Effectiveness of patient specific instrumentation for total joint replacement and implantable sensing technology in orthopedics: A review

For many decades, research has been conducted for total ankle replacement to be established as the optimal surgical treatment for diseased or degenerative ankle joints. However, the development rate has been slow and acceptable mid and long term clinical results have only been published since the year 2000. On the other hand, computer assisted surgery and patient specific instrumentation design have improved the outcomes in total knee and hip replacements. These advances, as well as sensing technology for evaluating stress distribution, have enhanced mechanical design for knees and hips implants and provided valuable input and load condition knowledge that was not previously available. Moreover, while few reports exist regarding computer assisted surgery (CAS) and patient specific instrumentation for total ankle replacement (TAR), no studies regarding instrumented ankle prostheses capable of obtaining stress distribution data exist currently, or related works using sensing technology for improving patient specific instrumentation. Therefore, the aim of this paper is to outline the advantages of these two technological approaches, as they are intended to provide potential benefits for component alignment and therefore could be used to enhance TAR final outcomes.