Computer assistance increases precision of component placement in total knee arthroplasty with articular deformity.
BACKGROUND
The accuracy of computer navigation applied to total knee arthroplasty (TKA) in knees with severe deformity has not been studied.


OBJECTIVE
The purpose of this study was to compare the radiographic alignment achieved in total knee replacements performed with and without navigation and to search for differences in the final alignment of two groups of patients (with and without previous joint deformities) using the same system of surgical navigation.


METHODS
The first series comprised 40 arthroplasties with minimal preoperative deformity. In 20 of them, surgical navigation was used, whereas the other 20 were performed with conventional jig-based technique. We compared the femoral angle, tibial angle, and femorotibial angle (FTA) by performing a post-TKA CT of the entire limb. In the second series, 40 additional TKAs were studied; in this case, however, they presented preoperative deformities greater than 10 masculine in the frontal plane.


RESULTS
The positioning of the femoral and tibial component was more accurate in the group treated with surgical navigation and FTA improvement was statistically significant. When comparing the results of both series, FTA precision was always higher when using computer-assisted surgery. As for optimal FTA, data showed the use of surgical navigation improved the results both in the group with preoperative deformity greater than 10 degrees in the frontal plane and in the group with minimal preoperative knee deformity.


CONCLUSIONS
Surgical navigation obtains better radiographic results in the positioning of the femoral and tibial components and in the final axis of the limb in arthroplasties performed on both deformed and more normally aligned knees.


METHODS
Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Hernández-Vaquero
Daniel
D
Department of Orthopaedic Surgery, School of Medicine, University of Oviedo, Oviedo, Spain. dhernandezv@meditex.es
Suarez-Vazquez
Abelardo
A
Sandoval-Garcia
Manuel A
MA
Noriega-Fernandez
Alfonso
A
D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome