Computer-Assisted Minimally Invasive Total Knee Arthroplasty Compared with Standard Total Knee Arthroplasty

Dutton, Andrew Quoc; Yeo, Seng-Jin; Yang, Kuang-Ying; Lo, Ngai-Nung; Chia, K. B.; Chong, Hwei Chi

doi:10.2106/jbjs.f.01148

Cited by 151 publications

(83 citation statements)

References 17 publications

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“…Repeated prudent examination of the position of instruments and cut surface is important to avoid outliers. Computer-assisted navigation systems are promising for increasing the precision of implanting prostheses during TKAs, but the navigation procedure further extends surgery time [3,5,6,12,42].…”

Section: Total (95% Ci)mentioning

confidence: 99%

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

Cheng

Liu

Zhang

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Concerns have been raised regarding minimally invasive surgery (MIS) and its possible effect on postoperative functional recovery, complications, and survival rate after TKA. Questions/purposes We specifically asked whether MIS TKA would be associated with (1) increased operative time, (2) reduced blood loss, (3) shortened hospital stay, (4) faster recovery of ROM, (5) higher knee scores, (6) inferior component positioning, and (7) increased complications. Methods We performed a systematic literature search of randomized controlled trials between minimally invasive and standard approaches in TKA that compared operative time, blood loss, ROM, knee scores, component positioning, and complications. We conducted a systematic review and meta-analysis of 13 trials published from 2007 to 2009 of MIS versus standard TKA.

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Section: Total (95% Ci)mentioning

confidence: 99%

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

Cheng

Liu

Zhang

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Numerous studies report use of a computer-assisted navigation system limits the prevalence of outlier values of limb and/or implant alignment measurements in the coronal plane [2,5,8,9,12,14,21,30,32,37]. Whether the same benefits are realized in the sagittal plane when a surgical navigation system is used is unclear [2, 6-8, 12, 18, 32].…”

Section: Introductionmentioning

confidence: 99%

Differences between Sagittal Femoral Mechanical and Distal Reference Axes Should Be Considered in Navigated TKA

Chung

Kang

Chang

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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In computer-assisted TKA, surgeons determine positioning of the femoral component in the sagittal plane based on the sagittal mechanical axis identified by the navigation system. We hypothesized mechanical and distal femoral axes may differ on lateral views and these variations are influenced by anteroposterior bowing and length of the femur. We measured angles between the mechanical axis and distal femoral axis on 200 true lateral radiographs of the whole femur from 100 adults. We used multivariate linear regression to identify predictors of differences between the axes. Depending on the method used to define the two axes, the mean angular difference between the axes was as much as 3.8°and as little as 0.0°, with standard differences ranging from 1.7°to 1.9°. Variation between the two axes increased with increased femoral bowing and increased femoral length. Surgeons should consider differences between the mechanical axes and distal femoral axes when they set the sagittal plane position of a femoral component in navigated cases. Our findings also may be relevant when measuring rotation of the femoral component in the sagittal plane from postoperative radiographs or when interpreting femoral component sagittal rotation results reported in other studies.

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“…Computer-based implantation systems, such as image-based or image-free systems, signifi cantly improve the femoral prostheses alignment [3,5,19,32,43,51,52,70] . These systems are also qualifi ed for minimally invasive interventions [17] and special cases with strong deformities [35] . However, the high costs for the instruments, the tracking system and necessary disposables [12,36] are major drawbacks of these technical approaches.…”

Section: Mechanical Axismentioning

confidence: 99%

A new approach to implant alignment and ligament balancing in total knee arthroplasty focussing on joint loads

Zimmermann

Schwenninger

Nolten

et al. 2012

Biomedizinische Technik/Biomedical Engineering

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Preservation and recovery of the mechanical leg axis as well as good rotational alignment of the prosthesis components and well-balanced ligaments are essential for the longevity of total knee arthroplasty (TKA). In the framework of the OrthoMIT project, the genALIGN system, a new navigated implantation approach based on intra-operative force-torque measurements, has been developed. With this system, optical or magnetic position tracking as well as any fi xation of invasive rigid bodies are no longer necessary. For the alignment of the femoral component along the mechanical axis, a sensorintegrated instrument measures the torques resulting from the deviation between the instrument ' s axis and the mechanical axis under manually applied axial compression load. When both axes are coaxial, the resulting torques equal zero, and the tool axis can be fi xed with respect to the bone. For ligament balancing and rotational alignment of the femoral component, the genALIGN system comprises a sensor-integrated tibial trial inlay measuring the amplitude and application points of the forces transferred between femur and tibia. Hereby, the impact of ligament tensions on knee joint loads can be determined over the whole range of motion. First studies with the genALIGN system, including a comparison with an imageless navigation system, show the feasibility of the concept.

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Computer-Assisted Minimally Invasive Total Knee Arthroplasty Compared with Standard Total Knee Arthroplasty

Cited by 151 publications

References 17 publications

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

Does Minimally Invasive Surgery Improve Short-term Recovery in Total Knee Arthroplasty?

Differences between Sagittal Femoral Mechanical and Distal Reference Axes Should Be Considered in Navigated TKA

A new approach to implant alignment and ligament balancing in total knee arthroplasty focussing on joint loads

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