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Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 2, pp 259–266 | Cite as

Combined CT-based and image-free navigation systems in TKA reduces postoperative outliers of rotational alignment of the tibial component

  • Shota MitsuhashiEmail author
  • Yasushi Akamatsu
  • Hideo Kobayashi
  • Yoshihiro Kusayama
  • Ken Kumagai
  • Tomoyuki Saito
Knee Arthroplasty

Abstract

Introduction

Rotational malpositioning of the tibial component can lead to poor functional outcome in TKA. Although various surgical techniques have been proposed, precise rotational placement of the tibial component was difficult to accomplish even with the use of a navigation system. The purpose of this study is to assess whether combined CT-based and image-free navigation systems replicate accurately the rotational alignment of tibial component that was preoperatively planned on CT, compared with the conventional method.

Materials and methods

We compared the number of outliers for rotational alignment of the tibial component using combined CT-based and image-free navigation systems (navigated group) with those of conventional method (conventional group). Seventy-two TKAs were performed between May 2012 and December 2014. In the navigated group, the anteroposterior axis was prepared using CT-based navigation system and the tibial component was positioned under control of the navigation. In the conventional group, the tibial component was placed with reference to the Akagi line that was determined visually. Fisher’s exact probability test was performed to evaluate the results.

Results

There was a significant difference between the two groups with regard to the number of outliers: 3 outliers in the navigated group compared with 12 outliers in the conventional group (P < 0.01).

Conclusions

We concluded that combined CT-based and image-free navigation systems decreased the number of rotational outliers of tibial component, and was helpful for the replication of the accurate rotational alignment of the tibial component that was preoperatively planned.

Keywords

Total knee arthroplasty (TKA) Rotational alignment Tibial component Image-free navigation CT-based navigation 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Shota Mitsuhashi
    • 1
    Email author
  • Yasushi Akamatsu
    • 1
  • Hideo Kobayashi
    • 1
  • Yoshihiro Kusayama
    • 1
  • Ken Kumagai
    • 1
  • Tomoyuki Saito
    • 1
  1. 1.Department of Orthopaedic SurgeryYokohama City University School of MedicineYokohamaJapan

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