{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T17:16:48Z","timestamp":1791825408132,"version":"4.3.4"},"reference-count":45,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":69,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p><jats:italic>Objective<\/jats:italic>. To conduct a meta\u2010analysis of randomized controlled trials (RCTs) to compare knee arthroplasty with patient\u2010specific instrumentation (PSI) with the conventional instrumentation (CI). <jats:italic>Methods<\/jats:italic>. RCTs were selected in PubMed and Embase from 2012 to 2018. Key data extracted included malalignment of mechanical axis, blood loss, surgical time, Oxford Knee Score (OKS), Knee Society Score (KSS), length of stay, and complications. Subgroup analysis was also performed regarding different PSI systems and different image processing methods. <jats:italic>Results<\/jats:italic>. 29 RCTs with 2487 knees were eligible for the meta\u2010analysis. Results showed that PSI did not improve the alignment of the mechanical axis compared with CI, but MRI\u2010based PSI and Visionaire\u2010specific PSI decrease the risk of malalignment significantly (<jats:italic>P<\/jats:italic> = 0.04 and <jats:italic>P<\/jats:italic> = 0.003, respectively). PSI reduced operative time (<jats:italic>P<\/jats:italic> = 0.03) and blood loss (<jats:italic>P<\/jats:italic> = 0.002) and improve the KSS (<jats:italic>P<\/jats:italic> = 0.02) compared with CI, but for CT\u2010based PSI, the difference of operative time becomes insignificant. PSI showed no significant difference with CI regarding risk of complication, length of stay in hospital, and functional outcomes of OKS. <jats:italic>Conclusion<\/jats:italic>. PSI reduced the blood loss and improved KSS. MRI\u2010based PSI reduced operative time and risk of malalignment of mechanical axis compared with CT\u2010based PSI. Moreover, Visionaire\u2010specific PSI achieves better alignment result of the mechanical axis than other systems.<\/jats:p>","DOI":"10.1155\/2020\/2164371","type":"journal-article","created":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T23:35:00Z","timestamp":1583883300000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Patient\u2010Specific or Conventional Instrumentations: A Meta\u2010analysis of Randomized Controlled 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