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allowing bone cutting to consume 25 specimens of plastic knee models.The results of this study showed a satisfactory level of accuracy with a mean alignment error of0.67º (maximum 2.5º). The mean error for bone cutting was 0.32 mm (maximum 1 mm). Thisstudy also showed that the positioning of the templates is reliable, as there was no significantintraobserver and interobserver variation for alignment, or levels of bone cutting, in both thefemur and the tibia. This is comparable with the results of a postoperative CT scan that wasdone for the patient specific templating technique in a previous study 11 , where the mean errorsfor alignment and bone cutting were within 1.7º and 0.8 mm, and maximum errors were lessthan 2.3º or 1.2 mm. The level of accuracy and reliability is better than what is reported 33,40,41for conventional techniques that had errors > 3º. This level of accuracy also comparesfavourably with the results of navigation 3,4,6,30,40 (within 3º) but less than what is reported byrobotic techniques (within 1º). 37The patient specific templating has therefore the potential to be used as a training tool, allowingcomplete planning of surgery with 3-D simulation that facilitates identification and correction oferrors in real time. Also, it allows the measurement of surgical performance, by comparingpostoperative imaging with the recorded preoperative planning. Rapid prototyping machines canproduce a patient specific model of the knee joint, based on the CT scan data of the patient.Thus, the surgeon can perform TKA on the patient’s model and evaluate the results beforeoperating on the real patient. The Patient-specific templating is suitable for patients with kneedeformities, in which intramedullary rods cannot be used. This technique also has the potentialto reduce the risk of infection, by shortening the operative time and eliminating medullaryperforation, excessive bleeding and tracking pins (in the case of navigation techniques). Since itprovides single use instruments, it may be useful in areas where there is a high risk of variantCreutzfeldt-Jakob Disease (vCJD) that requires an extraordinarily high level of sterlization. 42Other imaging modalities may be used in the future, such as MRI or 3-D radiographX-ray. 34This templating technique has the potential to be used for other procedures, such asunicompartmental knee arthroplasty.Conclusion:This study showed a satisfactory level of accuracy and reliability of the computer assistedpatient specific templating technique for total knee arthroplasty. It appears that the patientspecific templating technique has several advantages over conventional instrumentation, as iteliminates medullary guides, reduces operative time, and provides better accuracy. We believethat this technique is a practical alternative to navigation and robotic techniques for TKA.AcknowledgementAuthors would like to thank the staff at The Institute for Computer Assisted OrthopaedicSurgery (ICAOS), Western Pennsylvania Hospital, Pittsburgh, PA who participated and/orhelped in conducting this study. Also, we are grateful to the contributions of Keyworth Institute,University of Leeds; the Radiology Department, St. Luke Hospital Bradford; DePuyInternational Ltd, Leeds; Materialise, Belgium; the Engineering and Physical Sciences ResearchCouncil (EPSRC); and the Arthritis Research Council (ARC).file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]
REFERENCES1. 1. Berry E, Cuppone M, Porada S, Millner PA, Rao A, Chiverton N, SeedhomBB. Personalised image-based templates for intra-operative guidance. Proc Inst MechEng [H] 2005;219:111-118.2. 2. Brown GA, Firoozbakhsh K, DeCoster TA, Reyna JR Jr, Moneim M. Rapidprototyping: The future of trauma surgery? J Bone Joint Surg Am. 2003;85(Suppl 4):49-55.3. 3. Chauhan SK, Scott RG, Breidahl W, Beaver RJ. Computer-assisted kneearthroplasty versus a conventional jig-based technique. A randomised, prospective trial. JBone Joint Surg Br. 2004;86:372-377.4. 4. Delp SL, Stulberg SD, Davies B, Picard F, Leitner F. Computer assisted kneereplacement. Clin Orthop Relat Res. 1998;354:49-56.5. 5. Dennis DA, Channer M, Susman MH, Stringer EA. Intramedullary versusextramedullary tibial alignment systems in total knee arthroplasty. J Arthroplasty.1993;8:43-47.6. 6. DiGioia AM 3rd, Jaramaz B, Plakseychuk AY, Moody JE Jr, Nikou C,Labarca RS, Levison TJ, Picard F. Comparison of a mechanical acetabular alignmentguide with computer placement of the socket. J Arthroplasty. 2002;17:359-364.7. 7. Ecker ML, Lotke PA, Windsor RE, Cella JP. Long-term results after totalcondylar knee arthroplasty: Significance of radiolucent lines. Clin Orthop Relat Res.1987;216:151–158.8. 8. Fehring TK, Odum S, Griffin WL, Mason JB, Nadaud M. Early failure in totalknee arthroplasty. Clin Orthop Relat Res. 2001;392:315-318.9. 9. Fortheine F, Ohnsorge JAK, Schkommodau E, Radermacher K. CT-BasedPlanning and Individual Template Navigation in TKA. In Stiehl JB, KonermannWH, Haaker RG (eds). Navigation and Robotics in Total Joint and Spine Surgery.Berlin, Springer 2004;336-342.10. Chelule K, Hafez MA, Seedhom BB, Sherman KP. Patient-specific template for totalknee arthroplasty in young, active patients. Proceedings, the International Society forTechnology in Arthroplasty, Oxford, UK, 2002.11. Hafez MA, Chelule KL, Seedhom BB, Sherman KP. Computer-assisted Total KneeArthroplasty Using Patient-Specific Templating. Clin Orthop Relat Res. 2006;444:184-19212. Hofmann AA, Evanich JD, Ferguson RP, Camargo MP. Ten- to 14-year clinicalfollowup of the cementless Natural Knee system. Clin Orthop Relat Res. 2001;388:85-94.13. Incavo SJ, Coughlin KM, Beynnon BD. Femoral component sizing in total kneearthroplasty: size matched resection versus flexion space balancing. J Arthroplasty.2004;19:493-497.14. Jazrawi LM, Birdzell L, Kummer FJ, Di Cesare PE. The accuracy of computedtomography for determining femoral and tibial total knee arthroplasty component rotation. JArthroplasty. 2000;15:761-766.15. Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. JBone Joint Surg Br. 1991;73:709-714.16. Jenny JY, Boeri C. Low reproducibility of the intra-operative measurement of thetransepicondylar axis during total knee replacement. Acta Orthop Scand. 2004;75:74-77.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]
