Journal article
Critical appraisal of United Kingdom clinical practice guidelines in kidney transplantation using the Appraisal of Guidelines for Research and Education (AGREE) II tool: A systematic review
- Abstract:
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Purpose
Patient specific instrumentation (PSI) has been proposed as a means of improving surgical accuracy and ease of implantation during technically challenging procedures such as unicompartmental knee arthroplasty (UKA). The purpose of this prospective randomised controlled trial (RCT) was to compare the accuracy of implantation and functional outcome of mobile bearing medial UKA s implanted with and without PSI by experienced UKA surgeons.
Methods
Mobile-bearing medial UKA s implanted were implanted in 43 patients using either PSI guides or conventional instrumentation. Intra-operative measurements, meniscal bearing size implanted, and post-operative radiographic analyses were performed to assess component positioning. Functional outcome was determined using the Oxford Knee Score (OKS).
Results
PSI guides could not be used in 3 cases due to concerns regarding accuracy and registration onto native anatomy, particularly on the tibial side. In general, similar component alignment and positioning was achieved using the two systems (n.s. for coronal/sagittal alignment and tibial coverage). The PSI group had greater tibial slope (p=0.029). The control group had a higher number of optimum size meniscal bearing inserted (95% versus 52%; p=0.001). There were no differences in OKS improvements (n.s).
Conclusions
Component positioning for the two groups was similar for the femur but less accurate on the tibial side using PSI, often with some unnecessarily deep resections of the tibial plateau. Although PSI was comparable to conventional instrumentation based on OKS improvements at 12-months, we continue to use conventional instrumentation for UKA at our institution until further improvements to the PSI guides can be demonstrated.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 198.5KB, Terms of use)
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- Publisher copy:
- 10.1002/bjs5.17
Authors
- Publisher:
- Wiley
- Journal:
- BJS Open More from this journal
- Publication date:
- 2017-09-01
- Acceptance date:
- 2017-08-03
- DOI:
- EISSN:
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2474-9842
- Keywords:
- Pubs id:
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pubs:720072
- UUID:
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uuid:793b1c9e-fd7d-4f78-941c-8701947b098b
- Local pid:
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pubs:720072
- Source identifiers:
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720072
- Deposit date:
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2017-08-17
- ARK identifier:
Terms of use
- Copyright holder:
- Knight et al
- Copyright date:
- 2017
- Notes:
- © 2017 The Authors. BJS Open published by John Wiley and Sons Ltd on behalf of BJS Society Ltd BJS Open This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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