Patient specific instrumentation (PSI) in total knee arthroplasty (TKA) promises faster operation time (by using less instruments and individual cutting jigs), less blood loss, faster rehabilitation, better implant sizing and accuracy, superior overall outcome, and at the end - less costs. However, as evident for every new development, its superiority remains to be proven over the conventional systems. Whilst dissatisfaction is reported to be eminent in up to 30% of patients having undergone conventional TKA, it is unclear, whether PSI can address to these patients as a suitable option in the future. The author believes that the current evidence does not support superiority of PSI in TKA over conventional systems. However, future long-term level I and II studies might aid to show its cost-effectiveness stating same results, accuracy, and overall outcome with less operation time.
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