title: Navigated revision knee arthroplasty using a system designed for primary surgery.
abstract: While navigation is now recognized as an efficient tool for improving femoro-tibial alignment of primary knee prostheses, its use in revision surgery has not yet been fully evaluated. We describe a procedure based on a bone morphing acquisition performed on the surface of the original implants, followed by a dependant bone cut sequence (tibia first). Using the current system, a preoperative CT-scan measurement of the original femoral component was required. Knee balancing was achieved using spacer blocks, with the trial tibial component and the original femoral component still in place. Preliminary experience from 19 cases, some with severe bone loss requiring reconstruction, is reported. A retrospective comparison to 10 non-navigated revision cases performed concomitantly by the same operating surgeon was carried out. Although there was no significant difference in the number of outliers for the two series, navigation appeared to be a valuable aid in reconstructing both bone extremities, while controlling the level of the joint line. However, definitive validation requires further prospective and comparative investigations in larger series.
authors.affiliation: Department of Orthopedic Surgery, INSERM 0335, Angers University Hospital, Angers, France. phmassin@chu-angers.fr
authors.forename: Philippe
authors.initials: P
authors.lastname: Massin
authors.forename: Patrick
authors.initials: P
authors.lastname: Boyer
authors.forename: Jerome
authors.initials: J
authors.lastname: Pernin
authors.forename: Cecile
authors.initials: C
authors.lastname: Jeanrot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation / Q000379:methods; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome