Introduction: Total knee arthroplasty is the most prevalent operation with a high success rate in the treatment of primary osteoarthritis. However, patients with complex secondary osteoarthritis remained marginalized to the surgical response or otherwise exposed to high risk conventional surgery. Early decades of life, surgical history, technical complexity, high surgical morbidity, variability of pathology and anatomy and poor clinical outcome are a few of the reasons. The assimilation of modern technology shifted the concept and practice in the field of arthroplasty, opening a window of treatment opportunities for patients with secondary osteoarthritis with patient specific implants (PSI).
Aims: Evaluate safety, efficacy and applicability limitations of PSI as an alternative to conventional total knee arthroplasty in complex clinical settings. Furthermore, the study aimed to conduct assessments of clinical outcome and technical aspects.
Methods: This was a prospective cohort clinical study, based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire pre and post-operative. The study was conducted through a structured analysis of parameters characterizing patients who are candidates for treatment with PSI, highlighting technical points.
Results: A curve of 31point improvement (p=0.021) in the WOMAC score at minimum 12 month follow up was observed. There was demonstration of the specific elements required for balancing lower limb axis deformity and previous metal retaining situations.
Conclusions: PSI technology offers a reduction of surgical complexity, morbidity and complication potential with significant improvement in clinical outcome, in patients with secondary osteoarthritis associated with extra articular deformities, presence of hardware, and in musculoskeletal rare diseases.
Discussion: A first time presentation of focused, isolated and specified characteristics of a patient population with secondary osteoarthritis where PSI establishes a step forward in the treatment and outcome of patients with complex clinical presentation.