These authors point out that patient-specific guides have been introduced, with the proponents claiming a significant improvement in accuracy and reproducibility of component positioning in total knee arthroplasty. They studied three-planar component alignment and overall coronal mechanical alignment between patient specific guides and conventional instrumentation.
They found that patient specific guides did not improve accuracy in TKA and, in their experience, were somewhat impractical in that the procedure not infrequently needed to be either modified or abandoned.
Comment: while similar patient specific guides have been suggested for the shoulder, it has yet to be demonstrated that the incremental cost and time are offset by increased benefit to the patient.
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