scholarly journals Postoperative radiologic outcome comparison between conventional and computer-assisted navigation total knee arthroplasty in extra-articular tibia vara

2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090570 ◽  
Author(s):  
Yongun Cho ◽  
Hun-Kyu Shin ◽  
Eugene Kim ◽  
Jai Hyung Park ◽  
Se-Jin Park ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Lower Extremity ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Computer Assisted ◽  
Tibia Vara ◽  
Assisted Navigation ◽  
Significant Difference ◽  
Outcome Comparison ◽  
Total Knee

Purpose: Total knee arthroplasty (TKA) is the definite treatment for osteoarthritis. Meanwhile, significant inherent extra-articular varus angulation is associated with abnormal postoperative hip–knee–ankle (HKA) angle. Computer-assisted navigation TKA (CAS-TKA) used in patients who have severe varus deformity. The purpose of this study was to compare postoperative radiologic outcome between CAS-TKA and conventional TKA for extra-articular tibia vara. Methods: A retrospective review of postoperative HKA on standing lower extremity views was conducted in patients who underwent TKA by a single surgeon from 2010 to 2018, including knee with conventional TKA ( n = 83) and CAS-TKA ( n = 246). Extra-articular tibia vara was assessed by measuring the metaphyseal–diaphyseal angle (MDA) of the tibia in preoperative standing lower extremity view. Postoperative alignment was assessed by measuring the HKA in postoperative standing lower extremity view. Results: There was no significant difference in age ( p = 0.063), gender ( p = 0.628), body mass index ( p = 0.426), preoperative range of motion ( p = 0.524), preoperative HKA ( p = 0.306), preoperative MDA ( p = 0.523), or postoperative HKA ( p = 0.416) between the two groups (conventional TKA and CAS-TKA). There was no significant difference in postoperative alignment for cases with MDA ≤4° ( p = 0.351) or MDA >4° ( p = 0.866) in each group. There was a positive correlation between preoperative HKA and postoperative HKA in the CAS-TKA group ( p < 0.001, r = 0.243). However, there was no significant correlation between preoperative HKA and postoperative HKA in the conventional TKA group ( p = 0.732). Conclusions: There was no significant difference in postoperative alignment between conventional TKA and CAS-TKA in extra-articular tibial vara even for cases with MDA >4°.

Ligament balancing in computer-assisted total knee arthroplasty: Improved clinical results with a spring-loaded tensioning device

2007 ◽  
Vol 221 (7) ◽  
pp. 755-761 ◽  
Author(s):  
M Swank ◽  
J R Romanowski ◽  
L L Korbee ◽  
S Bignozzi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Clinical Results ◽  
Computer Assisted ◽  
Knee Ligament ◽  
Assisted Navigation ◽  
Knee Mechanics ◽  
Computer Assistance ◽  
Significant Difference ◽  
Total Knee

Total knee arthroplasty (TKA) remains one of the most successful procedures in orthopaedic surgery. Complications certainly exist and are often related to failure of knee ligament balance. This asymmetry subsequently leads to component mal-alignment and loosening often secondary to deviation of the lower extremity mechanical axis. Understanding knee mechanics is essential, and recent technological advances have begun to minimize postoperative problems. A tensioning device that respects the native patellofemoral anatomy as well as the natural ligamentous strains has been developed. The surgical integration of computer-assisted navigation has allowed for enhanced accuracy and subsequently better results. The purpose of the current paper is to discuss the evolution of an improved ligament tensioning device, in the setting of classic mechanical guidance versus computer assistance and its postoperative impact on total knee outcomes in terms of manipulation rates and two-year radiographic alignment data. Based on a single surgeon series, mechanically guided arthroplasties resulted in a 16 per cent manipulation rate. Computer assistance with spacer blocks decreased the manipulation rate to 14 per cent, while using a novel tensioner device further decreased the manipulation rate to 7 per cent, a significant difference of p <0.01. Radiographic data illustrate all TKAs with the tensioner to be within 4° of the desired position.

scholarly journals NAVIGATED TOTAL KNEE ARTHROPLASTY FOR OSTEOARTHRITIS WITH EXTRA-ARTICULAR DEFORMITY

2018 ◽  
Vol 26 (3) ◽  
pp. 170-174 ◽  
Author(s):  
IZUMI TANI ◽  
NAOKI NAKANO ◽  
KOJI TAKAYAMA ◽  
KAZUNARI ISHIDA ◽  
RYOSUKE KURODA ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Case Series ◽  
Computer Assisted ◽  
Level Of Evidence ◽  
Assisted Navigation ◽  
Radiographic Outcomes ◽  
Navigation Group ◽  
Significant Difference ◽  
Total Knee

ABSTRACT Objective It is difficult to achieve proper alignment after total knee arthroplasty (TKA) in patients with extra-articular deformity (EAD) because of altered anatomical axis and distorted landmarks. As of this writing, only case series have been reported with regard to the usefulness of computer-assisted navigation systems for TKA with EAD. This study therefore compared outcomes in TKA with EAD, with and without navigation. Methods Fourteen osteoarthritis patients with EAD due to previous fracture malunion or operations were assessed. Seven TKAs were performed with navigation (navigation group) and another 7 were performed without navigation (manual group). Clinical and radiographic outcomes were compared before and two years after surgery. Results The mean postoperative Knee Society function score was significantly higher in the navigation group. No significant difference was found in postoperative range of motion and Knee Society knee score. The rate of outliers in radiographic outcomes tended to be lower in the navigation group. Conclusion Better clinical outcomes were achieved in cases in which navigation was used. Computer-assisted navigation is useful in TKA for patients with EAD. Level of Evidence III; Case control study.

scholarly journals Comparison of Total Knee Arthroplasty Using Computer-Assisted Navigation versus Conventional Guiding Systems: A Prospective Study

2009 ◽  
Vol 17 (2) ◽  
pp. 170-173 ◽  
Author(s):  
CH Pang ◽  
WL Chan ◽  
CH Yen ◽  
SC Cheng ◽  
SB Woo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Varus Deformity ◽  
Osteoarthritis Of The Knee ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Alignment Correction ◽  
Total Knee ◽  
A Prospective Study

Purpose. To compare knee alignments in total knee arthroplasty (TKA) using computer-assisted navigation versus conventional guiding systems. Methods. Five men and 49 women aged 49 to 79 years underwent TKA for primary osteoarthritis of the knee with varus deformity. All valgus knees were associated with inflammatory arthritis and thus excluded. Computer-assisted navigation was used for the first 35 TKAs, whereas conventional extramedullary tibial and intramedullary femoral guiding systems were used for the next 35 TKAs. The mechanical axis, coronal tibial and femoral angles, sagittal tibial and femoral angles in the 2 groups were compared. Results. Sagittal tibial and femoral angles aligned more optimally in TKAs using computer-assisted navigation. In the respective computer-assisted navigation and conventional guiding systems, 33 (94%) and 26 (74%) of the TKAs attained a postoperative mechanical axis of <3° varus/valgus. Conclusion. Computer-assisted navigation gives a more consistent alignment correction and reduces outliers during implant positioning.

scholarly journals Acquisition of coronal alignment according to the degree of varus deformity in total knee arthroplasty using computer-assisted navigation

2020 ◽  
Vol 28 (2) ◽  
pp. 230949902092626 ◽  
Author(s):  
Suk Kyoon Song ◽  
Myung Rae Cho ◽  
Seo Ho Lee ◽  
Hee Chan Kim ◽  
Dae won Kang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Occurrence Rate ◽  
Computer Assisted ◽  
Coronal Alignment ◽  
Assisted Navigation ◽  
Total Knee ◽  
Group 2 ◽  
Group 1

Purpose: We have analyzed the surgical outcomes of primary total knee arthroplasty (TKA) using computer-assisted navigation that were performed by a single surgeon in terms of postoperative coronal alignment depending on preoperative varus deformity. Methods: We conducted a retrospective study of patients who have undergone navigated primary TKA from January 2016 through December 2019. Two hundred and fifty-six cases with varus deformity of 10° or less were assigned to group 1, and 216 cases with varus deformity of more than 10° were assigned to group 2. The postoperative mechanical hip–knee–ankle (mHKA) angle was measured from scanograms which were taken preoperatively and 3 months after surgery. The postoperative mHKA angle was targeted to be 0°, and the appropriate range of coronal alignment was set as 0 ± 3°. Results: The Pearson correlation showed a significant correlation with the degree of preoperative varus deformity and with the absolute error of postoperative mHKA ( p = 0.01). Among all patients, 64 cases (13.6%) were detected as outliers (mHKA > 0° ± 3°) at 3 months after surgery. Of the 64 cases, 25 cases (9.8%) were affiliated to group 1 and 39 cases (18.1%) were affiliated to group 2. Group 2 showed significantly higher occurrence of outliers than group 1 ( p = 0.01). Multiple variables logistic regression analysis, which analyzed the difference in the occurrence rate of outliers (mHKA > 0° ± 3°), showed that the occurrence rate of group 2 was 2.04 times higher than group 1. After adjusting for patient’s age, gender, and body mass index, the occurrence rate of outliers in group 2 was 2.01 times higher than group 1. Conclusion: The benefit of computer-assisted navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative varus deformity is severely advanced.

Is Standing Coronal Long-Leg Alignment View Effective in Predicting the Extent of Medial Soft Tissue Release in Varus Deformity during Total Knee Arthroplasty?

2021 ◽  
Author(s):  
Mohammadreza Minator Sajjadi ◽  
Mohammad Ali Okhovatpour ◽  
Yaser Safaei ◽  
Behrooz Faramarzi ◽  
Reza Zandi
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Arthroplasty ◽  
Varus Deformity ◽  
Soft Tissue Release ◽  
Varus Knee ◽  
Significant Difference ◽  
Leg Alignment ◽  
Total Knee ◽  
Group 2

AbstractThe aim of this study was to assess the predictive value of the femoral intermechanical-anatomical angle (IMA), mechanical lateral distal femoral angle (mLDFA), medial proximal tibia angle (MPTA), femorotibial or varus angle (VA), and joint line convergence angle (CA) in predicting the stage of the medial collateral ligament (MCL) during total knee arthroplasty (TKA) of varus knee. We evaluated 229 patients with osteoarthritic varus knee who underwent primary TKA, prospectively. They were categorized in three groups based on the extent of medial soft tissue release that performed during TKA Group 1, osteophytes removal and release of the deep MCL and posteromedial capsule (stage 1); Group 2, the release of the semimembranosus (stage 2); and Group 3, release of the superficial MCL (stage 3) and/or the pes anserinus (stage 4). We evaluated the preoperative standing coronal hip-knee-ankle alignment view to assessing the possible correlations between the knee angles and extent of soft tissue release. A significant difference was observed between the three groups in terms of preoperative VA, CA, and MPTA by using the Kruskal–Wallis test. The extent of medial release increased with increasing VA and CA as well as decreasing MPTA in preoperative long-leg standing radiographs. Finally, a patient with a preoperative VA larger than 19, CA larger than 6, or MPTA smaller than 81 would need a stage 3 or 4 of MCL release. The overall results showed that the VA and MPTA could be useful in predicting the extent of medial soft tissue release during TKA of varus knee.

scholarly journals Reliability of Imageless Computer-Assisted Navigation for Femoral Rotational Alignment in Total Knee Arthroplasty

2021 ◽  
Vol 15 (1) ◽  
pp. 79-84
Author(s):  
Leelasestaporn C ◽  
Thuwapitchayanant M ◽  
Sirithanapipat P ◽  
Sa-ngasoongsong P ◽  
Ruengsilsuwit P
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Knee

scholarly journals Accuracy of femoral rotational alignment in total knee arthroplasty using computer assisted navigation

2008 ◽  
Vol 13 (3) ◽  
pp. 167-172 ◽  
Author(s):  
Camilo Restrepo ◽  
William J. Hozack ◽  
Fabio Orozco ◽  
Javad Parvizi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Rotational Alignment ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Total Knee

scholarly journals Robot-Assisted Navigation versus Computer-Assisted Navigation in Primary Total Knee Arthroplasty: Efficiency and Accuracy

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Tanner C. Clark ◽  
Frank H. Schmidt
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Secondary Outcome ◽  
Computer Assisted ◽  
Robot Assisted ◽  
Tourniquet Time ◽  
Assisted Navigation ◽  
Total Knee ◽  
Primary Total Knee

Background. Since the introduction of robot-assisted navigation in primary total knee arthroplasty (TKA), there has been little research conducted examining the efficiency and accuracy of the system compared to computer-assisted navigation systems. Objective. To compare the efficiency and accuracy of Praxim robot-assisted navigation (RAN) and Stryker computer-assisted navigation (CAN) in primary TKA. Methods. This was a retrospective study consisting of 52 patients who underwent primary TKA utilizing RAN and 29 patients utilizing CAN. The primary outcome measure was navigation time. Secondary outcome measures included intraoperative final mechanical axis alignment, intraoperative robot-assisted bone cut accuracy, tourniquet time, and hospitalization length. Results. RAN navigation times were, on average, 9.0 minutes shorter compared to CAN after adjustment. The average absolute intraoperative malalignment was 0.5° less in the RAN procedures compared to the CAN procedures after adjustment. Patients in the RAN group tended to be discharged 0.6 days earlier compared to patients in the CAN group after adjustment. Conclusions. Among patients undergoing TKA, there was decreased navigation time, decreased final malalignment, and decreased hospitalization length associated with the use of RAN when compared to CAN independent of age, BMI, and pre-replacement alignment.

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