No difference in mid-term survival and clinical outcome between patient-specific and conventional instrumented total knee arthroplasty: a randomized controlled trial

M.G.M. Schotanus*, B. Boonen, W. van der Weegen, H. Hoekstra, R. van Drumpt, R. Borghans, R. Vos, L. van Rhijn, N.P. Kort

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Web of Science)


PurposeThe purpose of this multicentre prospective randomized controlled trial was to compare the survival rate and clinical outcome in total knee arthroplasty (TKA) after MRI-based patient-specific instruments (PSI) and conventional instruments 5 years after initial surgery.MethodsAt a mean follow-up of 5.1 years (0.4), 163 patients (90.6%) with a mean age of 71.8 years (8.7) were analysed. A survival analysis with revision of the TKA as endpoint was performed. The Knee Society Score (KSS), evaluations on plain radiographs and patient-reported outcome measures (PROMs) were obtained preoperatively and at each FU.ResultsAt final follow-up, one TKA in the PSI- (1.2%) and 3 TKAs in the conventional group (3.8%) had undergone revision surgery (n.s.). No radiological abnormalities were noted at any time point. Postoperatively, the KSS and PROMs significantly improved within each group compared with the preoperative values. There were no clinically relevant differences for the KSS [PSI: 77.4, 9.8 (95% CI 75.0-79.7) vs. conventional: 77.3 10.5 (95% CI 74.9-79.8)] and the PROMs between both groups (n.s.) at 5 years follow-up.ConclusionThere is still a lack of reliable data on the survival of TKA and clinical evidence, when using PSI for TKA. Longer follow-up studies are, therefore, needed.Level of evidenceI.
Original languageEnglish
Pages (from-to)1463-1468
Number of pages6
JournalKnee Surgery Sports Traumatology Arthroscopy
Issue number5
Publication statusPublished - 1 May 2019


  • alignment
  • conventional instruments
  • euroqol
  • hip
  • mid-term
  • multicenter
  • patient-specific instruments
  • positioning guides
  • proms
  • psi
  • randomized controlled trial
  • rct
  • surgery
  • survival
  • tka
  • total knee arthroplasty
  • RCT
  • Conventional instruments
  • Mid-term
  • Total knee arthroplasty
  • PSI
  • TKA
  • Survival
  • Randomized controlled trial
  • HIP
  • Patient-specific instruments

Cite this