Computer Assisted Knee Replacement

Delp, Scott L.; Stulberg, S. David; Davies, Bob; Picard, F.; Leitner, Florian

doi:10.1097/00003086-199809000-00007

Cited by 321 publications

(152 citation statements)

References 12 publications

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“…These demands indicated the need to devise computeraided knee prosthesis navigation systems [4,12], which have become more and more sophisticated ever since. First CT navigated systems were created, but they had the disadvantage of necessitating pre-and postoperative CT imaging.…”

Section: Discussionmentioning

confidence: 99%

Experiences with computer navigated total knee arthroplasty

Bejek

Sólyom

Szabó

2006

International Orthopaedics (SICO

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The successful outcome of total knee arthroplasty (TKA) is very much dependent on precise positioning of the components. Inaccuracy may result in complaints as well as in early mechanical failure. Between March 2003 and September 2005, 69 TKA procedures were performed by the computer navigated technique. The postoperative outcome of this cohort was compared with the same number of TKAs done by the traditional technique. The lower limb anatomical axis was determined in all cases preand postoperatively by weight-bearing anteroposterior (AP) and lateral full length X-rays. The positions of femoral and tibial components were recorded. Comparing the data in the navigation group on the AP view, 96.6% of femoral and 96.9% of tibial components and on the lateral view in 95.4% of femoral and in 95.4% of tibial components, the overall postoperative axis in 95.4% fell in the range considered in the literature as optimal. In the traditional group on the AP view, 75.7% of femoral and 68.1% of tibial components and on the lateral view 81.8% of femoral and 63.6% of tibial components, the overall postoperative axis in 60.6% fell between the values considered optimal in the literature. It seems to be proven that the computer navigated total knee arthroplasty technique ensures positioning of components significantly more precisely compared with the traditional surgical method. Accuracy of navigation depends on the software used, on the correct detection of anatomical reference points, and on a potentially uneven thickness of the cement layer during final insertion of the components. The computer navigated technique does not substitute professional skill and experience, since it merely transmits information for the surgeon. The decision is in the hands of the doctor during the entire procedure. The real benefits of the computer navigated technique require further research and can be determined only after long-term analyses. Résumé Le succés de l'arthroplastie totale de genou dépend beaucoup du positionnement des implants. Entre mars 2003 et septembre 2005, 69 athroplasties étaient réalisées avec une technique de navigation informatique. Le devenir de ce groupe était comparé avec le même nombre d'arthroplasties faites avec la technique traditionnelle. L'axe anatomique du membre inférieur était déterminé par des radiographies antéro-postérieures en charge et de profil en extension. Dans le groupe navigué, la position des implants était optimale sur les radio de face pour 96,6% des pièces fémorales, 96,9% des pièces tibiales, sur les radio de profil pour 95,4% des pièces fémorales et tibiales, avec un bon axe dans 95,4% des cas. Dans le groupe traditionnel, les chiffres étaient: 75,7% pour les pièces fémorales, 68,1% pour les pièces tibiales sur les radio de face et 81,8% pour les pièces fémorales, 63,6% pour les pièces tibiales sur les radio de profil avec un bon axe dans 60,6% des cas. Il semble prouvé que l'utilisation de la navigation informatique permette un meilleur positionnement des implants que la méthode convention...

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Section: Discussionmentioning

confidence: 99%

Experiences with computer navigated total knee arthroplasty

Bejek

Sólyom

Szabó

2006

International Orthopaedics (SICO

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“…Currently, navigation systems often use CT data to navigate pedicle screw applications [1,11,17], cup placements for hip arthroplasties [16], TKAs [8,19], and cruciate ligament reconstructions [9,23]. Excising bone tumors is sometimes difficult even for an experienced surgeon because the extent and anatomic location of the tumors are variable and cannot be detected by ordinary radiography or fluoroscopy [15,30].…”

Section: Introductionmentioning

confidence: 99%

Navigation-assisted Surgery for Bone and Soft Tissue Tumors With Bony Extension

Ieguchi

Hoshi

Takada

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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“…Research has repeatedly shown that using navigation results in more accurate and more consistent implant positioning and restoration of the mechanical axis [1][2][3], both key factors in determining the long-term performance of the prosthesis [4][5][6][7][8]. These encouraging results have led to an increasing number of orthopaedic surgeons using the technology in their practice.…”

Section: Introductionmentioning

confidence: 99%

Computer navigated total knee arthroplasty: The learning curve

Smith

Deakin

Baines

et al. 2010

Computer Aided Surgery

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The learning curve for computer navigated total knee arthroplasty (TKA) is not well defined. We collected data prospectively on a consultant surgeon's first 50 navigated TKAs. Over the same period, matching data was taken from 50 consecutive cases performed by an expert who has performed over 1000 navigated TKAs. From the first case, the novice navigator was able to achieve the same standard as the expert in terms of post-implant mechanical alignment in the coronal and sagittal planes. Equally, at 6 weeks and one year post-surgery there was no significant difference in the mean Oxford score, mechanical axis and range of movement for the two groups of patients. Operative time was significantly longer for the novice surgeon in the first 20 cases (92 versus 73 min, p < 0.001), but by the final 20 cases there was no difference (72 versus 74 min, p ¼ 0.944). This study shows that the learning curve for navigated TKA is approximately 20 cases and that a beginner can reproduce the results of an expert from the outset.

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Computer Assisted Knee Replacement

Cited by 321 publications

References 12 publications

Experiences with computer navigated total knee arthroplasty

Experiences with computer navigated total knee arthroplasty

Navigation-assisted Surgery for Bone and Soft Tissue Tumors With Bony Extension

Computer navigated total knee arthroplasty: The learning curve

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