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Convened under the auspicious of es
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Special Thank YouISTA’s Board of
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Invited SpeakersJean Noel ArgensonM
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Thursday, October 7, 2010Session AS
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Oxinium Versus Metal on Polyethylen
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13:30 - 14:00Invited talk: Hip Arth
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What Can We Do With Periprosthetic
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New Concept in Soft Tissue Balancin
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Comparison of Drain Clamp After Bil
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Session - A7:45 - 8:15Invited talk:
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Massive Endoprosthetic Replacement
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Hydroxyapatite Block for Reconstruc
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13. Dilute Betadine Lavage Prior to
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37. Fluoroscopic Analysis of Advanc
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60. Influence of Impaction Forces o
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85. Surgical Wound Infection as a P
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Saturday, October 9, 2010, 8:15-9:0
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algorithm was tested for short incr
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Ten patients with fracture acetabul
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Saturday, October 9, 2010, 14:00-14
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*Email: drbaldiniandrea@yahoo.itThe
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evision surgery were aseptic loosen
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*Dante Parodi - Clinica Alemana De
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Thursday, October 7, 2010, 17:30-18
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and subsequent exposure time to rad
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of the patient during the acetabula
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FiguresFriday, October 8, 2010, 11:
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Results: No further revisions were
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Minimally Invasive Total Knee Arthr
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and are due to insufficient fixatio
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Methods: An inverse finite element
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Finally a subject-specific model co
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prosthesis component have been calc
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novel tools and devices that are ab
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from 48.6 to 92.2, while functional
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Friday, October 8, 2010, 8:00-8:30S
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The Kaplan-Meier survival rate was
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especially because most of the stan
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knee and offer a new development of
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This was the patient with revision
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Ain Shams UniversityCairo, EgyptPle
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Two-stage revision arthroplasty is
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inexpensive modular femoral compone
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successful treatment outcome was de
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Pathogen N PercentStaphylococcus au
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component as their permanent prosth
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FiguresFigure 1Friday, October 8, 2
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*Email: joseph.fetto@nyumc.orgNon-c
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MATERIAL AND METHODS423 total knee
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MATERIALS AND METHODSFrom January 1
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Introduction:Mike Reed - Wansbeck G
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Conclusions:To the best our knowled
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ing superior clinical results when
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one) in 11 (26%), type II (failure
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Correction of leg length discrepanc
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motion is separated from the transv
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Is the Frecnh Paradox a Reality? Lo
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uncovered in the remaining 53 hips.
