Patient specific cutting blocks are currently of no proven value

J Bone Joint Surg Br. 2012 Nov;94(11 Suppl A):95-9. doi: 10.1302/0301-620X.94B11.30834.


Patient specific cutting guides generated by preoperative Magnetic Resonance Imaging (MRI) of the patient's extremity have been proposed as a method of improving the consistency of Total Knee Arthroplasty (TKA) alignment and adding efficiency to the operative procedure. The cost of this option was evaluated by quantifying the savings from decreased operative time and instrument processing costs compared to the additional cost of the MRI and the guide. Coronal plane alignment was measured in an unselected consecutive series of 200 TKAs, 100 with standard instrumentation and 100 with custom cutting guides. While the cutting guides had significantly lower total operative time and instrument processing time, the estimated $322 savings was overwhelmed by the $1,500 additional cost of the MRI and the cutting guide. All measures of coronal plane alignment were equivalent between the two groups. The data does not currently support the proposition that patient specific guides add value to TKA.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / economics
  • Arthroplasty, Replacement, Knee / instrumentation
  • Arthroplasty, Replacement, Knee / methods*
  • Cost Savings / statistics & numerical data*
  • Cost-Benefit Analysis
  • Female
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Knee Prosthesis
  • Magnetic Resonance Imaging / economics*
  • Male
  • Middle Aged
  • Missouri
  • Models, Anatomic*
  • Operative Time
  • Outcome and Process Assessment, Health Care
  • Preoperative Care / economics
  • Preoperative Care / methods*