Computer-assisted implantation of total knee prostheses: A case–control comparative study with classical instrumentation

Jenny, Jean–Yves; Boéri, Cyril

doi:10.1002/igs.10006.abs

Cited by 41 publications

(58 citation statements)

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“…The initial clinical results of using navigation systems in TKA have been encouraging [3,6,7,10,14]. Saragaglia [10] conducted a randomized study and reported that a satisfactory alignment in the coronal plane, defined as a mechanical axis between 3°varus and 3°valgus alignment, was observed more often with the navigation system than with the conventional procedure (84 versus 75%).…”

Section: Discussionmentioning

confidence: 99%

“…Saragaglia [10] conducted a randomized study and reported that a satisfactory alignment in the coronal plane, defined as a mechanical axis between 3°varus and 3°valgus alignment, was observed more often with the navigation system than with the conventional procedure (84 versus 75%). In a case-control study, Jenny et al [6] compared 60 prostheses implanted with the navigation system to 60 prostheses implanted using conventional instruments. In the navigation group, 53 prostheses were judged to have a satisfactory coronal plane alignment, whereas this was only the case for 43 of 60 in the conventional group (p<0.05).…”

Section: Discussionmentioning

confidence: 99%

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Prosthetic alignment and sizing in computer-assisted total knee arthroplasty

Matsumoto

Tsumura

Kurosaka

et al. 2004

International Orthopaedics (SICOT)

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We implanted 60 posterior stabilized total knee prostheses (P.F.C. Sigma, DePuy, Warsaw, USA). In 30 cases, we used a CT-free navigation system (Vector Vision, Brain LAB, Heimstetten, Germany), and in 30 matched-paired controls, we used a conventional manual implantation. We compared postoperative long-leg radiographs in the two groups. The results revealed a significant difference in favor of navigation. In addition, we compared the preoperative anteroposterior dimension of the femoral condyle with the postoperative value. While there were no significant differences in the preoperative anteroposterior dimension of the femoral condyle between the two groups, the postoperative value in the navigation group was significantly larger than that of the preoperative value. Therefore, surgeons using navigation systems should guard against the possibility of oversizing when determining the size of the femoral component.Résumé Nous avons implanté 60 prothèses totales postéro-stabilisées du genou (P.F.C. Sigma, DePuy). Dans 30 cas nous avons utilisé un système de navigation sans scanner (Vector vision R, Laboratoire du Cerveau, Heimstetten, Allemagne) et dans 30 contrôles appairés nous avons utilisé une implantation manuelle habituelle. Nous avons comparé les grandes radiographies postopératoires des membres inférieurs dans les deux groupes. Les résultats ont révélé une différence notable en faveur de la navigation. De plus nous avons comparé la dimension antéro-postérieure du condyle fémoral avant l'intervention avec la valeur postopératoire. Tandis qu'il n'y avait pas de différence notable dans la dimension antéro-postérieure préopératoire du condyle fémoral entre les deux groupes, la valeur postopératoire dans le groupe de la navigation était nettement plus grande que la valeur préopératoire. Par conséquent les chirurgiens qui utilisent des systèmes de navigation doivent prendre garde à ne pas implanter un composant fémoral sur-dimensionné.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prosthetic alignment and sizing in computer-assisted total knee arthroplasty

Matsumoto

Tsumura

Kurosaka

et al. 2004

International Orthopaedics (SICOT)

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“…Computer assisted surgical techniques have become popular for hip and knee arthroplasty, but similar developments for the shoulder are still in their infancy [10][11][12][13][14][15]. There is currently no established computer assisted method for shoulder replacement that has been fully developed for the accurate placement of the glenoid component based on preoperative images.…”

Section: Discussionmentioning

confidence: 99%

Design and development of a computer assisted glenoid implantation technique for shoulder replacement surgery

Nguyen

Ferreira

Brownhill

et al. 2007

Computer Aided Surgery

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Objective: Replacement of the diseased shoulder joint with implants is a procedure whose frequency is rapidly increasing. However, glenoid replacement remains challenging due to the difficult joint exposure and visualization of anatomical reference landmarks during the procedure. Improper positioning of the glenoid component can lead to early failure. The objective of this study was to develop and evaluate a Computer Assisted Glenoid Implantation (CAGI) technique to achieve a more accurate and reliable placement of the glenoid component. Materials and Methods: Twenty cadaveric scapulae were imaged with CT. The accuracy of an electromagnetic tracking system and 3D surface modeling for the measurement of glenoid position was compared to that of the standard CT-based method. Custom jigs were then developed to track instruments and to correct for scapular motion during in vitro trials. A standardized protocol for determining, in real time, the glenoid position and placement was developed and validated. Results: The version angles measured by the tracking system, CT, and the 3D modeling software were 0.0 AE 1.2 , -1.3 AE 1.0 , and -1.1 AE 1.1 , respectively. The magnitudes for inclination angles were 0.7 AE 0.7 , 0.9 AE 0.8 , and 1.0 AE 0.7 , respectively. A statistically significant difference was found only between measurements made with the tracking system and with CT (p < 0.05). Testing of the CAGI system in a cadaveric trial resulted in an accuracy of 1.17 of version and 0.60 of inclination. The procedure was readily performed with excellent feedback and guidance for the surgeon. Conclusions: Preoperative planning using CT imaging with 3D modeling and intraoperative tracking were combined to produce improved accuracy and reliability of glenoid implantation in the setting of total shoulder arthroplasty.

