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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n\u003Cp id=\u0022p-1\u0022\u003EThis randomized trial was designed to compare outcomes in patients undergoing total knee arthroplasty using either a customized cutting block or conventional instrumentation. There was no difference in hemodynamic parameters or knee stability using either approach, but surgical time was significantly reduced using a customized cutting block.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Etotal knee arthroplasty\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecustomized cutting block\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Econventional instrumentation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eoperative time\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehemodynamic outcomes\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehip-knee-ankle angle\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ehip \u0026amp; knee conditions\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eorthopedic procedures\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n\n\u003Cp id=\u0022p-2\u0022\u003ENattapol Tammachote, MD, Thammasat University, Bangkok, Thailand, presented data from a study comparing the use of a customized cutting block (CCB) with conventional instrumentation (CI) in patients undergoing total knee arthroplasty (TKA). The results demonstrated that CCBs save surgical time, thereby improving operating theater efficiency.\u003C\/p\u003E\n\u003Cp id=\u0022p-3\u0022\u003ECCBs are designed to improve alignment accuracy in TKA, and this technology provides advantages over the use of CI, including a lack of reliance on instrumentation of the intramedullary femoral canal. Nevertheless, it does carry some disadvantages, such as the need for preoperative scheduling for imaging studies and preoperative planning time by the surgeon, as well as the delay in obtaining the CCB. Yet, although the ultimate goal of using this patient-specific instrumentation is to allow more efficient use of operative resources, increase component alignment accuracy, and thereby improve patient outcomes, well-designed studies to confirm its efficacy are lacking.\u003C\/p\u003E\n\u003Cp id=\u0022p-4\u0022\u003EProf Tammachote and colleagues therefore conducted a randomized controlled trial to compare the use of a CCB with CI in TKA. The study was performed from 2012 to 2014 at a single center, and it enrolled 129 patients. Inclusion criteria included patients aged between 50 and 85 years with osteoarthritis of the knee who were willing to wait 4 to 6 weeks for surgery and had no contraindication for preoperative magnetic resonance imaging. Patients were excluded if they had undergone previous ipsilateral hip, knee, or ankle replacement or had metallic hardware around the knee or deformity of the tibia or femur.\u003C\/p\u003E\n\u003Cp id=\u0022p-5\u0022\u003EA total of 108 patients were ultimately included in the study and were randomized to undergo TKA using either CCB (n\u2005=\u200554) or CI (n\u2005=\u200554). All surgeries were performed by the same experienced surgeon, using the standard medial parapatellar approach. Patients were followed for up to 3 months, and primary outcome measurements included limb and prosthesis alignment, operative time, and hemodynamic evaluations.\u003C\/p\u003E\n\u003Cp id=\u0022p-6\u0022\u003EAccording to Prof Tammachote, the average operative time was 11 minutes shorter in the CCB group (93 vs 104 minutes; \u003Cem\u003EP\u003C\/em\u003E\u2005\u0026lt;\u2005.0001; \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E).\u003C\/p\u003E\n\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16264\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16264\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16264\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \u003Cp id=\u0022p-7\u0022 class=\u0022first-child\u0022\u003ETotal Knee Arthroplasty Operative Time Using a CCB or CI\u003C\/p\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n\u003Cp id=\u0022p-11\u0022\u003EHowever, there was no significant difference in the mean hip-knee-ankle angle (179.4\u00b0 vs 179.1\u00b0; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.55) between the CCB and CI groups. Hemodynamic evaluations were also similar between the groups, including the average total blood loss postsurgery (466 vs 514 mL; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.21) and reduction in hemoglobin concentration at 24 hours postsurgery (2.2 vs 2.8 g\/dL; \u003Cem\u003EP\u003C\/em\u003E\u2005=\u2005.42).\u003C\/p\u003E\n\u003Cp id=\u0022p-12\u0022\u003EThe results of this study demonstrate that use of the CCB for TKA reduces surgical time compared with CI, thereby improving operating theater efficiency. CCB use is also as accurate as CI when the procedure is performed by an experienced surgeon, and there is no difference in hemodynamic outcomes, concluded Prof Tammachote.\u003C\/p\u003E\n\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/7\/15.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlq3e\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlq3e\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}