Optimizing Revision Total Knee Arthroplasty: An In-Depth Analysis of 3D Planning Prediction and Patient-Specific Instruments for Revision Surgery

Abstract

In today’s medicine, 3D planning and PSI are not commonly used in revision TKA surgery and little is known about the accuracy and implementation of these techniques in revision TKA. Therefore, the question arises, what are the potential benefits of 3D planning and PSI in revision surgery? The goal of this thesis is to explore the potential benefits of 3D planning and PSI in revision surgery. To achieve this, a retrospective study and a prospective study are performed, and a first design of a 3D printed PSI is created. For both retrospective and prospective study, 3D plannings are made of patients undergoing revision TKA, comparing the pre-operative planning with the post-operative results based on size prediction, augmentation prediction and component placement analysis. The results of the studies conducted in this research align closely with each other, providing similar results for size and augmentation prediction and component placement analysis. All in all, these studies indicated consistency and reliability of the 3D prediction in different scenarios, affirming the potential of 3D planning in revision TKA surgery. Additionally, the first design for a PSI, a 3D-printed guide, is constructed. This design incorporates several important landmarks for component placement during revision TKA, increasing the outcome of these surgeries, especially if landmarks are missing or unidentifiable during surgery. Together 3D planning and PSI have a bright future in revision surgery, however, future research needs to be conducted to implement 3D planning and PSI in modern-day healthcare.