Computer-assisted surgery: a wine before its time: in opposition.
Total knee arthroplasty (TKA) surgery has achieved a high degree of success since the introduction of concepts of alignment and ligament balance in the early 1970s. Continuing pressure to improve function and longevity from the operative intervention has led to the design of increasingly sophisticated devices placed with the use of mechanical jigs. Although significant improvement has been made, errors of alignment and stability remain. Methods to diminish the margin of error have not been substantially improved with mechanical jigs, suggesting that intraoperative feedback is difficult to teach and learn, and resulting decision making is not as predictable as one would hope. This discussion will suggest why computer-assisted TKA may be the right answer to improving the predictability of TKA.
Stulberg
Bernard N
BN
Cleveland Center for Joint Reconstruction Inc., and the Cleveland Orthopedic and Spine Hospital, Cleveland Clinic Health Sysytem, Cleveland, Ohio 44113, USA.
Zadzilka
Jayson D
JD
D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods* / Q000639:trends; D005269:Femur / Q000601:surgery; D006801:Humans; D007593:Joint Instability; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods / Q000639:trends*; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome