title: Differences in component and limb alignment between computer-assisted and conventional surgery total knee arthroplasty.
abstract: OBJECTIVE
  Marked coronal femoral bowing may bear a risk for mal-alignment of femoral component and reconstructed mechanical axis (MA) by using conventional instrumentations. The aim of this study was to investigate the usefulness of computer-assisted surgery-total knee arthroplasty (CAS-TKA) under this circumstance.
  
  
  METHODS
  We retrospectively analyzed patients with osteoarthritic knee and marked coronal femoral bowing who underwent TKA at our institution. The CAS-TKA and the conventional techniques were compared by radiographic parameters in coronal and sagittal planes, and rotational alignment of femoral component was assessed by computed tomography (CT) scans. The Hospital for Special Surgery (HSS) and International Knee Society (IKS) scores were obtained for all patients preoperatively and at the last follow-up.
  
  
  RESULTS
  A total of 65 knees were enrolled in this study. Twenty-eight TKAs implanted using a CT-free navigation system, and the remaining 37 TKAs implanted using the conventional technique. CAS-TKAs were more consistent than conventional TKAs in aiding proper postoperative MA and ideal alignments of femoral component in the coronal and sagittal planes. However, CAS-TKA group was not obtained at significantly higher rates of femoral component in axial plane. At a mean follow-up of 43 months, there was no significant difference in HSS and IKS scores between the groups.
  
  
  CONCLUSIONS
  Although CAS-TKA did not have superior functional outcomes in the short-term follow-up, proper coronal and sagittal alignment of femoral component and postoperative MA were obtained in patients with marked coronal femoral bowing. The long-term follow-up will be needed to clarify the eventual benefits.
  
  
  METHODS
  Retrospective comparative study, Level III.
authors.affiliation: Division of Joint Reconstruction, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, No. 6, West Section, Chia-Pu Road, Putz, 613, Chia-Yi, Taiwan.
authors.forename: Tsan-Wen
authors.initials: TW
authors.lastname: Huang
authors.forename: Kuo-Ti
authors.initials: KT
authors.lastname: Peng
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.forename: Mel S
authors.initials: MS
authors.lastname: Lee
authors.forename: Robert Wen-Wei
authors.initials: RW
authors.lastname: Hsu
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D017760:Bone Malalignment / Q000517:prevention & control; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D020370:Osteoarthritis, Knee / Q000601:surgery*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted; D013977:Tibia / Q000601:surgery; D014057:Tomography, X-Ray Computed