Introduction: All available custom-made cutting guides are based on implant companies. Most of these companies outsource some of the steps of PST such as imaging, preoperative planning, manufacturing of PST, packing/sterilization and then deliver them to surgeon or hospital for the planned surgery. None of these PST techniques have been reported as a hospital based procedure. Methods: This study is a proof of a new concept of hospital-based PST. Using this technique, all five steps of PST (i.e., imaging, planning, PST production, packing/sterilization and surgery) were done in one location (inside the hospital). Results: The process of hospital-based PST was feasible. The outcome of the process of 250 cases showed that CT-based imaging was easier and more affordable. Planning was controlled by the surgeon. Polyamide nylon was the best available material and it was autoclavable. Desktop 3D printers were able to manufacture PST made of nylon. The whole process could be done in as short duration as 3 days. Conclusion: Hospital-based PST was feasible and it was facilitated by the introduction of desktop 3D printers. The technique was less expensive and more time-saving than commercially available PSI as well as conventional TKA.
