{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T22:46:25Z","timestamp":1779317185860,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T00:00:00Z","timestamp":1594857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Efforts in total knee arthroplasty are made to improve accuracy for a correct leg axis and reduce component malpositioning using patient\u2010specific instruments. It was hypothesized that use of patient\u2010specific instruments (vs. computer\u2010navigated and conventional techniques) will reduce the number of outliers. Our second hypothesis was that single\u2010use instrumentation will lead to the same accuracy compared to patient\u2010specific instruments made of metal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>708 primary total knee arthroplasties between 2014 and 2018 using computer tomography (CT)\u2010based patient\u2010specific cutting block technique and a preoperative planning protocol were retrospectively reviewed. Preoperative data [hip\u2013knee\u2013angle (HKA), lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), tibial slope, femoral component flexion] was compared to postoperative performed standard radiological follow\u2010up X\u2010rays. Differences of &gt;\u20093\u00b0 between measurements were defined as outliers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall 500 prostheses using standard instrumentation and 208 prostheses using single\u2010use instruments were implanted. Preoperative HKA axes (\u2212\u20091.2\u00b0; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), femoral component flexion (\u0394 0.8\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), LDFA (\u0394 \u2212\u20091.5\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), MPTA (\u0394 \u2212\u20090.5\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and tibial posterior slopes (\u0394 0.5\u00b0, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), respectively, were different from postoperative axes. More outliers occurred using standard (vs. single\u2010use) instruments (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) regarding postoperative HKA (ranges of standard\u2010 vs. single\u2010use: instruments: HKA 178.0\u00b0\u2013180.5\u00b0 vs. 178.0\u00b0\u2013180.5\u00b0, femoral component flexion 0.0\u00b0\u20136.0\u00b0 vs. 0.0\u00b0\u20134.5\u00b0, LDFA 90.0\u00b0\u201391.0\u00b0 vs. 90.0\u00b0\u201390.0\u00b0, MPTA 90.0\u00b0\u201390.0\u00b0 vs. 90.0\u00b0\u201390.0\u00b0, tibial posterior slope \u2212\u200910\u00b0 to 10\u00b0 vs. \u2212\u20091\u00b0 to 10\u00b0). No differences were seen for other angles measured. Comparing both systems, total number of outliers was higher using standard (8%) vs. single\u2010use instruments (4.3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study shows a high accuracy of CT\u2010based patient\u2010specific instrumentation concerning postoperative achieved knee angles and mechanical leg axes. Single\u2010use instruments showed a similar accuracy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06150-x","type":"journal-article","created":{"date-parts":[[2020,7,16]],"date-time":"2020-07-16T02:29:16Z","timestamp":1594866556000},"page":"447-455","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["CT\u2010based patient\u2010specific instrumentation for total knee arthroplasty in over 700 cases: single\u2010use instruments are as accurate as standard instruments"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8882-4623","authenticated-orcid":false,"given":"Stefan","family":"Gaukel","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology Cantonal Hospital Winterthur Brauerstrasse 15 8409 Winterthur Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael N.","family":"Vuille\u2010dit\u2010Bille","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Pediatric Surgery University Children\u2019s Hospital of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel","family":"Schl\u00e4ppi","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology Cantonal Hospital Winterthur Brauerstrasse 15 8409 Winterthur Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter P.","family":"Koch","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedics and Traumatology Cantonal Hospital Winterthur Brauerstrasse 15 8409 Winterthur Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,7,16]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000148578.22729.0e"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.93B9.26573"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010200706000\u201000020"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010200111000\u201000015"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.73B5.1894655"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104744\u2010y"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010017\u20104823\u20100"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010198807000\u201000022"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199402000\u201000021"},{"issue":"1","key":"e_1_2_9_11_2","first-page":"16","article-title":"Computer\u2010assisted surgery in total knee replacement: advantages, surgical procedure and review of the literature","volume":"90","author":"Confalonieri N","year":"2019","journal-title":"Acta Biomed"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2007.08.001"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102407\u20103"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968\u20100160(13)70005\u2010X"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.95B3.29903"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103345\u20102"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/1602400211"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447\u201020150402\u201059"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102625\u20106"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010011\u20101996\u20106"},{"key":"e_1_2_9_21_2","unstructured":"DurandetA RicciP.\u2010L SavehAH VanatQ WangB EsatI ChizariM(2013)Radiographic analysis of lower limb axial alignments.Lecture Notes in Engineering and Computer Science vol 2 pp1354\u20131358"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq\u20102018\u2010000493"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010009\u20100999\u20101"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101588\u20108"},{"key":"e_1_2_9_25_2","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2016.03.33"},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00386"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2011.12.028"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010007\u20100399\u20104"},{"key":"e_1_2_9_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2018.02.038"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12306\u2010019\u201000612\u20103"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01398"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102620\u2010y"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010199610000\u201000014"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.93B5.25893"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2012.07.009"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-020-06150-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00167-020-06150-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-020-06150-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-020-06150-x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T08:38:35Z","timestamp":1760863115000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-020-06150-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,16]]},"references-count":34,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2]]}},"alternative-id":["10.1007\/s00167-020-06150-x"],"URL":"https:\/\/doi.org\/10.1007\/s00167-020-06150-x","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,16]]},"assertion":[{"value":"5 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"Cantonal Ethics Committee Zurich Reference no. 2020-00198.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all participants included in the study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}