scholarly journals The benefits of computer-assisted total knee arthroplasty on coronal alignment with marked femoral bowing in Asian patients

2014 ◽  
Vol 9 (1) ◽  
Author(s):  
Chien-Yin Lee ◽  
Shih-Jie Lin ◽  
Liang-Tseng Kuo ◽  
Kuo-Ti Peng ◽  
Kuo-Chin Huang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computer Assisted ◽  
Coronal Alignment ◽  
Asian Patients ◽  
Total Knee ◽  
Femoral Bowing

scholarly journals The advantage of navigation for knee with lateral femoral bowing in total knee arthroplasty

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902096567
Author(s):  
Jun Ho Nam ◽  
Suk-Kyoon Song ◽  
Myung-Rae Cho ◽  
Dae-Won Kang ◽  
Won-Kee Choi
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Occurrence Rate ◽  
Computer Assisted ◽  
Coronal Alignment ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Femoral Bowing ◽  
Group 1

Purpose: We have analyzed the surgical outcomes of primary total knee arthroplasty (TKA) using computer-assisted (CA) navigation in terms of postoperative coronal alignment depending on preoperative lateral femoral bowing. Methods: We conducted a retrospective study of patients who have undergone navigated primary TKA from January 2016 through January 2020. Two hundred and ninety-nine cases with lateral femoral bowing of 3° or less were assigned to group 1, 95 cases of lateral femoral bowing between 3° and 5° were assigned to group 2, and 89 cases with lateral femoral bowing of more than 5° were assigned to group 3. The postoperative mechanical hip–knee–ankle (mHKA) angle was measured from scanograms, which were taken 3 months after surgery. The appropriate range of coronal alignment was set as 0 ± 3°. Results: The number of outliers of mHKA occurred was 31 cases (10.4%) in group 1, 17 cases (17.9%) in group 2, and 17 cases (19.1%) in group 3. There was a significant correlation between the degree of lateral femoral bowing and the occurrence rate of mHKA outliers. Multiple variables logistic regression analysis showed occurrence rate of outliers in group 3 to be 2.04 times higher than group 1. After adjusting the patient’s age, sex, body mass index, and preoperative HKA deformity, the occurrence rate of outliers in group 3 was still 1.96 times higher than group 1. Conclusion: The benefit of CA navigation during TKA in obtaining coronal alignment within 0 ± 3° may be lessened when the preoperative lateral femoral bowing is severely advanced.

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.

scholarly journals Clinical Outcomes of First 100 Navigated Total Knee Arthroplasties at Duke University Medical Center

2014 ◽  
Vol 4 (1) ◽  
pp. 13-18
Author(s):  
Todd E Bertrand
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Medical Center ◽  
Coronal Plane ◽  
Computer Assisted ◽  
Coronal Alignment ◽  
Component Alignment ◽  
Duke University ◽  
Total Knee ◽  
Postoperative Knee

ABSTRACT Background Total knee arthroplasty (TKA) is one of the most clinically successful and cost-effective interventions in medicine. Implant malalignment can be a cause of early failure following total knee arthroplasty. Computer-assisted surgery has been employed to improve the precision of component alignment. Questions/purpose: We asked (1) What is the average coronal plane alignment of the first 100 patients undergoing computer-assisted total knee arthroplasty at our institution? (2) How do our clinical and radiographic results compare to those values reported in the literature? (3) Was a ‘learning curve’ present as evidenced by improvements in coronal plane alignment over time? Methods We retrospectively reviewed our first 100 patients undergoing computer navigated total knee arthroplasty. We calculated postoperative knee range of motion (ROM), coronal alignment as well as preoperative and postoperative Knee Society Scores. Minimum follow-up was 4.3 years (0.2-8.25 years). Results Of the 100 patients, average postoperative limb alignment was 0.9° varus compared to the mechanical axis. Seventy-nine percent of patients had coronal plane alignment of ±3°. Knee Society Scores improved on average from 60 preoperatively (52-67) to 85 postoperatively (56-97). Conclusion Computer-assisted total knee arthroplasty is potentially a way to improve component alignment and overall patient satisfaction. In our cohort, average coronal alignment was similar to literature reported values for navigated and conventional total knee arthroplasty. The benefit of this technology remains unproven. Level of evidence Level IV Bertrand TE, Bolognesi MP. Clinical Outcomes of First 100 Navigated Total Knee Arthroplasties at Duke University Medical Center. The Duke Orthop J 2014;4(1):13-18.

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.

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