Efficiency Assessment of Intelligent Patient-Specific Instrumentation in Total Knee Arthroplasty: A Prospective Randomized Controlled Trial

Comprehensive Summary

This study evaluates the clinical utility of intelligent patient-specific instrumentation (i-PSI) in total knee arthroplasty (TKA). Conducted as a prospective randomized controlled trial, 102 patients with late-stage knee osteoarthritis were assigned to undergo TKA using either i-PSI or conventional instrumentation (CI), with both groups receiving AI-guided preoperative planning. The findings revealed that i-PSI significantly improved the accuracy of distal femoral resections and postoperative coronal alignment, as evidenced by a more neutral hip-knee-ankle (HKA) axis, improved femoral component alignment (FCA), and decreased joint line convergence angle (JLCA) compared to CI. Although i-PSI procedures took longer, blood loss, hemoglobin loss, and complication rates were similar between the groups. The study highlights the potential of i-PSI to enhance surgical precision, particularly in patients with atypical femoral anatomy.

Outcomes and Implications

The integration of AI and 3D printing in i-PSI presents a promising advancement in TKA, addressing limitations of traditional PSI and robotic methods. This approach could improve alignment and outcomes, especially in cases where standard guides are inadequate. Despite the need for further validation of long-term functional results, i-PSI's rapid production process and compatibility with existing surgical protocols suggest it could be widely adopted soon. The study underscores the potential for i-PSI to become a valuable tool in orthopedic surgery, enhancing precision and efficiency while maintaining comparable safety profiles.