J Korean Orthop Assoc.  2009 Dec;44(6):599-603. 10.4055/jkoa.2009.44.6.599.

The Accuracy of Lower Extremity Alignment in Total Knee Arthroplasty Using Navigation System: Data Analysis of 661 Cases

Affiliations
  • 1Arthroplasty Center, Department of Orthopaedic Surgery, Gongju Medical Center, Gongju, Korea. meds77@hanmail.net

Abstract

PURPOSE
We wanted to evaluate the accuracy of the alignment of the lower extremity in 661 cases of total knee arthroplasty (TKA) with using a navigation system.
MATERIALS AND METHODS
We evaluated 661 cases (431 patients) that underwent TKA using a navigation system from June 2006 to September 2008. To analyze the mechanical axis, the weight bearing full length lower extremity radiographs were taken preoperatively and the again at3 weeks after the operation. The results from a well- experienced surgeon (423 cases) were compared with those from a less-experienced surgeon (238 cases), and they both used the navigation system.
RESULTS
The mean of the mechanical axis was -13.3degrees (range: -33.3degrees-10.6degrees) preoperatively, but it was corrected to -2.0degrees (range: -14.3degrees-7.5degrees) after TKA using a navigation system. There was no significant difference between the mean of, -1.8degrees (range: -13.4degrees-6.8degrees) by a well-experienced surgeon and the mean of, -2.2degrees (range: -14.3degrees-7.5degrees) by a less-experienced one. CONCLUSION: According to the radiologic results, the navigation system is beneficial for the accuracy of the mechanical axis in TKA. The navigation system helps a less-experienced surgeon increase the accuracy of the lower extremity alignment.

Keyword

Knee; Arthroplasty; Navigation; Alignment of lower extremity

MeSH Terms

Arthroplasty
Axis, Cervical Vertebra
Knee
Lower Extremity
Statistics as Topic
Weight-Bearing

Reference

1. Perlick L, Bäthis H, Perlick C, Lüring C, Tingart M, Grifka J. Revision total knee arthroplasty: a comparison of postoperative leg alignment after computer-assisted implantation versus the conventional technique. Knee surg sports Traumatol Arthrosc. 2005. 13:167–173.
Article
2. Choi CH, Kang SK, Lee BK, Chung HK. The results of revision total knee replacement arthroplasty. J Korean Knee Soc. 2004. 16:51–58.
3. Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res. 2005. 433:152–159.
Article
4. Choong PF, Dowsey MM, Stoney JD. Does accurate anatomical alignment result in better function and quality of life? Comparing conventional and computer-assisted total knee arthroplasty. J Arthroplasty. 2009. 24:560–569.
Article
5. Andriacchi TP. Biomechanics and gait analysis in total knee replacement. Orthop Rev. 1988. 17:470–473.
6. Bai B, Baez J, Testa N, Kummer FJ. Effect of posterior cut angle on tibial component loading. J Arthroplasty. 2000. 15:916–920.
Article
7. Laskin RS. Total knee arthroplasty using an uncemented, polyethylene tibial implant. A seven-year follow-up study. Clin Orthop Relat Res. 1993. 288:270–276.
Article
8. Matsuda S, Miura H, Nagamine R, et al. Posterior tibial slope in the normal and varus knee. Am J Knee Surg. 1999. 12:165–168.
9. Mihalko WM, Krackow KA. Posterior cruciate ligament effects on the flexion space in total knee arthroplasty. Clin Orthop Relat Res. 1999. 360:243–250.
Article
10. Dorr LD, Boiardo RA. Technical considerations in total knee arthroplasty. Clin Orthop Relat Res. 1986. 205:5–11.
Article
11. Ritter MA, Gioe TJ, Stringer EA, Littrell D. The posterior cruciate condylar total knee prosthesis. A five-year follow-up study. Clin Orthop Relat Res. 1984. 184:264–269.
12. Hofmann AA, Bachus KN, Wyatt RW. Effect of the tibial cut on subsidence following total knee arthroplasty. Clin Orthop Relat Res. 1991. 269:63–69.
Article
13. Kilgus DJ, Moreland JR, Finerman GA, Funahashi TT, Tipton JS. Catastrophic wear of tibial po-lyethylene inserts. Clin Orthop Relat Res. 1991. 273:223–231.
Article
14. Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991. 73:709–714.
Article
15. Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br. 2004. 86:682–687.
16. Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S. Alignment and clinical result in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2006. 457:156–162.
17. Mullaji A, Kanna R, Marawar S, Kohli A, Sharma A. Comparison of limb and component alignment using computer assisted navigation versus image intensifier-guided conventional total knee arthroplasty: a prospective, randomized, singlesurgeon study of 467 knees. J Arthroplasty. 2007. 22:953–959.
18. Saragaglia D, Picard F, Chaussard C, Montbarbon E, Leitner F, Cinquin P. Computer-assisted knee arthroplasty: comparison with a conventional procedure. Result of 50 cases in a prospective randomized study. Rev Chir Orthop Reparatrice Appar Mot. 2001. 87:18–28.
19. Seon JK, Song EK. The accuracy of lower extremity alignment in a total knee arthroplasty using computer-assisted navigation system. J Korean Orthop Assoc. 2004. 39:566–571.
Article
20. Stulberg SD, Loan P, Sarin V. Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am. 2002. 84:Suppl. 90–98.
21. Rand JA, Coventry MB. Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop Relat Res. 1998. 232:168–173.
Article
22. Bae DK, Yoon KH, Kim SG, Park KJ. Efficacy of computer assisted surgery in revision total knee arthroplasty. J Korean Orthop Assoc. 2006. 41:974–980.
Article
Full Text Links
  • JKOA
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr