Skip to main content
Log in

CT analysis after navigated versus conventional implantation of TKA

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bargren JH, Blaha JD, Freeman MA (1983) Alignment in total knee arthoplasty. Clin Orthop 173:178–183

    PubMed  Google Scholar 

  2. 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

    Google Scholar 

  3. Coull R, Bankes MJK, Rossouw DJ (1990) Evaluation of tibial component angles in 79 consecutive total knee arthroplasties. Knee 6:235–237

    Article  Google Scholar 

  4. Crossett LS (2002) Fixed- versus mobile-bearing total knee arthroplasty: technical issues and surgical tips. Orthopaedics 25(2 Suppl):251–256

    Google Scholar 

  5. 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

    Article  Google Scholar 

  6. Hauser R (2000) Computer-aided 3D-navigation systems—a plea for an error model. HNO 48(2):71–74

    Article  PubMed  CAS  Google Scholar 

  7. Insall JN, Dorr LD, Scott R, Scott WN (1989) Rationale of the knee society clinical rating system. Clin Orthop 248:13–14

    PubMed  Google Scholar 

  8. Janecek M, Bucek B, Hart R (2001) OrthoPilot (Aesculap)—Computernavigation der Endoprothese des Kniegelenks. Acta Chir Austriaca 33:175

    Google Scholar 

  9. Jeffrey RS, Morris RW, Denham RA (1991) Coronal alignement after total knee replacement. J Bone Joint Surg 73B:709–714

    Google Scholar 

  10. 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

    Google Scholar 

  11. 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

    Article  PubMed  CAS  Google Scholar 

  12. 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

    Article  Google Scholar 

  13. 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

    Google Scholar 

  14. 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

    PubMed  CAS  Google Scholar 

  15. 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

  16. Mahoney FL, Barthel DW (1965) Activities of daily living. Md State Med J 14/2:61–65

    Google Scholar 

  17. 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

    Article  PubMed  CAS  Google Scholar 

  18. 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

    Article  Google Scholar 

  19. 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

    CAS  Google Scholar 

  20. Olcott CW, Scott RD (1999) The Ranawat award. Femoral component rotation during total knee arthroplasty. Clin Orthop 367:39–42

    PubMed  Google Scholar 

  21. Olcott CW, Scott RD (2000) Determining proper femoral component rotational alignment during total knee arthroplasty. Am J Knee Surg 13/3:166–168

    Google Scholar 

  22. 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

    Article  Google Scholar 

  23. 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

    Article  PubMed  Google Scholar 

  24. Rand JA, Coventry MB (1988) Evaluation of geometric total knee arthroplasty. Clin Orthop 232:168–173

    PubMed  Google Scholar 

  25. 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

    Article  PubMed  CAS  Google Scholar 

  26. Ritter MA, Faris PM, Keating EM, Meding JB (1994) Postoperative alignement of total knee replacement. Its effect on survival. Clin Orthop 299:153–156

    PubMed  Google Scholar 

  27. 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

    Google Scholar 

  28. 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

    Google Scholar 

  29. 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

    PubMed  CAS  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. Tew M, Waugh W (1985) Tibial-femoral alignement and the results of knee replacement. J Bone Joint Surg 67B:551–556

    Google Scholar 

  32. 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

    Google Scholar 

  33. 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

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Michael Oberst.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-007-0486-5

Keywords

Navigation