Navigation in total-knee arthroplasty: CT-based implantation compared with the conventional technique.
Background Exact axial limb alignment in total-knee arthroplasty (TKA) is important for a successful outcome. We evaluated the efficiency of computer-assisted implantation in TKA and compared it with the classical surgeon-controlled technique. Patients and methods We implanted 100 TKA using either the computer-assisted technique (50) or the conventional approach (50). There were no significant differences between the groups regarding the preoperative leg deformity. Accuracy of implantation was determined in postoperative long-leg coronal and lateral radiographs. Results A postoperative leg axis between 3 degrees varus and 3 degrees valgus was achieved in 46 patients in the group with computer-assisted implantation and 36 patients in the control group (p=0.01). A significant difference was also seen for the femoral component alignment in frontal plane. No complications influencing the clinical outcome were observed. Interpretation A CT-based navigation system improves the accuracy of TKA, but higher costs and time-consuming planning will mean that its usage is limited to special cases. Additional tools such as ligament balancing, which are presently only available with the CT-free software module, require to be added to the CT-based system.
Perlick
Lars
L
Department of Orthopaedic Surgery, University of Regensburg, Postbox 100662, DE-93042 Regensburg, Germany. lars.perlick@klinik.uni-regensburg.de
Bäthis
Holger
H
Tingart
Markus
M
Perlick
Carsten
C
Grifka
Joachim
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed