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Computer-assisted alignment system for tibial component placement in total knee replacement: a radiological study

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Abstract

In total knee replacement (TKR), regarding tibial component positioning, almost all implants offer both an intramedullary and an extramedullary alignment guide, leaving it up to the surgeon which guide to use. However, early failure in TKR can be caused by incorrect positioning or orientation with poor limb alignment. Recently computer-based alignment systems have been developed to help the surgeon to overcome these complications. The Authors retrospectively analysed their experience using a computer-based CT-free alignment system. They assessed the radiological alignment of the tibial components in 38 computer-assisted TKR 6 months after surgery. The frontal tibial component angle (FTC) and the sagittal orientation of the tibial component (slope) were evaluated 6 months after the operation. The results were compared to those achieved with traditional alignment systems. The surgical time was statistically longer in the computer-assisted group but in this group all the tibial components were aligned within 4° of all the ideal measurements in both frontal and sagittal planes.

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References

  1. Aglietti P, Buzzi R (1988) Posteriorly stabilized total condylar knee replacement: three to eight years follow-up of knees. J Bone Joint Surg Br 70:211–216

    PubMed  CAS  Google Scholar 

  2. Insall JN, Scott W, Ranawat CS (1979) The total condylar knee prosthesis. A report of two hundred and twenty cases. J Bone Joint Surg Am 61:173–177

    PubMed  CAS  Google Scholar 

  3. Lotke PA, Ecker ML (1977) Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am 59:77–82

    PubMed  CAS  Google Scholar 

  4. Wasielewski RC, Galante JO, Leighty R et al (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop Relat Res 299:31–36

    PubMed  Google Scholar 

  5. Ecker MI, Lotke PA, Windor RE, Cello JP (1997) Long term results after total condylar knee arthroplasty. Clin Orthop Relat Res 216:151–157

    Google Scholar 

  6. Oswald MH, Jakob RP, Schneider E, Hoogewoud HM (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8:419–423

    Article  PubMed  CAS  Google Scholar 

  7. Ritter MA, Faris PM, Keating EM, Meding JB (1994) Postoperative alignment of total knee replacement: its effect on survival. Clin Orthop Relat Res 299:153–158

    PubMed  Google Scholar 

  8. Nabeyama R, Matsuda S, Miura H et al (2004) The accuracy of image-guided knee replacement based on computed tomography. J Bone Joint Surg Br 86:366–372

    Article  PubMed  CAS  Google Scholar 

  9. Saragaglia D, Picard F, Chaussard R (2001) Computer assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomised study. Rev Chir Orthop Reparatrice Appar Mot 87:18–23

    PubMed  CAS  Google Scholar 

  10. Confalonieri N, Saragaglia D, Picard F et al (2000) Computerised OrthoPilot system in arthroprosthesis surgery of the knee. J Orthopaed Traumatol 2:91–98

    Article  Google Scholar 

  11. Maestro A, Harwin S, Sandoval MG et al (1998) Influence of intramedullary versus extramedullary alignment guides on final total knee arthroplasty component position: a radiographic analysis. J Arthroplasty 13:552–556

    Article  PubMed  CAS  Google Scholar 

  12. Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84[Suppl 2]:90–94

    PubMed  Google Scholar 

  13. Stulberg SD (2003) How accurate is current TKR instrumentation? Clin Orthop Relat Res 416:177–183

    Article  PubMed  Google Scholar 

  14. Garg A, Walker PS (1990) Prediction of total knee motion using a three-dimensional computer graphics model. J Biomech 23:45–50

    Article  PubMed  CAS  Google Scholar 

  15. Brys DA, Lombardi AV Jr, Mallory Th, Vaughan BK (1991) A comparison of intramedullary and extramedullary alignment systems for tibial component placement in total knee arthroplasty. Clin Orthop Relat Res 263:175–181

    PubMed  Google Scholar 

  16. Reed MR, Bliss W, Sher L et al (2002) Extramedullary or intramedullary tibial alignment guides: a randomised prospective trial of radiological alignment. J Bone Joint Surg Br 84:858–862

    Article  PubMed  CAS  Google Scholar 

  17. Chauban SK, Scott RG, Breidahl W, Beaver RJ (2004) Computer assisted knee arthroplasty versus conventional jig-based technique: a randomised, prospective trial. J Bone Joint Surg Br 86:372–376

    Article  Google Scholar 

  18. Confalonieri N, Saragaglia D, Picard F et al (2000) Il sistema computerizzato Orthopilot negli interventi di artroprotesi di ginocchio. Giorn Ital Ortop Traumat 26[Suppl 1]:5415–5422

    Google Scholar 

  19. Jenny JY, Boeri C (2001) Computer-assisted implantation of total knee prostheses: a case control comparative study with classical instrumentation. Comput Aided Surg 6:217–223

    Article  PubMed  CAS  Google Scholar 

  20. Sparmann M, Wolke B, Czupalla H et al (2003) Positioning of total knee arthroplasty with and without navigation support. A prospective randomised study. J Bone Joint Surg Br 85:830–834

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. I U.O. di Ortopedia e Traumatologia, Ospedale C.T.O. — I.C.P., Via S. Pertini 21, 20040, Cambiago, Milan, Italy

    Alfonso Manzotti & Norberto Confalonieri

  2. Divisione di Ortopedia e Traumatologia, Royal Melbourne Hospital, Grattan Street, Parkville, Vic., Australia

    Chris Pullen

Authors
  1. Alfonso Manzotti
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  2. Chris Pullen
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  3. Norberto Confalonieri
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Correspondence to Alfonso Manzotti.

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Manzotti, A., Pullen, C. & Confalonieri, N. Computer-assisted alignment system for tibial component placement in total knee replacement: a radiological study. Chir Organi Mov 91, 7–11 (2008). https://doi.org/10.1007/s12306-007-0002-7

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  • DOI: https://doi.org/10.1007/s12306-007-0002-7

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