P u rp o s e :To compare the radiologic measurements of the mechanical axis and the implant position of Total Knee Arthroplasty (TKA) using a computer-assisted navigation system with those using conventional TKA in varus deformity. M a te ria ls a n d M e th o d s : From January 2004 to January 2005, 49 TKAs using a CT-free navigation system (Vector Vision Ⓡ , BrainLab, Heirnstetten, Germany) (Group I) and 24 TKAs using the conventional technique (Group II) were performed on patients who had a preoperative varus deformity>10 o . The patients were also subdivided into two groups, patients with a varus deformity<20 o (group A) and patients with varus deformity>20° (group B). The PFC Sigma implants were used in both groups. The mechanical axis and implant position were measured by 2 observers according to the reontgenographic evaluation system of the American Knee Society. R e s u lts : There was no significant difference in α, β, δ angle and mechanical axis between group I and II. There was a significant difference in the γ angle between group I and II (p<0.05). There was a significant difference in the α and β angle and mechanical axis between group IA and IB (p<0.05). There was a significant difference in the α angle and mechanical axis between group IIA and IIB (p<0.05). There was a positive correlation between the measured angle by the respective observers in all groups (p<0.05). C o n c lu s io n : Patients with a preoperative varus deformity>20 o tended to have more postoperative varus mechanical alignment than those with a preoperative varus deformity between 10 o and 20 o after TKA. M ore careful attention during the registration of the femoral mechanical axis should be paid in patients with a larger varus deformity in TKA using a computer-assisted navigation system. O n the other hand, a reasonable mechanical valgus angle should be considered in femoral bone cutting for a varus deformity of the distal femur in conventional TKA. In addition, inadequate positioning of intramedullary rod should be recognized in conventional TKA.K e y W o rd s : Knee, Varus deformity, Arthroplasty, C omputer-assisted navigation system, R adiologic measurements
Purpose:The current study reports the clinical results of total elbow arthroplasties (TEA) which were Performed on patients with poor clinical and radiological results after initial surgeries for elbow fractures or dislocations. Materials and Methods:The clinical outcomes of twelve consecutive patients who underwent TEA after failed surgeries for elbow fractures or dislocations from january, 1995 to December, 2005 were evaluated. The initial diagnoses were distal humeral fractures in 8 cases and fracture-dislocations in 4 cases. The Mean period from the initial operations to the TEAs was 12 months. The mean folloow up period after TEA was 43 months. Results: The mean range of motion, in terms of active extension, activeflexion, supination, and pronation, improved from 14. 2� , 96.7� , 50.8�and 53.3�to 5.4� , 122.1� , 63.3�and 67.5� , respectively (p<0.05).RAdiolucent lines were found in 3 cases, which were 1 case of type 3, and 2 cases of type 4. All three loosening cases underwent revision TEAs. The mean postoperative Mayo elvow performance score was 79 point. There were 6 cases of excellent, 2 cases of good, and 4 cases in poor. Conclusion: Good clinical results were obtained after TEA performed in failed surgeries for elbow fractures of dislocations.
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