title: Comparison of limb and component alignment using computer-assisted navigation versus image intensifier-guided conventional total knee arthroplasty: a prospective, randomized, single-surgeon study of 467 knees.
abstract: Total knee arthroplasty was performed in 282 knees with image-free navigation (group A) and in 185 with optimized conventional technique (group B). Mean postoperative mechanical axis of the limb was 179.7 degrees in group A and 179.1 degrees in group B (P < .002). There was a higher percentage of knees in group A that had restoration of mechanical axis to +/-1 degrees, +/-2 degrees, and +/-3 degrees of neutral (P < .0001). There were 9.2% outliers (+/-3 degrees) in group A and 21.6% outliers in group B (P < .0001). For knees exceeding 20 degrees varus, there was no significant difference between the mean mechanical axes in the 2 groups. Both components were aligned within 3 degrees of neutral in 90.8% of the knees in group A and 76.2% of the knees in group B (P < .0001).
authors.affiliation: Department of Orthopaedic Surgery, Breach Candy Hospital, Mumbai, India.
authors.forename: Arun
authors.initials: A
authors.lastname: Mullaji
authors.forename: Raj
authors.initials: R
authors.lastname: Kanna
authors.forename: Satyajit
authors.initials: S
authors.lastname: Marawar
authors.forename: Anirudh
authors.initials: A
authors.lastname: Kohli
authors.forename: Amit
authors.initials: A
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D001696:Biomechanical Phenomena; D005260:Female; D005269:Femur / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006621:Hip Joint / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007719:Knee Joint / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D035002:Lower Extremity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013977:Tibia / Q000033:anatomy & histology / Q000000981:diagnostic imaging