Effects of patient-specific positioning guides (PSPGs) vs. conventional instrumentation on patient-reported outcome in total knee arthroplasty: secondary analysis of a randomized controlled trial after 5 years


  • Sean C S Rivrud Faculty of Medicine, University of Groningen, Groningen, The Netherlands
  • Stephan M Röhrl Department of Orthopedics, Oslo University Hospital, Oslo, Norway https://orcid.org/0000-0001-5784-2055
  • Justin A M J van Leeuwen Department of Orthopedic Surgery, Telemark Hospital, Notodden, Norway and Department of Orthopaedic Surgery, Lærdal Hospital – Helse Førde, Lærdal, Norway https://orcid.org/0000-0003-1846-6768




Arthroplasty, conventional instrumentation, Implants, Knee, Osteoarthrosis


Background and purpose: The use of patient-specific positioning guides (PSPGs) in total knee arthroplasty (TKA) has been advocated as a means of improving patient outcomes, but the reception of PSPGs has been mixed. The aim of our study was to compare patient-reported outcomes (KOOS, NRS-11, EQ-5D-3L, EQ-VAS) after TKA using PSPG with conventional instrumentation (CI) to determine whether there is a discernible clinical benefit to using PSPGs.
Patients and methods: This multicenter randomized controlled trial (RCT) followed 77 patients who were randomly assigned to 1 of 2 cohorts between September 2011 and January 2014—one receiving TKA with PSPGs (from Materialise NV) and one receiving TKA with CI—with each cohort followed up until 5 years after the operation. The Vanguard Cruciate Retaining Total Knee System and Refobacin Bone Cement R were used in all operations. KOOS was evaluated using confidence intervals, with differences of less than 10 KOOS units between the cohorts interpreted as indicating the absence of a clinically meaningful difference.
Results: No significant differences were found in any of the measured clinical outcomes—KOOS, NRS-11, EQ-5D-3L, EQ-VAS, range of motion, or radiolucent lines scoring—between the cohort operated on using PSPG and the cohort operated on using CI after 5 years of follow-up.
Conclusion: There was no statistically significant effect of PSPGs on patient-reported outcomes or range of motion in TKA.


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How to Cite

Rivrud, S. C. S., Röhrl, S. M., & van Leeuwen, J. A. M. J. (2023). Effects of patient-specific positioning guides (PSPGs) vs. conventional instrumentation on patient-reported outcome in total knee arthroplasty: secondary analysis of a randomized controlled trial after 5 years. Acta Orthopaedica, 94, 354–359. https://doi.org/10.2340/17453674.2023.15335





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