Current state of the art in total knee arthroplasty computer navigation

Picard, F.; Deep, Kamal; Jenny, J.-Y.

doi:10.1007/s00167-016-4337-1

Cited by 33 publications

(19 citation statements)

References 60 publications

(61 reference statements)

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“…a cutting tool, to be guided into the matched anatomy. This model also works for image-free computer-assistance following intraoperative data collection and registration of the "surgeon-defined anatomy", which generates the therapeutic object [9,10].…”

Section: A Few Definitionsmentioning

confidence: 99%

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Computer assisted orthopaedic surgery: Past, present and future

Picard

Deakin

Riches

et al. 2019

Medical Engineering & Physics

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Computer technology is ubiquitous and relied upon in virtually all professional activities including neurosurgery which is why it is baffling that it is not the case for orthopaedic surgery with less than 5% of surgeon using available computer 2 technology in their surgeries. In this review, we explore the evolution and background of computer assisted orthopaedic surgery (CAOS) delving into the basic principles behind the technology and the changes in the discussion on the subject throughout the years and the impact these discussions had on the field. We found that industry had an important role in driving the discussion at least in knee arthroplasty a leading field of CAOS with the ratio between patents and publications increased from approximately 1:10 in 2004 to almost 1:3 in 2014. The adoption of CAOS is largely restrained by economics and ergonomics with sceptics challenging the accuracy and precision of navigation during the early years of CAOS moving to patient functional improvements and long term survivorship. Despite this, the future of CAOS remains positive with new technologies such as improvements in imageguided surgery, enhanced navigation systems, robotics and artificial intelligence.

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Section: A Few Definitionsmentioning

confidence: 99%

“…This registration process requires precalibrated tools, such as probe or pointer with various forms and designs all utilised to collect landmarks for the above registration modalities. [9] The surgical calibrated probe is to intra-operative registration, what the computer mouse is to the computer-assisted planning.…”

Section: General Principlesmentioning

confidence: 99%

Computer assisted orthopaedic surgery: Past, present and future

Picard

Deakin

Riches

et al. 2019

Medical Engineering & Physics

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“…CAS systems are classified into three main categories:13 Passive: the system assists the procedure under the direct control of the surgeon. For example, CAS is used to position the cutting blocks in the exact desired position, but the surgeon uses conventional instruments to make the bone cuts.…”

Section: Types Of Casmentioning

confidence: 99%

“…Two different modalities are also available for these systems:13 Image-based modality: this modality consists of three-dimensional constructs created using images obtained from preoperative CT or MRI.Image-free modality: This technology does not require any imaging. The patient’s anatomical landmarks are collected directly during surgery (figure 1) to create the patient-specific model.…”

Section: Types Of Casmentioning

confidence: 99%

New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

et al. 2018

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“…With recent advances in computerized navigation software, the quantitative measurement for soft tissue balancing and intraoperative identification of the mechanical axis under stress are available in real time. [13][14][15][16] Furthermore, navigation software allows for precise bone cutting and osteotomy with equal thickness to the implant and preservation of the physiological joint line. Because an appropriate thickness of the implant is compensated for the bone defect and cartilage loss in the medial compartment without changing the joint line by using this technology, it is possible to evaluate cases of varus deformity over 10 that Bellemans was unable to evaluate.…”

Section: Introductionmentioning

confidence: 99%

Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis

Toyooka

Masuda

Nishihara

et al. 2021

J Orthop Surg (Hong Kong)

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Purpose: To evaluate the integrity of lateral soft tissue in varus osteoarthritis knee by comparing the mechanical axis under varus stress during navigation-assisted total knee arthroplasty before and after compensating for a bone defect with the implant. Methods: Sixty-six knees that underwent total knee arthroplasty were investigated. The mechanical axis of the operated knee was evaluated under manual varus stress immediately after knee exposure and after navigation-assisted implantation. The correlation between each value of the mechanical axis and degree of preoperative varus deformity was compared by regression analysis. Results: The maximum mechanical axis under varus stress immediately after knee exposure increased in proportion to the degree of preoperative varus deformity. Moreover, the maximum mechanical axis under varus stress after implantation increased in proportion to the degree of preoperative varus deformity. Therefore, the severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, regression coefficients after implantation were much smaller than those measured immediately after knee exposure (0.99 vs 0.20). Based on the results of the regression formula, the postoperative laxity of the lateral soft tissue was negligible, provided that an appropriate thickness of the implant was compensated for the bone and cartilage defect in the medial compartment without changing the joint line. Conclusion: The severity of varus knee deformity leads to a progressive laxity of the lateral soft tissue. However, even if the degree of preoperative varus deformity is severe, most cases may not require additional procedures to address the residual lateral laxity.

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Current state of the art in total knee arthroplasty computer navigation

Abstract: III.

Cited by 33 publications

References 60 publications

Computer assisted orthopaedic surgery: Past, present and future

Computer assisted orthopaedic surgery: Past, present and future

New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

Postoperative laxity of the lateral soft tissue is largely negligible in total knee arthroplasty for varus osteoarthritis

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