{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:21:14Z","timestamp":1765887674532},"reference-count":41,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,2,23]],"date-time":"2015-02-23T00:00:00Z","timestamp":1424649600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:p>Patient\u2010specific instrumentation (<jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content>) technology has been developed to improve alignment when implanting total knee arthroplasty (<jats:styled-content style=\"fixed-case\">TKA<\/jats:styled-content>) and is a new focus in the orthopaedic community. Current controversial data concerning <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> are discussed. A systematic review to compare <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> with conventional instrumentation and assess the radiographic outcomes was performed. Electronic databases (including <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content>, Medline, Embase, the Cochrane Library and the Science Citation Index database) and conference proceedings from 1950 to 2014 in the <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>nglish language were searched. Data, including relevant patient characteristics, sample size, radiographic method, <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> system manufacturer and outliers of implant positioning and alignment on radiography were independently extracted from all eligible studies by two of the authors. A total of 2739 <jats:styled-content style=\"fixed-case\">TKAs<\/jats:styled-content> were included (1410 performed with <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> and 1329 with conventional instrumentation). There were more <jats:styled-content style=\"fixed-case\">TCA<\/jats:styled-content> outliers (malalignment &gt;3\u00b0) and tibial slope outliers (malalignment &gt;3\u00b0) in the <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> group than in the conventional group. The other radiographic outcomes assessed, including coronal, sagittal or rotational alignment outliers did not differ between the two groups. With regard to radiographic outcomes, our findings indicate that <jats:styled-content style=\"fixed-case\">PSI<\/jats:styled-content> technology is not superior in reducing outliers of component alignment.<\/jats:p>","DOI":"10.1111\/os.12150","type":"journal-article","created":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T02:47:38Z","timestamp":1424746058000},"page":"19-25","source":"Crossref","is-referenced-by-count":20,"title":["No Evidence of Superiority in Reducing Outliers of Component Alignment for Patient\u2010specific Instrumentation for Total Knee Arthroplasty: a Systematic Review"],"prefix":"10.1111","volume":"7","author":[{"given":"Qing\u2010meng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics General Hospital of People's Liberation Army  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji\u2010ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics General 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