No difference in patient-reported satisfaction after 12 months between customised individually made and off-the-shelf total knee arthroplasty - Report - MDSpire
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No difference in patient-reported satisfaction after 12 months between customised individually made and off-the-shelf total knee arthroplasty
No Significant Difference in Patient Satisfaction at 12 Months Between Custom-Made and Standard TKA
Overview
This prospective cohort study compared patient satisfaction and patient-reported outcome measures (PROMs) at 12 months after custom-made (CIM) versus off-the-shelf (OTS) total knee arthroplasty (TKA). Results showed no significant difference in satisfaction rates between the two implant types. Secondary PROMs including KOOS, Forgotten Joint Score, and EQ-5D-3L also demonstrated comparable outcomes.
Background
Total knee arthroplasty is a common and effective treatment for end-stage knee osteoarthritis, yet up to 20% of patients remain dissatisfied postoperatively. Factors influencing dissatisfaction include implant-related issues, mental health, and unmet expectations. Custom-made TKAs have been developed to better match individual knee anatomy and potentially improve outcomes, but evidence from comparative studies remains limited. This study aimed to evaluate whether CIM TKAs provide superior patient satisfaction and clinical outcomes compared to standard OTS TKAs.
Data Highlights
The study included patients receiving primary cruciate-retaining CIM or OTS TKAs, with PROMs collected preoperatively and at 12 months postoperatively. Satisfaction was measured on a five-point Likert scale. Secondary outcomes included KOOS subscales, Forgotten Joint Score, EQ-5D-3L, overall improvement, and willingness to undergo surgery again. Both groups followed identical perioperative and rehabilitation protocols.
Key Findings
No significant difference in patient satisfaction at 12 months between CIM and OTS TKA groups.
Secondary PROMs such as KOOS, Forgotten Joint Score, and EQ-5D-3L showed similar improvements in both groups.
Both implant types used mechanical alignment and similar surgical approaches with minimal soft tissue release.
CIM TKA offers a personalized approach respecting individual knee anatomy but involves longer manufacturing time and higher radiation exposure.
Patients with CIM TKA self-selected their surgeon due to interest in new technology, but this did not translate into superior satisfaction outcomes.
Clinical Implications
Clinicians can consider that custom-made TKAs do not demonstrate superior patient satisfaction or PROMs at 12 months compared to standard off-the-shelf implants. Given the additional costs and logistical considerations of CIM TKAs, standard implants remain a valid and effective option for most patients. Patient counseling should emphasize realistic expectations regardless of implant type.
Conclusion
This study found no significant advantage of custom-made over standard total knee arthroplasty in terms of patient satisfaction and functional outcomes at one year. Both implant types provide comparable results when performed with standardized surgical and rehabilitation protocols.
References
Study Protocol and Outcomes -- No Significant Difference in Patient Satisfaction at 12 Months Between Custom-Made and Standard Total Knee Arthroplasty
Investigators find that short sleep, insomnia, and night shift work are associated with increased risk of knee and hip osteoarthritis and joint replacement.
