Pin Site Complications Associated With Computer-Assisted Navigation in Hip and Knee Arthroplasty

Kamara, Eli; Berliner, Zachary P.; Hepinstall, Matthew S.; Cooper, H. John

doi:10.1016/j.arth.2017.03.073

Cited by 57 publications

(38 citation statements)

References 24 publications

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“…Some studies describe the use of navigation for TKA in knee arthritis with EAD with good clinical results, appropriate bone cuts, and soft tissue release [9e16]. (Table 2) However, despite many encouraging data, CAS have some disadvantages such as the use of trackers placed on the bone with transosseous pins that enhance the risk of weakening the anterior cortex of femur and tibia and of additional bleeding [39,40]. Furthermore, the system requires a recording chamber for the signal, and the surgeon needs to observe the monitor during the whole procedure.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

Matassi

Lepri

Innocenti

et al. 2019

The Journal of Arthroplasty

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Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

Matassi

Lepri

Innocenti

et al. 2019

The Journal of Arthroplasty

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“…Computer-assisted navigation technology is utilized intraoperatively to provide surgeons real-time feedback on the position and orientation of implants [12], allowing for less variation in implant position [13–18]. The use of pins is a necessary part of computer navigation and has been associated with complications such as infections and transient neuropraxia [10, 19–21]. It is hypothesized that the pin site complications could be directly associated with the necrosis caused from the drilling through or near the cortical bone to place the pins [22].…”

Section: Discussionmentioning

confidence: 99%

“…The CAS camera tracker requires several pins to be placed in the iliac crest and greater trochanter of the femur. There are several reports of complications associated with the pelvic pins; however, there are no known reports related to pins placed in the femur [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Periprosthetic Fracture of Greater Trochanter in Total Hip Replacement Stemming from Pin Site Placement in Navigation-Assisted Surgery

Brozovich

Lionberger

2019

Case Reports in Orthopedics

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Surgeons are looking to use computer computer-assisted surgery (CAS) in total hip arthroplasty (THA) in order to quantify leg length measurement, angular cup placement, and enhance stability to provide enhanced accuracy in implant placement. As a result, CAS in THA is gaining popularity. This technology employs the use of pins and provides the surgeon with real-time feedback on positioning intraoperatively. Previous total knee arthroplasty (TKA) literature has reported pin-associated complications such as infections, neuropraxia, and suture abscess. To our knowledge, there have been reports of tibial stress fracture after CAS TKA, but this is the first report of a pin causing fracture of the greater trochanter leading to dislocation in THA. Further studies may be warranted to optimize pin placement for trackers to prevent fractures of the greater trochanter.

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“…In CAS-TKA, several temporary pins are placed in the thigh and the upper tibia percutaneously through separate stab incisions. After the addition of these temporary pins, the early postoperative recovery is often hindered by significant pain, swelling, and stiffness [3]. The pain sensation and extremity swelling inhibit patients' motivation for early mobilization, which results in prolonged hospital stays, delayed functional recovery and negative psychological responses.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial

Chen

Lin

et al. 2020

Preprint

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Background: Cryotherapy and continuous passive motion (CPM) are commonly used for conventional total knee arthroplasty (TKA) to reduce postoperative pain and increase of the range of motion (ROM). However, this postoperative nursing intervention remains elusive for patients undergoing computer-assisted total knee arthroplasty (CAS-TKA) Methods: A prospective, randomized controlled trial with a purposive sampling method was utilized. Sixty patients scheduled for a unilateral CAS-TKA at a medical center were randomly assigned to the intervention group (n=30) and control group (n=30). The intervention group applied programed cryotherapy and CPM within one hour while returning to the ward on the day of surgery, while the control group did not. Data were analyzed using mixed models to compare numeric rating scale (NRS) for pain, ROM, and swelling at postoperative day (POD) 4. Results: There was no significant difference in the NRS score between the groups ( p = 0.168). The intervention group had significantly higher ROM than the control group (98 degrees vs. 91 degrees, p = 0.004) at POD 4. Although no significant difference in joint swelling was found between groups ( p = 0.157), the intervention group had lower mean joint swelling (32.2 cm) than the control group (33.9 cm). Conclusions: Programmed cryotherapy and continuous passive motion can improve the range of motion after CAS-TKA. It should be incorporated into the daily nursing plan for patients undergoing CAS-TKA.

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Pin Site Complications Associated With Computer-Assisted Navigation in Hip and Knee Arthroplasty

Cited by 57 publications

References 24 publications

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

Periprosthetic Fracture of Greater Trochanter in Total Hip Replacement Stemming from Pin Site Placement in Navigation-Assisted Surgery

The Effects of Programmed Cryotherapy and Continuous Passive Motion in Patients after Computer-Assisted Total Knee Arthroplasty: A prospective, randomized controlled trial

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