The Knee, ISSN: 1873-5800, Vol: 22, Issue: 6, Page: 613-7

Total knee arthroplasty using patient-specific guides: Is there a learning curve?

Chinnappa, Jason; Chen, Darren B; Harris, Ian A; MacDessi, Samuel J


  • No significant differences in post operative alignment between initial 30 cases and subsequent 56 cases.
  • Slightly longer average surgery time in initial 30 (85 min) cases versus subsequent 56 (78 min) cases.
  • Patient specific guides have learning curve as operative time but not alignment for experienced knee arthroplasty surgeons.



Patient specific guides (PSG) have been reported to improve overall component alignment in total knee arthroplasty (TKA). With more surgeons likely to consider this method of TKA in the future, this study was performed to establish whether there is a learning curve with use of PSG in TKA.


Eighty-six consecutive PSG TKAs performed by one surgeon were retrospectively analyzed in two groups. The first 30 patients were compared to the second 56 patients with regards to their operative times and post-operative multi-planar alignments on computed tomography (CT) scan.


Mean operative time was higher in the initial 30 cases compared to the second 56 cases (85 min vs. 78 min; p = 0.001). No statistically significant differences were found in post-operative TKA alignment between the two groups.


This study suggests that there is a minimal learning curve with operative time associated with use of PSG in TKA. This study was unable to detect a significant learning curve with regards to restoration of mechanical knee alignment with the use of PSG in TKA.


Level of Evidence: Level III, retrospective comparative study.

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