Custom/Patient-Specific Total Knee Arthroplasty

With the growing demand for TKA and with procedures being performed in younger and more active patients, there is an increasing need to achieve longer survivorship, better clinical outcomes, and improved patient satisfaction after TKA. Anatomic studies of the knee have demonstrated distinct geometrical differences in gender and race, which may result in imperfect positioning and bony coverage of traditional components during TKA. Custom TKA aims to restore knee anatomy and kinematics using anatomical data obtained primarily from advanced preoperative imaging such as computed tomography (CT), from which both patient-specific cutting jigs and custom implants unique to the patient are developed for the procedure. In this chapter, indications and operative technique for a modern custom, patient-specific total knee arthroplasty (TKA) system as well as the existing literature surrounding custom TKA are reviewed.