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- W2271736128 abstract "We wish to congratulate JY Chen et al [1Chen JY, Chin PL, Tay DK, et al. Functional outcome and quality of life after patient-specific instrumentation in total knee arthroplasty. J Arthroplasty. http://dx.doi.org/10.1016/j.arth.2015.04.007.Google Scholar] for their well-done comparative study on “Functional Outcome and Quality of Life After Patient-Specific Instrumentation (PSI) in Total Knee Arthroplasty (TKA).” We, however, differ with the authors about several points:1.Although they had carried out a power analysis, their conclusions were based on a small sample of 30 patients in each group and it may not be valid for larger number of patients. They had excluded majority of patients (249 of 309) from this study because of variety of reasons.2.We agree with the authors that the clinical Knee Society Knee Scores were better in their PSI group, but the functional scores were similar at 2-year follow-up. It is understandable that the concept of PSI is based on providing a better mechanical alignment after TKA, and all the other benefits that this technology may offer are only additional bonus to the patient, surgeon, and hospital [2Hafez M.A. Chelule K.L. Seedhom B.B. et al.Computer-assisted total knee arthroplasty using patient-specific templating.Clin Orthop Relat Res. 2006; 444: 184Crossref PubMed Scopus (137) Google Scholar]. This superior alignment has been proposed to improve implant longevity and survival. It has not been proposed to provide any other immediate or short-term improvements in patients' quality of life or functional outcome, and hence, even this 2-year follow-up does not answer the original basis for introduction of PSI technology.3.We do not agree with their conclusions that “the PSI cannot justify the additional costs and waiting time incurred by the patients.” We use computed tomography–based customized blocks for our TKA (PrePlan; Stryker). These are available to us within 5 working days (vis-à-vis 23 days mentioned by the authors) at an affordable price of <$400 [3Vaishya R. Vijay V. Vaish A. Patient-specific instrumentation does not shorten surgical time: a prospective, randomized trial.J Arthroplasty. 2014; 29: 1508Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar]. This has become possible due to local manufacturing of these blocks. We believe that with increasing use of this technology, in the near future, more companies would provide local manufacturing facilities for their users and thereby reducing its cost and time to manufacture.4.In our experience, the extra cost incurred for computed tomography scan and customized block manufacturing is often offset by various factors such as lesser operating time (reduced operating room usage and anesthesia), lesser pain and blood transfusion requirements, lesser need for analgesics, and so forth [4Vaishya R. Vijay V. Patient-specific instruments in total knee arthroplasty.Int Orthop. 2014; 38: 1123Crossref PubMed Scopus (5) Google Scholar].5.We agree with the authors about the shortcomings of their study, including the use of one specific type of magnetic resonance imaging–based blocks. Their findings and conclusions cannot therefore be applied to other systems. Download .pdf (.36 MB) Help with pdf files Conflict of Interest Statement for Vaishya Download .pdf (.34 MB) Help with pdf files Conflict of Interest Statement for Vijay Download .pdf (.35 MB) Help with pdf files Conflict of Interest Statement for Agarwal Functional Outcome and Quality of Life after Patient-Specific Instrumentation in Total Knee ArthroplastyThe Journal of ArthroplastyVol. 30Issue 10PreviewPatient-specific instrumentation (PSI) surgery may represent the next advancement in total knee arthroplasty (TKA). In 2011, 60 patients were prospectively recruited and divided into two groups based on the patient’s choice: (1) PSI surgery; and (2) conventional TKA. At two years after surgery, the Knee Society Function Score, Oxford Knee Score and SF-36 scores were comparable between the two groups. Although the Knee Society Knee Score (KSKS) was 9 ± 3 points better in the PSI group (P = 0.008), the two years improvement in KSKS was comparable between the two groups. Full-Text PDF Functional Outcome and Quality of Life After Patient-Specific Instrumentation in Total Knee ArthroplastyThe Journal of ArthroplastyVol. 31Issue 4PreviewWe would like to congratulate the authors on recently published article “Functional Outcome and Quality of Life After Patient-Specific Instrumentation in Total Knee Arthroplasty” [1]. They have not found the high costs of patient-specific jigs justifiable in view of its midterm results. However, we have a few questions regarding the study, and it would be kind of the authors to clear our doubts. Full-Text PDF Reply to Letter to the Editor on “Functional Outcome and Quality of Life After Patient-Specific Instrumentation in Total Knee Arthroplasty”The Journal of ArthroplastyVol. 31Issue 4PreviewWe thank Vaishya et al for their interest in our article titled “Functional Outcome and Quality of Life After Patient-Specific Instrumentation in Total Knee Arthroplasty.” Full-Text PDF" @default.
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- W2271736128 title "“Functional Outcome and Quality of Life After Patient-Specific Instrumentation (PSI) in Total Knee Arthroplasty (TKA)”: Our Concerns" @default.
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