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

  • Symposium: Current Issues in Knee Reconstruction
  • Published:
Clinical Orthopaedics and Related Research®

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 10º 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° 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.

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Acknowledgments

We thank J. M. Fernandez-Carreira, MD, for statistical analysis.

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, University of Oviedo, Oviedo, Spain

    Daniel Hernández-Vaquero MD, PhD

  2. Apartado de Correos 341, 33400, Avilés, Oviedo, Spain

    Daniel Hernández-Vaquero MD, PhD

  3. Hospital St Agustín, Avilés, Spain

    Abelardo Suarez-Vazquez MD, PhD, Manuel A. Sandoval-Garcia MD, PhD & Alfonso Noriega-Fernandez MD

Authors
  1. Daniel Hernández-Vaquero MD, PhD
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  2. Abelardo Suarez-Vazquez MD, PhD
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  3. Manuel A. Sandoval-Garcia MD, PhD
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  4. Alfonso Noriega-Fernandez MD
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Corresponding author

Correspondence to Daniel Hernández-Vaquero MD, PhD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

This study belongs to a project promoted by the Health Research Institute (Carlos III Health Institute) of the Spanish National Healthcare System.

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Hernández-Vaquero, D., Suarez-Vazquez, A., Sandoval-Garcia, M.A. et al. Computer Assistance Increases Precision of Component Placement in Total Knee Arthroplasty with Articular Deformity. Clin Orthop Relat Res 468, 1237–1241 (2010). https://doi.org/10.1007/s11999-009-1175-1

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  • DOI: https://doi.org/10.1007/s11999-009-1175-1

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