Computer Assistance Increases Precision of Component Placement in Total Knee Arthroplasty with Articular Deformity

Overview

Journal Clin Orthop Relat Res

Publisher Wolters Kluwer

Specialty Orthopedics

Date 2009 Nov 26

PMID 19937166

Citations 23

Authors

Daniel Hernandez-Vaquero

Abelardo Suarez-Vazquez

Manuel A Sandoval-Garcia

Alfonso Noriega-Fernandez

Affiliations

Soon will be listed here.

Abstract

Background: The accuracy of computer navigation applied to total knee arthroplasty (TKA) in knees with severe deformity has not been studied.

Questions/purposes: The purpose of this study was to compare the radiographic alignment achieved in total knee replacements performed with and without navigation and to search for differences in the final alignment of two groups of patients (with and without previous joint deformities) using the same system of surgical navigation.

Methods: The first series comprised 40 arthroplasties with minimal preoperative deformity. In 20 of them, surgical navigation was used, whereas the other 20 were performed with conventional jig-based technique. We compared the femoral angle, tibial angle, and femorotibial angle (FTA) by performing a post-TKA CT of the entire limb. In the second series, 40 additional TKAs were studied; in this case, however, they presented preoperative deformities greater than 10 masculine in the frontal plane.

Results: The positioning of the femoral and tibial component was more accurate in the group treated with surgical navigation and FTA improvement was statistically significant. When comparing the results of both series, FTA precision was always higher when using computer-assisted surgery. As for optimal FTA, data showed the use of surgical navigation improved the results both in the group with preoperative deformity greater than 10 degrees in the frontal plane and in the group with minimal preoperative knee deformity.

Conclusions: Surgical navigation obtains better radiographic results in the positioning of the femoral and tibial components and in the final axis of the limb in arthroplasties performed on both deformed and more normally aligned knees.

Level Of Evidence: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Citing Articles

Clinical and Radiological Outcomes of Computer-Assisted versus Conventional Total Knee Arthroplasty at 5-Year Follow-Up: Is There Any Benefit?.

Chavez-Valladares S, Trigueros-Larrea J, Pais-Ortega S, Gonzalez-Bedia M, Caballero-Garcia A, Cordova A J Pers Med. 2023; 13(9).

PMID: 37763133 PMC: 10533044. DOI: 10.3390/jpm13091365.

Trends in Computer-Assisted Surgery for Total Knee Arthroplasty in Germany: An Analysis Based on the Operative Procedure Classification System between 2010 to 2021.

Heinz T, Eidmann A, Anderson P, Weissenberger M, Jakuscheit A, Rudert M J Clin Med. 2023; 12(2).

PMID: 36675478 PMC: 9863460. DOI: 10.3390/jcm12020549.

Can the need for soft tissue release in total knee replacement be predicted pre-operatively? A study based on surgical navigation.

Hernandez-Vaquero D, Noriega-Fernandez A, Roncero-Gonzalez S, Ruete-Gil G, Fernandez-Carreira J Int Orthop. 2021; 46(4):815-821.

PMID: 34817630 PMC: 8930874. DOI: 10.1007/s00264-021-05263-3.

Comparison of Postoperative Coronal Leg Alignment in Customized Individually Made and Conventional Total Knee Arthroplasty.

Wunderlich F, Azad M, Westphal R, Klonschinski T, Belikan P, Drees P J Pers Med. 2021; 11(6).

PMID: 34204771 PMC: 8231644. DOI: 10.3390/jpm11060549.

Reliability of Imageless Computer-Assisted Navigation for Femoral Rotational Alignment in Total Knee Arthroplasty.

Leelasestaporn C, Thuwapitchayanant M, Sirithanapipat P, Sa-Ngasoongsong P, Ruengsilsuwit P Malays Orthop J. 2021; 15(1):79-84.

PMID: 33880152 PMC: 8043641. DOI: 10.5704/MOJ.2103.012.

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