Knee Surg Relat Res 2019 Mar; 31(1): 19-24
The Accuracy of Alignment Determined by Patient-Specific Instrumentation System in Total Knee Arthroplasty
Kwangkyoun Kim, MD1, Jungsung Kim, PhD2, Dokyoung Lee, MD1, Sohui Lim2, and Jiyoon Eom2
Departments of 1Orthopedic Surgery and 2Medical Engineering, Konyang University College of Medicine, Daejeon, Korea
Correspondence to: Kwangkyoun Kim, MD Department of Orthopaedic Surgery, Konyang University College of Medicine, 158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: +82-42-600-9862, Fax: +82-42-545-2373 E-mail:
Received: June 8, 2018; Revised: September 7, 2018; Accepted: September 27, 2018; Published online: March 1, 2019.
© Korean Knee Society. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Purpose: The aim of this study is to assess the accuracy of alignment determined by patient-specific instrumentation system in total knee arthroplasty(TKA).
Materials and Methods: Twenty-seven TKAs using patient-specific instrument were reviewed. The intraoperative pin location determined by the patient-specific guide was recorded using imageless navigation software. Data recorded included tibial coronal alignment and posterior slope, femoral coronal alignment and sagittal alignment, and transepicondylar axis. A discrepancy within ±3° in each plane was considered an acceptable result.
Results: On the tibia, an acceptable alignment was obtained in 24 (88.1%) in the coronal plane and 21 (77.8%) in the sagittal plane. On the femur, a satisfactory alignment was obtained in 25 (92.6%) in the coronal plane and 24 (88.1%) in the sagittal plane. Based on the transepicondylar axis, a satisfactory alignment was obtained in 23 (85.1%).
Conclusions: Satisfactory alignment was obtained in more than 85% of each plane of the femur and in the coronal plane of the tibia and relative to the transepicondylar axis. Sufficeint experience and precise preoperative planning are required to improve the accuracy of sagittal alignment of the tibia.
Keywords: Knee, Arthroplasty, Computer assisted, Patient specific instrument


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