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Hospital-based Patient-specific Templates for Total Knee Arthroplasty

A Proof of Concept Clinical Study

Hafez, Mahmoud A., MD, FRCSEd; Hamza, Hosamuddin, MFDS FRCSEd; Nabeel, Ahmed, MSc Ortho & Tr

doi: 10.1097/BTO.0000000000000253
Special Technical Articles

Introduction: All available patient-specific instruments or patient-specific templates (PSTs) are controlled by implant companies. Most of these companies outsource some of the steps of the PST such as imaging, preoperative planning, manufacturing of PST, and packing/sterilization. This is a proof of concept clinical study on the hospital-based PST system for total knee arthroplasty (TKA).

Methods: A total number of 257 TKA procedures were performed on the basis of a new concept of hospital-based PSTs. All 5 steps of the PST [ie, imaging (computed tomographic scanning), planning, PST production, packing/sterilization, and surgery] were performed by the hospital. All cases included in this work are documented in the Egyptian Community Arthroplasty Register.

Results: All cases had their surgeries performed without resorting to conventional intramedullary guides. Computed tomography–based imaging was easy and affordable. Planning was controlled by the surgeon. Polyamide nylon was the best available material and it was autoclavable. Desktop 3-dimensional printers were able to produce PSTs made of nylon, but it was difficult and time consuming. Industrial printers were superior in quality to desktop printers but more expensive. The whole process could be performed in as short a duration as 3 working days.

Conclusions: Hospital-based PST was feasible and it was facilitated by the introduction of desktop 3-dimensional printers. This technique was less expensive and more time saving than commercially available PSTs as well as the conventional TKA.

Orthopaedic Department, October 6 University, Cairo, Egypt

The authors declare that they have nothing to disclose.

For reprint requests, or additional information and guidance on the techniques described in the article, please contact Mahmoud A. Hafez, MD, FRCS Ed, at or by mail at The Orthopaedic Department, October 6 University, Central Axis, October 6 City, Giza, Cairo 11412, Egypt. You may inquire whether the author(s) will agree to phone conferences and/or visits regarding these techniques.

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