Patient-specific instrumentation improves tibial component rotation in TKA

Alcindo Silva*, Ricardo Sampaio, Elisabete Pinto

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Purpose: To compare the femoral and tibial components rotational alignment in total knee arthroplasty (TKA) performed either with conventional or with patient-specific instrumentation. Methods: Forty-five patients underwent primary TKA and were prospectively randomized into two groups: 22 patients into the conventional instrumentation group (group A) and 23 patients into the Signature™ patient-specific instrumentation group (group B). All patients underwent computed tomography of the operated knee in the first week after surgery to measure the components rotation. Results: The femoral component rotation was 0.0° (-0.25, 1.0) in group A, and 0.0° (0.0, 1.0) in group B. The tibial component rotation was -16.0° (-18.5, 11.8) in group A, and -16.0° (-19.0, -14.0) in group B. There were no significant differences between the two groups in tibial and femoral components rotation. The difference between the tibial component rotation and the neutral tibial rotation was similar in both groups [2.0° (-0.5, 6.3) in group A and 2.0° (-1.0, 4.0) in group B], but the dispersion around the median was different between the two groups. The amplitude of the difference between tibial rotation and neutral position was 27° (-13, 14) in group A and 9° (-3, 6) in group B. Conclusions: There is a smaller chance of internal malrotation of the tibial component with the Signature™ patient-specific instrumentation system, with less dispersion and amplitude of the tibial component rotation around the neutral position. Level of evidence: II.
Original languageEnglish
Pages (from-to)636-642
Number of pages7
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Issue number3
Publication statusPublished - 1 Mar 2014
Externally publishedYes


  • Femoral component rotation
  • Patient-matched instrumentation
  • Patient-specific instrumentation
  • Tibial component rotation
  • Total knee arthroplasty


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