Abstract
Introduction
Within a 15-month period, 64 patients underwent 71 primary total knee arthroplasties in a randomized trial comparing the navigated versus the conventional implantation technique. CT scans were chosen for use as imaging procedures pre- and post-operatively to collect data concerning alignment and rotation of the leg as well as the prosthesis.
Results
There was no difference between pre- and post-operative data in rotation of the femoral component for navigated versus conventional implantation. The average deviation from the correct long-leg axis was found to be 1.8 ± 1.3° in the navigated group and 2.5 ± 1.6° in the conventional group (P < 0.05).
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References
Bargren JH, Blaha JD, Freeman MA (1983) Alignment in total knee arthoplasty. Clin Orthop 173:178–183
Clemens U, Miehlke RK, Kohler S, et al (2003) Computer assisted navigation with the OrthoPilot-system and the search-evolution-knee prosthesis. Results of a multicenter study. In: Konermann W, Haaker R (eds) Navigation und Robotik in der Gelenk- und Wirbelsäulenchirurgie. Springer, Berlin, Heidelberg, New York, Tokio, pp 207–216
Coull R, Bankes MJK, Rossouw DJ (1990) Evaluation of tibial component angles in 79 consecutive total knee arthroplasties. Knee 6:235–237
Crossett LS (2002) Fixed- versus mobile-bearing total knee arthroplasty: technical issues and surgical tips. Orthopaedics 25(2 Suppl):251–256
Fujiko R, Kotten B, Zettl R, Ritschl P (2004) The accuracy of palpation from orientation points for the navigated implantation of knee prostheses. Orthopäde 33:338–343
Hauser R (2000) Computer-aided 3D-navigation systems—a plea for an error model. HNO 48(2):71–74
Insall JN, Dorr LD, Scott R, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop 248:13–14
Janecek M, Bucek B, Hart R (2001) OrthoPilot (Aesculap)—Computernavigation der Endoprothese des Kniegelenks. Acta Chir Austriaca 33:175
Jeffrey RS, Morris RW, Denham RA (1991) Coronal alignement after total knee replacement. J Bone Joint Surg 73B:709–714
Jenny JY, Boeri C (2001) Computerassisted implantation of a total knee arthroplasty: a case-controlled study in comparison with classical instrumentation. Rev Chir Orthop Reparative Appar Mot 87/7:645–652
Jerosch J, Peuker E, Philipps B, Filler T (2002) Interindividual reproducibility in perioperative rotational alignment of femoral components in knee prosthetic surgery using the transepicondylar axis. Knee Surg Sports Traumatol Arthrosc 10:194–197
Kienapfel H, Springorum HP, Ziegler A, et al (2003) Effect of rotation of the femoral and tibial components on patellofemoral malalignment in knee arthroplasty. Orthopäde 32/4:312–318
Konermann W, Saur MA (2003) Postoperative alignment of conventional and navigated implantation of TKA. In: Konermann W, Haaker R (eds) Navigation und Robotik in der Gelenk- und Wirbelsäulenchirurgie. Springer, Berlin, Heidelberg, New York, Tokio, pp 189–198
Krackow KA, Pepe CL, Galloway EJ (1990) A mathematical analysis of the effect of flexion and rotation on apparent varus/valgus alignment at the knee. Orthopedics 13(8):861–868
Lampe F, Honl M, Wieman R, Hille E (1999) Computergestützte navigation gelenkerhalt und Endoprothetik bei gonarthose. In: Implant 2—1999 Kasuistik. Springer, Berlin, Heidelberg, New York, Tokio
Mahoney FL, Barthel DW (1965) Activities of daily living. Md State Med J 14/2:61–65
Mielke RK, Clemens U, Jens JH, Kershally S (2001) Navigation in knee prosthesis implantation—prelaminary experiences and prospective comparative study with conventional implantation technique. Z Orthop 139:109–116
Oberst M, Bertsch C, Lahm A, Wuerstlin S, Holz U (2006) Regression and correlation analysis of preoperative versus intraoperative assessment of axes during navigated total knee arthroplasty. Comp Aid Surg 11(2):87–91
Oberst M, Bertsch C, Wuerstlin S, Holz U (2003) CT-analysis of leg alignment after free hand and navigated TKA: prelaminary results of a controlled, prospective and randomised study. Unfallchir 106:941–948
Olcott CW, Scott RD (1999) The Ranawat award. Femoral component rotation during total knee arthroplasty. Clin Orthop 367:39–42
Olcott CW, Scott RD (2000) Determining proper femoral component rotational alignment during total knee arthroplasty. Am J Knee Surg 13/3:166–168
Olcott CW, Scott RD (2000) A comparison of 4 intraoperative methods to determine femoral component rotation during total knee arthroplasty. J Arthroplasty 15/1:22–26
Perlick L, Bäthis H, Tingart M, Perlick C, Grifka J (2004) Navigation in total-knee arthroplasty: CT-based implantation compared with the conventional technique. Acta Orthop Scand 75(4):464–470
Rand JA, Coventry MB (1988) Evaluation of geometric total knee arthroplasty. Clin Orthop 232:168–173
Robertsson O, Dunbar M, Pehrsson T, Knutson K, Lidgren L (2000) Patient satisfaction after knee arthroplasty: a report on 27,372 knees operated on between 1981 and 1995 in Sweden. Acta Orthop Scand 71(3):262–267
Ritter MA, Faris PM, Keating EM, Meding JB (1994) Postoperative alignement of total knee replacement. Its effect on survival. Clin Orthop 299:153–156
Saragaglia D, Picard F (2003) Computergestützte Implantation von Knietotalendoprothesen ohne präoperative bildgebende verfahren: das kinematische Modell. In: Konermann W, Haaker R (eds) Navigation und robotik in der gelenk- und Wirbelsäulenchirurgie. Springer, Berlin, Heidelberg, New York, Tokio, pp 199–206
Saragaglia D, Picard F, Chaussard C (2001) Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomised study. Rev Chir Orthop Repatrice Appar Mot 87/1:18–28
Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A (2003) Positioning of total knee arthroplasty with and without navigation support. A prospective randomised study. J Bone Joint Surg Br 85(6):830–835
Swanson KE, Stocks GW, Warren PD, Hazel MR, Janssen HF (2000) Does axial limb rotation affect the alignment measurements in deformed limbs? Clin Orthop 371:246–252
Tew M, Waugh W (1985) Tibial-femoral alignement and the results of knee replacement. J Bone Joint Surg 67B:551–556
Waidelich HA, Strecker W, Schneider E (1992) Computed tomographic torsion-angle and length measurement of the lower extremity. The methods, normal values and radiation load. RoFo 157/3:245–251
Yoshino N, Takai S, Ohtsuki Y, Hirasawa Y (2001) Computer tomography measurement of the surgical and clinical transepicondylar axis of the distal femur in osteoarthitic knees. J Arthroplasty 16(4):493–497
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Oberst, M., Bertsch, C., Konrad, G. et al. CT analysis after navigated versus conventional implantation of TKA. Arch Orthop Trauma Surg 128, 561–566 (2008). https://doi.org/10.1007/s00402-007-0486-5
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DOI: https://doi.org/10.1007/s00402-007-0486-5