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TKA Sagittal Alignment with Navigation Systems and Conventional Techniques Vary Only a Few Degrees

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Clinical Orthopaedics and Related Research

Abstract

Navigation systems have been developed to achieve more reliable prosthetic alignment in TKAs. However, the component alignment in the sagittal plane is reportedly less reliable than in the coronal plane even with navigation systems. We measured and compared sagittal prosthetic alignments for TKAs with the conventional technique and three navigation approaches to establish reference frames, using radiographs of the entire lower extremity while standing. The sagittal alignments simulated on the radiographs with the conventional technique and navigation systems differed by a mean of 2° to 4°. Use of navigation systems resulted in a mean of 1° to 4° hyperextension between the femoral and tibial components and use of the conventional technique resulted in a mean of 1° flexion. Use of different reference points on the distal femoral condyle for the navigation systems resulted in differences of as much as 3° alignment in the sagittal plane. Although optimal prosthetic alignment for TKA in the sagittal plane is unknown, surgeons and technicians using navigation systems should be aware of this difference in the sagittal plane and the risk of hyperextension between the femoral and tibial components, which might be associated with osteolysis and anterior post-cam impingement.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi Abeno-ku, Osaka, 545-8585, Japan

    Yukihide Minoda MD, PhD, Akio Kobayashi MD, PhD, Hiroyoshi Iwaki MD, PhD & Kunio Takaoka MD, PhD

  2. Department of Orthopaedic Surgery, Saiseikai Nakatsu Hospital, Osaka, Japan

    Hirotsugu Ohashi MD, PhD

Authors
  1. Yukihide Minoda MD, PhD
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  2. Akio Kobayashi MD, PhD
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  3. Hiroyoshi Iwaki MD, PhD
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  4. Hirotsugu Ohashi MD, PhD
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  5. Kunio Takaoka MD, PhD
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Corresponding author

Correspondence to Yukihide Minoda MD, PhD.

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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 has 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.

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Minoda, Y., Kobayashi, A., Iwaki, H. et al. TKA Sagittal Alignment with Navigation Systems and Conventional Techniques Vary Only a Few Degrees. Clin Orthop Relat Res 467, 1000–1006 (2009). https://doi.org/10.1007/s11999-008-0449-3

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  • DOI: https://doi.org/10.1007/s11999-008-0449-3

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