Cutting errors in total knee replacement: assessment by computer assisted surgery.
The observed errors in the position of the implanted prosthesis can be due to a number of potential causes. One of these is the potential error during execution of the bone cuts. However, there is only minimal information on this in the current literature. The amount of cutting errors in 40 consecutive total knee replacements was reported. All the operations were done by the same surgeon. The amount of cutting error was measured by the use of computer navigation system. It was hypothesized that there was no difference in the amount of error between bone cut through the cutting slot (slotted cutting) and bone cut done on the surface of the cutting guide (open cutting). It was found that the average absolute cutting error was 1 masculine in the coronal plane and 1.4 masculine in the sagittal plane. Significantly more outlier (more than 3 masculine) was observed in the errors in the sagittal plane (P = 0.014, chi square test). Open cutting resulted in less error in the sagittal plane of the tibial cut when compared with slotted cutting (P = 0.031, Mann-Whitney U Test). This was attributed by the use of a thicker saw blade with higher stiffness in the open cutting method.
Yau
W P
WP
Department of Orthopaedics and Traumatology, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Room 216, New Clinical Building, No. 102, Pokfulam Road, Hong Kong, Hong Kong. peterwpy@hkucc.hku.hk
Chiu
K Y
KY
D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery