Measurement of rotational and coronal alignment in total knee arthroplasty using a navigation system is reproducible

2016 ◽  
Vol 136 (2) ◽  
pp. 271-276 ◽  
Author(s):  
Keizo Wada ◽  
Hiroshi Mikami ◽  
Daisuke Hamada ◽  
Hiroshi Yonezu ◽  
Koichi Oba ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Coronal Alignment ◽  
Total Knee

The Adjustment of the Rotational Alignment of the Distal End of the Extramedullary Guide to the Anteroposterior Axis of the Proximal Tibia in Total Knee Arthroplasty

2021 ◽  
Author(s):  
Hideki Mizu-uchi ◽  
Hidehiko Kido ◽  
Tomonao Chikama ◽  
Kenta Kamo ◽  
Satoshi Kido ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Proximal Tibia ◽  
Rotational Alignment ◽  
Coronal Alignment ◽  
Ideal Position ◽  
Total Knee ◽  
Alignment Guide ◽  
The Ideal

AbstractThe optimal placement within 3 degrees in coronal alignment was reportedly achieved in only 60 to 80% of patients when using an extramedullary alignment guide for the tibial side in total knee arthroplasty (TKA). This probably occurs because the extramedullary alignment guide is easily affected by the position of the ankle joint which is difficult to define by tibial torsion. Rotational direction of distal end of the extramedullary guide should be aligned to the anteroposterior (AP) axis of the proximal tibia to acquire optimal coronal alignment in the computer simulation studies; however, its efficacy has not been proven in a clinical setting. The distal end of the guide can be overly displaced from the ideal position when using a conventional guide system despite the alignment of the AP axis to the proximal tibia. This study investigated the effect of displacement of the distal end of extramedullary guide relative to the tibial coronal alignment while adjusting the rotational alignment of the distal end to the AP axis of the proximal tibia in TKA. A total of 50 TKAs performed in 50 varus osteoarthritic knees using an image-free navigation system were included in this study. The rotational alignment of the proximal side of the guide was adjusted to the AP axis of the proximal tibia. The position of the distal end of the guide was aligned to the center of the ankle joint as viewed from the proximal AP axis (ideal position) and as determined by the navigation system. The tibial intraoperative coronal alignments were recorded as the distal end was moved from the ideal position at 3-mm intervals. The intraoperative alignments were 0.5, 0.9, and 1.4 degrees in valgus alignment with 3-, 6-, and 9-mm medial displacements, respectively. The intraoperative alignments were 0.7, 1.2, and 1.7 degrees in varus alignment with 3-, 6-, and 9-mm lateral displacements, respectively. In conclusion, the acceptable tibial coronal alignment (within 2 degrees from the optimal alignment) can be achieved, although some displacement of the distal end from the ideal position can occur after the rotational alignment of the distal end of the guide is adjusted to the AP axis of the proximal tibia.

Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty

2019 ◽  
Author(s):  
Masanori Tsubosaka ◽  
Tomoyuki Kamenaga ◽  
Yuichi Kuroda ◽  
Koji Takayama ◽  
Shingo Hashimoto ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Slope Angle ◽  
Posterior Slope ◽  
Tibial Bone ◽  
Significant Difference ◽  
Portable Navigation ◽  
Total Knee

AbstractSeveral studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.

Changes in the Functional Flexion Axis of the Knee Before and After Total Knee Arthroplasty Using a Navigation System

2014 ◽  
Vol 29 (7) ◽  
pp. 1388-1393 ◽  
Author(s):  
David A.J. Wilson ◽  
Janie L. Astephen Wilson ◽  
Glen Richardson ◽  
Michael J. Dunbar
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Before And After ◽  
Total Knee

scholarly journals Custom total knee arthroplasty facilitates restoration of constitutional coronal alignment

2020 ◽  
Author(s):  
Michel P. Bonnin ◽  
Lucas Beckers ◽  
Augustin Leon ◽  
Jules Chauveau ◽  
Jacobus H. Müller ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Coronal Alignment ◽  
Total Knee
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