Patient-specific custom cutting guides for total knee replacement

At the most recent meeting of the American Academy of Orthopedic Surgeons in San Diego, California in February 2011, there were several papers reviewing the efficacy and indication for patient-specific custom cutting guides for total knee replacement. While there is general amount that these are accurate, and either meet or exceed the alignment for total knee replacement, the question of their cost versus benefit continues to evolve. When looking at the time saved by the custom cutting guides, and the decreased turn-over time, there still seems to be a need for price reduction with these custom cutting guides. At their current cost the return on investment does not seem to be favoring use of these custom cutting guides, while in the future the price will come down and may lead to wider use of these custom cutting guides. We have performed a study involving 45 of these and the accuracy and reproducibility of the cuts seems to be quite good. We anticipate writing this data up later this year and comparing it to a previous experience with computer-assisted surgery and traditional cutting guides. Stay tuned for the results of this study.

William P. Barrett, MD