We present a new technique for TKA implantation which utilizes patient-specific femoral and tibial positioning guides developed from MRI to offer an individualized approach to total knee replacement. This is a prospective non controlled study which aims to analyse the precision of this technique, its advantages and inconvenients in comparison with the conventional instrumented technique. The MRI provides a consistent three-dimensional data set of the patient's anatomy which allows for 3D axis identification. The ideal position and sizing is performed by the surgeon on this 3D model and the patient specific guides are manufactured in advance in order to reproduce the bone cuts corresponding to this positioning and implant size. There are no intramedullary nor extramedullary instruments during the surgery. We compared 20 patients operated with this technique with 20 patients operated with the conventional technique. The hypothesis was a difference < 2° between the 2 techniques The measured parameters were: HKS, HKA, tibial slope, femoral rotation on CT Duration, bleeding, pain on VAS and morphine consumption, active flexion, KSS, Oxford score, recovery of independant walking and delay of return to home. Both groups were identical for gender, age, BMI, etiology, comorbidities, pain and rehabilitation protocols.Material
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