Abstract
Recently, a new technique of custom-made cutting guides for TKA is introduced to clinical practice. However, no published data yet on the comparison between this new technique against both navigation and conventional techniques.
The author prospectively compared between custom-made cutting guides, navigation and conventional techniques. A total number of 90 cases were included in this study with 30 consecutive cases for each technique. The highest number of medically unfit patients and those with articular and extra articular deformities were in custom guides groups.
The results showed one case of aseptic loosening after one year in custom guides, one case of superficial infection and loose pins but with no fracture in navigation group, and higher need for blood transfusion in conventional. One case in the custom guide group had a periprosthetic fracture 3 weeks postoperatively diagnosed as insufficiency fracture after a relatively minor trauma to an osteoporotic bone. Navigation was the most accurate in alignment but custom guides was the most accurate in implant sizing and had the least bleeding.
This clinical study showed some advantages of custom-made cutting guides over conventional instrumentation. It eliminated medullary guides, reduced operative time, and provided better accuracy. The technique was proved to be useful in complex cases of deformities and unfit patients.