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“…Recently, navigation systems have been developed to improve the accuracy of component alignment in total knee arthroplasty (TKA), and the first follow-up results of computer-assisted TKA are promising [10,15]. To our knowledge, for computer-assisted UKR, only one study is available in the literature.…”

Section: Introductionmentioning

confidence: 99%

“…A major advantage of UKR is that it can be performed through a small incision that need not be extended into the quadriceps tendon [1,16]. Despite the favor of preserving undamaged soft tissue, the surgeon has a reduced overview and is in risk of component malpositioning [8].Recently, navigation systems have been developed to improve the accuracy of component alignment in total knee arthroplasty (TKA), and the first follow-up results of computer-assisted TKA are promising [10,15]. To our knowledge, for computer-assisted UKR, only one study is available in the literature.…”

mentioning

confidence: 99%

Minimally invasive unicompartmental knee replacement with a nonimage-based navigation system

Perlick

Bäthis

Tingart

et al. 2004

International Orthopaedics (SICOT)

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In a prospective study, two groups of 20 unicompartmental knee replacements (UKR) each were operated either using a CT-free navigation system or the conventional minimal invasive technique. Radiographic assessment of postoperative alignment was performed by long-leg coronal and lateral radiographs. The results revealed a significant difference between the two groups in favor of navigation. In the computer-assisted group, 95% of UKRs were in a range of 4-0 varus (mechanical axis) compared with 70% in the conventional group. The only inconvenience was a prolonged operation time (+19 min). Due to the limited exposure, the navigation system is helpful in achieving a more precise component orientation. The danger of overcorrection is diminished by real-time information about the leg axis at each step during the operation.RØsumØ Dans une Øtude prospective, deux groupes de 20 proth ses unicompartimentales de genou ont ØtØ opØrØs soit en utilisant un syst me de navigation sans scanner, soit par une technique mini-invasive habituelle. L'estimation de l'alignement postopØratoire a ØtØ faite avec des grandes radiographies frontales et sagittales coronales. Les rØsultats ont rØvØlØ une diffØrence notable entre les deux groupes en faveur de la navigation. Dans le groupe aidØ par ordinateur, 95% des cas Øtaient dans une gamme de 0 à 4 de varus comparØ à 70% dans le groupe conventionnel. Le seul inconvØnient Øtait un temps d'opØration prolongØ (+19 min). En raison de l'exposition limitØe, le syst me de navigation est utile pour donner une orientation plus prØcise aux implants. Le danger d'hypercorrection est diminuØ par l'information en temps rØel sur l'axe du membre à chaque temps de l'opØration. IntroductionIn several studies, excellent 10-year survivorships of unicompartmental knee replacement (UKR) have been reported [3,4,6]. A major advantage of UKR is that it can be performed through a small incision that need not be extended into the quadriceps tendon [1,16]. Despite the favor of preserving undamaged soft tissue, the surgeon has a reduced overview and is in risk of component malpositioning [8].Recently, navigation systems have been developed to improve the accuracy of component alignment in total knee arthroplasty (TKA), and the first follow-up results of computer-assisted TKA are promising [10,15]. To our knowledge, for computer-assisted UKR, only one study is available in the literature. Jenny et al. [12] reported superior results when using a navigation system in UKR compared with the standard procedure. There are only a few previous papers focussing on postoperative alignment after conventional UKR [11], especially when using a minimally invasive technique [8]. Fisher et al. reported significant differences of the postoperative leg alignment when comparing the results of minimally invasive versus open UKR [8].The aim of this prospective study was to analyze the accuracy of postoperative leg alignment and component orientation in minimally invasive, computer-assisted UKR when using a nonimage-based navigatio...

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Computer-assisted implantation of total knee prostheses: A case–control comparative study with classical instrumentation

Cited by 41 publications

References 0 publications

Prosthetic alignment and sizing in computer-assisted total knee arthroplasty

Prosthetic alignment and sizing in computer-assisted total knee arthroplasty

Design and development of a computer assisted glenoid implantation technique for shoulder replacement surgery

Minimally invasive unicompartmental knee replacement with a nonimage-based navigation system

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