Abstract
Aim
To assess the process of using patient matched cutting blocks in Primary TKA with respect to: radiology, the proposed engineering plans, the process in theatre and cost effectiveness. Background: Patient matched cutting blocks (PMCB) are the subject of much interest in primary TKA. Our unit has experience of over 100 cases with a single system.
Method
We have analysed our initial experience with PMCB. We have compared the sizes of implants used in theatres versus the sizes predicted on the image-generated plans. We have assessed the potential time saving in theatre, during each case and in the turn-around time between cases. We have also looked at the number of trays of instruments used in PMCB versus non-PMCB cases.
Results
In 5 cases repeat imaging was required, in 3 cases patient movement artefact meant that scans were of insufficient quality and in 2 cases with complex deformity, additional imaging was required to better define the deformity. The tibial size was change intra-operatively in comparison with the plan in 6 cases and on the femoral side, in 2 cases. In each case the change in size could have been predicted by more detailed analysis of the plan pre-operatively. Using PMCB did reduce procedure time but only by approximately 10 minutes. The effect on turn-around time was greater with approximately 20 minutes saved. This was mainly as a result of the standard 7 trays of instruments being reduced to 2 trays. The greatest saving was in the reduction of sterilisation cost which more that covered the cost of the radiology and the cutting block.
Conclusion
PMCB technology does allow accurate prediction of implant sizes, but careful checking of the pre-operative plan allows improved accuracy. Theatre efficiency can be improved to potentially allow an extra case per day and the technology does pay for itself in increased efficiency and reduced sterilisation costs.
MULTIPLE DISCLOSURES