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found in the currently used MOM bea
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followed since their initial presen
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ã€€On the axial plane, the ave
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For revision hip replacements, the
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Friday, October 8, 2010, 15:20-16:0
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ResultCup geometries with screws ha
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to insert the guide pin into the fe
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to 8% of THA patients have cups mal
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In a recent investigation the effec
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Conclusions.Fixed valgus angle rese
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fluoroscopic analysis of kinematics
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vivo motion of MB total knee arthro
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ResultsMean follow-up was 6 yrs (SD
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precision of implant placement. We
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*J. Philippe Kretzer - Laboratory o
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COM group whereas both components w
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In the present study, the patella h
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characteristic of the MB prosthesis
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Friday, October 8, 2010, 15:00-16:0
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The ceramic on ceramic strategy wit
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acetabulum, which with a modern por
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Friday, October 8, 2010, 14:00-14:5
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Conclusion: The results of this stu
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The incidence of periprosthetic fra
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*Email: sgh_iizu@grn.janis.or.jpAbs
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components (78 %) that remained rig
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hydroxyapatite ceramic in bone tumo
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one month later to a mean value of
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Keywords: total knee arthroplasty,
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of the tensor (Fig. 1B). During eac
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structures including MCL cut for ac
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31. Whiteside LA, Kasselt MR, Hayne
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Corne van Loon - rijnstate hospital
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Osaka, JapanTomonori Arita - Gradua
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Gary Poehling - Wake forest univers
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mean Harris hip score was 98 points
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Discussion:This study demonstrates
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Thursday, October 7, 2010, 8:00-8:5
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we usually excise both ACL & PCL, s
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true and false acetabulum2- In Femo
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Minimal invasive surgery (MIS)is ac
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*Stephen Murphy - New England Bapti
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scratching effect against the femor
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transformation associated with the
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Bearing Surfaces in Primary Total H
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Introduction: Proper rotational ali
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Materials and Method4 cases and 5 k
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to improve exposure in difficult ca
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We have used different stems (strai
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Our preliminary results are encoura
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A modified titanium spinal pedicle
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Use of a novel ligament gap balanci
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femur 659, proximal tibia 198, prox
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*Pietro Ruggieri - University of Bo
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The presentattion will focus on tec
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Accuracy of Femoral Component Align
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Results.Dislocation: no.Clinical ou
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iocompatible material to man,it is
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BackgroundThe current literature te
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axis and component positioning. We
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stability of joint in full extensio
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with femoralrevision combined with
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arthroplasty. Obesity is an appropr
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Conclusions:We conclude that with u
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There was no difference in function
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We present the results of a consecu
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Barbara Maestri - university of rom
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gap balancing and providing reasona
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Highly Crosslinked PE as Alternativ
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plastic limit of UHMWPe. Changes in
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equired blood transfusion (RD -0.34
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age limit for THA can be lowered.Fr
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lood transfusion might be necessary
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The hammering sounds in press-fit i
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We investigated the period from fir
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technique.The subjects were 16 knee
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Persistent patellofemoral symptoms
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peak dynamic varus angle over time.
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Page 324 and 325: Tateaki Shimakawa - Tokushima Munic
Page 326 and 327: male.We retrospectively reviewed pr
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Page 332 and 333: Introduction:Cadaveric Evaluation o
Page 334 and 335: defects.Conclusion: Periprosthetic
Page 336 and 337: FiguresFigure 1 Figure 2 Figure 3 F
Page 338 and 339: Poster: 4Testing High Performance A
Page 340 and 341: Background:Modular endoprosthetic r
Page 342 and 343: The mean follow up was 4.2 years (3
Page 344 and 345: compared to the attending surgeon.D
Page 346 and 347: Poster: 13Postural Control Features
Page 348 and 349: e extended to the cup with malposit
Page 350 and 351: Poster: 17A Novel Method to Determi
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Page 356 and 357: Poster: 23Lumbar Disc Replacement.
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Page 360 and 361: Poster: 27Accuracy of Acetabular Cu
Page 362 and 363: Poster: 29In Vivo Measurement of Pe
Page 364 and 365: Poster: 31Clinical and Laboratory V
Page 366 and 367: Figure 1: Typical steps used for co
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Page 372 and 373: 17. Jonsson B, Astrom J. Alignment
Page 374 and 375: Branislav Jaramaz - The Western Pen
Page 376 and 377: Poster: 34What Is the Blood Transfu
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Page 380 and 381: Poster: 38Intraarticular Injection
Page 382 and 383: Sudhir Rao - South London Heathcare
Page 384 and 385: *Naoyuki Katayama - Hokkaido Orthop
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Page 388 and 389: Introduction*Sujith Konan - Univers
Page 390 and 391: Poster: 48IntroductionRevision Hip
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Page 402 and 403: Poster: 52Development of a Constant
Page 404 and 405: *Takahiro Lida - Osaka City Univers
Page 406 and 407: coating, have been developed with t
Page 408 and 409: 3. Push-out Biomechanical AnalysisM
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Page 416 and 417: Lucia Manunta - University - sassar
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3, 6, 12, 18, and 24 months post-op
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amorphous and degrades faster in th
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Conclusion: the longivity of hip ar
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Poster: 70Outcome of Ceramic-Cerami
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posterior structures (facets and fa
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After thirty-eight months in vivo,
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disadvantages are provided by this
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chipping of the insert. Therefore a
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Metal cups, embedded in a cast resi
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about their preferences regarding f
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A periprosthetic femoral fracture a
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Superficial wound infection occurre
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International scientific literature
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were balanced to within 2° to 3°
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ecause of deep infction. One was ma
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Poster: 91So Are Sutures Actually B
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patients having staged bilateral pr
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adiographs often underestimate the
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A total of 7 osteoarthritis hip wer
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Poster: 98Appropriate Spatial Desig
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Poster: 100Total Hip Arthroplasty i
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Poster: 102Aggressive Early Debride
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this study was to assess the agreem
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Hemiarthroplasty - an Innovative Me
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p=0.55. This minimal change in leng
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Poster: 109Severe Persistent Synovi
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*Email: jerome.tonetti@free.frIn pr
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in 5 QFT-G positive patients with a
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arthroplasty (TKA). In the other ha
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