Bert Boonen- Patient-matched positioning guides in total knee arthroplasty

Several techniques for alignment of a total knee arthroplasty (TKA) exist. Patient-matched positioning guides (PMPG) are a new technique for outlining a TKA. Pre-operative MRI-scans or CT-scans and specific software are used to create virtual models of the patient’s femur and tibia. Ideal implant position and size can be calculated using anatomical landmarks that are readily defined on these scans. A rapid prototyping technique is then used to fabricate jigs that have only one fitting position on the patients anatomy during surgery. They dictate the orientation and level of the bony resections in preparation of prosthesis placement.

In this thesis we compared PMPG to conventional (intramedullary) instruments for outlining a TKA and concluded that they performed equally well with respect to obtaining a correct alignment, clinical outcomes, length of hospital stay and safety. A small reduction in blood loss and operation time was observed. Based on our observations, there is nothing against continued use of PMPG for performing a TKA. Import remaining issue is that of the cost-benefit of PMPG, compared to conventional instruments. This was not studied in detail in this thesis. We briefly investigated the potential of PMPG to adequately predict implant size preoperatively and found reasonable accuracy in this respect.