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Beitragstitel Clinical and Patient-Reported Short-Term Results after Customized Individually Made Total Knee Arthroplasty
Beitragscode P068
Autoren
  1. Raphael Kaelin Praxis LEONARDO, Hirslanden Klinik Birshof Vortragender
  2. Nicole Vogel Praxis LEONARDO, Hirslanden Klinik Birshof
  3. Markus P. Arnold Praxis MEIN KNIE, Hirslanden Klinik Birshof
Präsentationsform Poster
Themengebiete
  • A05 - Knie
Abstract Introduction
The purpose of this study was to assess the clinical and patient-reported outcome measures of a customized individually made total knee arthroplasty (CIM TKA).

Methods
Since January 2017, we prospectively collected clinical and patient-reported outcome measures from patients scheduled for CIM TKA (iTotal, ConforMIS, Inc., Bedford, MA). All surgeries were done by the senior author. We collected data before the surgery, 4 months and 12 months postoperatively. Outcome measures included the functional Knee Society Score (fKSS), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Forgotten Joint Score (FJS), the EQ-5D-3L and patient satisfaction. We analyzed data with paired t-tests.
Consistent with the indications for TKA, we exclude patients with compromised collateral ligaments or having a varus/valgus deformity > 15°.

Results
We analyzed data for 24 prostheses (21 patients, 12 male) with a mean patient age of 66.5 years (standard deviation [SD] 9.4, range 48 to 82 years). Anatomic alignment before the surgery was neutral (n = 4), varus (n = 12) and valgus (n = 8), mean range of motion (ROM) was 108° flexion (SD 15.3, range 70 to 130°).
Complete follow-up data will be available in June 2019. Preliminary results of the first 14 prostheses (11 patients) showed 12 months after the surgery neutral alignment for all patients and a mean ROM of 130° flexion (p < 0.001). All scores improved significantly: fKSS from 46 to 99 points (p < 0.001), KOOS symptoms from 50 to 83 points (p=0.001), KOOS pain from 49 to 88 points (p < 0.001), KOOS daily living from 58 to 87 points (p < 0.001), KOOS sport from 18 to 73 points (p < 0.001), KOOS quality of life from 25 to 77 points (p < 0.001), FJS from 16 to 69 points (p < 0.001) and EQ-5D-3L from 0.579 to 0.877 (p < 0.001).
Ten patients (91 %) were very satisfied or satisfied with the result of the surgery. One patient with a bilateral surgery was neutral and unsatisfied, respectively. There were no complications, besides one patient who required an arthrolysis following an arthrofibrosis due to a meanwhile healed complex regional pain syndrome.

Conclusion
The 12 months follow-up data collected on CIM TKA showed very good clinical and patient-reported results including a high patient satisfaction. Those results are at least as good as those reported from off-the-shelf implants. Future studies have to confirm those in long-term.