arthritis; Ankle
Introduction/Purpose:
Total Ankle Arthroplasty (TAA) can now be performed using Patient Specific Instrumentation (PSI). Advantages include the ability to pre-operatively plan bone resections and implant position and reduce the number of intra- operative surgical steps. The aim of this study was to compare PSI with Standard Instrumentation (SI) in a non-randomised retrospective cohort study with respect to patient reported outcomes, tourniquet time, fluoroscopy time and post-operative alignment.
Methods:
159 patients (111 male, 48 female) undergoing a total of 168 INFINITY TAA using PSI (Prophecy, Wright Medical Technology) or SI between 2014 and 2020 were included with a minimum follow up of 12 months. Patient reported outcome measures (PROMS) were obtained pre-operatively and at one year and included the Manchester-Oxford Foot Questionnaire (MOXFQ), Ankle Osteoarthritis Scale (AOS) and EQ-5D Index. Coronal plane deformity correction was assessed using the midline tibiotalar angle (MTTA). Demographics, tourniquet time and intra-operative fluoroscopy times were obtained from the hospital records.
Results:
There were 106 TAA in the SI group and 62 TAA in the PSI group. The was no significant difference in total MOXFQ, AOS or EQ5D. There was however a significant difference (p=.032) in favour of PSI in the walking/standing domain of the MOXFQ at 12 months. There was a significantly reduced tourniquet time (PSI mean: 95.39 mins, SI mean: 116.87 mins, p<.001) and radiation exposure (PSI mean: 31 seconds, SI mean: 53 seconds, p<.001). Angular correction was more accurate in the PSI group (PSI mean: 1.29°, SI mean: 2.26°, p=.005).
Conclusion:
This study supports the use of patient specific instrumentation to decrease operative time, reduce intraoperative fluoroscopy and improve accuracy of implantation in TAA. The walking/standing domain of the MOXFQ has been shown to be the most sensitive to change and in this study demonstrated a further potential benefit. |
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| ISSN: | 2473-0114 2473-0114 |
| DOI: | 10.1177/2473011421S01012 |