Computer assisted versus conventional cemented total knee prostheses alignment accuracy and micromotion of the tibial component

Strien, Thisbe van; Zwaag, E. van der Linden-van der; Kaptein, Bart L; Erkel, A. van; Valstar, Edward R.; Nelissen, Rob G H H

doi:10.1007/s00264-008-0642-8

Cited by 28 publications

(28 citation statements)

References 29 publications

(39 reference statements)

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“…Although many studies have confirmed this theory [1,3,9,24,39], others have shown that there is no difference in orientation or alignment of the femoral or tibial components than that achieved by conventional methods [12,22,23,42]. When evaluating the published reports on navigation knee arthroplasty, two important factors limit comparisons among clinical series.…”

Section: Alignmentmentioning

confidence: 87%

Navigation knee replacement

Dattani

Patnaik

Kantak

et al. 2008

International Orthopaedics (SICO

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Total knee replacement (TKR) achieves an immediate and exceptional restoration in the quality of life that is comparable only to a few other procedures. It has been suggested that the most common cause of revision TKR is error in surgical technique, from malpositioning of the components which results in a poorer post-operative outcome. Based on the theoretical assumption that the use of computer-assisted systems (CAS) in TKRs may improve implant alignment and thus implant longevity, the use of this technology is becoming increasingly popular. This article (a) reviews whether computer-assisted TKR (CASTKR) results in improved prosthesis alignment compared with the conventional technique, (b) assesses the functional and clinical outcomes of CASTKR and (c) evaluates the cost-effectiveness of using this technology.Résumé La prothèse totale du genou (TKR) permet de restaurer une qualité de vie comparable à peu d'autres techniques. Il est courant de penser que la cause la plus habituelle de reprise des prothèses du genou est secondaire à une erreur technique du fait d'un mauvais positionnement des composants. Sur le plan théorique, l'utilisation de la navigation (CAS) permet d'améliorer l'alignement des implants et donc la longévité de la prothèse. Cette technique devenant de plus en plus populaire. Cet article permet d'analyser les résultats en fonction de l'utilisation de la navigation comparée à une technique conventionnelle, avec évaluation clinique, fonctionnelle (CATKR) ainsi que le rapport coût/utilité de cette technique.

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Section: Alignmentmentioning

confidence: 87%

Navigation knee replacement

Dattani

Patnaik

Kantak

et al. 2008

International Orthopaedics (SICO

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“…In a former study by Van Strien et al [31], the CAOS system was evaluated using postoperative radiographs and CT scans as well as RSA. The protocol was approved by the institutional medical ethics committee.…”

Section: Methodsmentioning

confidence: 99%

A computed tomography based study on rotational alignment accuracy of the femoral component in total knee arthroplasty using computer-assisted orthopaedic surgery

Zwaag

Bos

Heide

et al. 2010

International Orthopaedics (SICOT)

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Rotation of the femoral component in total knee arthroplasty (TKA) is of high importance in respect of the balancing of the knee and the patellofemoral joint. Though it is shown that computer assisted surgery (CAOS) improves the anteroposterior (AP) alignment in TKA, it is still unknown whether navigation helps in finding the accurate rotation or even improving rotation. Therefore the aim of our study was to evaluate the postoperative femoral component rotation on computed tomography (CT) with the intraoperative data of the navigation system. In 20 navigated TKAs the difference between the intraoperative stored rotation data of the femoral component and the postoperative rotation on CT was measured using the condylar twist angle (CTA). This is the angle between the epicondylar axis and the posterior condylar axis. Statistical analysis consisted of the intraclass correlation coefficient (ICC) and Bland-Altman plot. The mean intraoperative rotation CTA based on CAOS was 3.5° (range 2.4–8.6°). The postoperative CT scan showed a mean CTA of 4.0° (1.7–7.2). The ICC between the two observers was 0.81, and within observers this was 0.84 and 0.82, respectively. However, the ICC of the CAOS CTA versus the postoperative CT CTA was only 0.38. Though CAOS is being used for optimising the position of a TKA, this study shows that the (virtual) individual rotational position of the femoral component using a CAOS system is significantly different from the position on a postoperative CT scan.

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“…The number of total knee arthroplasties (TKAs) performed worldwide is growing considerably, and for the past few years new computer-assisted navigation systems have been developed to help orthopaedic surgeons achieve more accurate prosthetic alignment [1][2][3][4][5]. The PLEOS knee system (Tornier®, Saint-Ismier, France) is image-free and creates the mechanical axis of the femur for femoral component positioning using the "rotational method" [6,7].…”

Section: Introductionmentioning

confidence: 99%