Navigation improves accuracy of rotational alignment in total knee arthroplasty.

Authors:
Michael Nogler
Michael Nogler
Medical University Innsbruck
Innsbruck | Austria
Rafal Rosiek
Rafal Rosiek
University of Innsbruck
Austria
Martin Fischer
Martin Fischer
Duke University
United States
Martin Krismer
Martin Krismer
Innsbruck Medical University
Oliver Kessler
Oliver Kessler
University of Zurich
Switzerland

Clin Orthop Relat Res 2004 Sep(426):180-6

Department of Orthopaedics, University of Innsbruck, Innsbruck, Austria.

Successful total knee arthroplasty is dependent on the correct alignment of implanted prostheses. Major clinical problems can be related to poor femoral component positioning, including sagittal plane and rotational malalignment. A prospective randomized study was designed to test whether an optical navigation system for total knee arthroplasty achieved greater implantation precision than a nonnavigated technique. The primary variable was rotation of the femoral component in the transverse plane, measured from postoperative radiographs and computed tomography images. Sixty-four patients were included in the study. All patients received the Duracon total knee prosthesis. The patients were randomly divided into two groups: Group C patients had conventional total knee arthroplasty without navigation; Group N patients had total knee arthroplasty using a computer-assisted knee navigation system. Analysis showed that patients in Group N had significantly better rotational alignment and flexion angle of the femoral component than patients in Group C. In addition, superior postoperative alignment of the mechanical axis, posterior tibial slope, and rotational alignment was achieved for patients in Group N. The use of a navigation system provides improved alignment accuracy, and can help to avoid femoral malrotation and errors in axial alignment.

Download full-text PDF

Source
September 2004
13 Reads

Publication Analysis

Top Keywords

total knee
24
knee arthroplasty
20
rotational alignment
12
femoral component
12
navigation system
12
patients group
12
group patients
8
patients
8
knee
7
alignment
7
total
6
group
5
navigation
5
arthroplasty
5
superior postoperative
4
images sixty-four
4
sixty-four patients
4
measured postoperative
4
postoperative radiographs
4
alignment mechanical
4

Similar Publications

Rotational alignment in total knee arthroplasty: nonimage-based navigation system versus conventional technique.

Chin Med J (Engl) 2012 Jan;125(2):236-43

Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200233, China.

Background: Proper rotational alignment during total knee arthroplasty (TKA) is important for adequate postoperative patellofemoral and tibiofemoral kinematics, as well as for achieving balanced flexion space at 90. The effects of computer navigation-assisted total knee replacement and conventional total knee arthroplasty on rotational alignment, mechanical axis, component position and clinical outcomes were compared.

Methods: Two methods were used in 82 patients and the rotation of the femoral and tibial components in the transverse plane, the combined rotation of the two components, the mismatch between them, and the mechanical axis of the lower limb were analyzed. Read More

View Article
January 2012

A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation.

J Bone Joint Surg Am 2007 Feb;89(2):236-43

Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Charitéplatz 1, D-10117 Berlin, Germany.

Background: Despite the use of modern instruments in total knee arthroplasty, component malalignment remains a problem. Whether a computer-assisted implantation technique can improve the accuracy of the spatial positioning of an implant is a matter of debate. The objective of this study was to determine whether computer-assisted total knee arthroplasty is superior to the conventional surgical method with regard to the precision of implant positioning. Read More

View Article
February 2007

Comparison of robot-assisted and conventional total knee arthroplasty: a controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment.

Comput Aided Surg 2012 ;17(2):86-95

Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Introduction: A functional total knee replacement has to be well aligned, which implies that it should lie along the mechanical axis and in the correct axial and rotational planes. Incorrect alignment will lead to abnormal wear, early mechanical loosening, and patellofemoral problems. There has been increased interest of late in total knee arthroplasty with robotic assistance. Read More

View Article
June 2012

[Rotational alignment of femoral component with computed-assisted surgery (CAS) during total knee arthroplasty].

Rev Chir Orthop Reparatrice Appar Mot 2008 Oct 27;94(6):580-4. Epub 2008 May 27.

Service de chirurgie-orthopédique, centre hospitalier de Versailles, 177, rue de Versailles, 78157 Le Chesnay, France.

Introduction: Accurate implantation of the prosthesis components is a prognostic factor for long-term total knee arthroplasty survival as it reduces wear and loosening failure. Computer-assisted navigation systems have proved to produce accurate bone cuts orthogonal to the mechanical axis. Proper rotational alignment of the femoral component is one of the requirements for optimal positioning of the femoral prosthesis. Read More

View Article
October 2008