Clinical and Radiological Outcomes after Knee Arthroplasty with Patient-Specific versus Off-the-Shelf Knee Implants: A Systematic Review

Abstract

Customised, patient-specific implants (PSI) manufactured based on computed tomography data are intended to improve the clinical outcome by restoring more natural knee kinematics as well as providing a better fit and a more precise positioning. The aim of this systematic review is to investigate the effect of these PSI on the clinical and radiological outcome compared to standard, off-the-shelf (OTS) implants. Thirteen comparative studies including a total of 2127 knee implants were identified. No significant differences in clinical outcome assessed with the range of motion, the Knee Society Score (KSS), and the Forgotten Joint Score (FJS-12) were found between PSI and OTS implants. PSI showed fewer outliers from the neutral limb axis and a better implant fit and positioning. Whether these radiological differences lead to long-term advantages in terms of implant survival cannot be answered based on the current data. Patients receiving PSI could be discharged home earlier at the same or at an even lower total cost. The effective overall superiority of PSI has yet to be proven in long-term studies.