The accuracy of femoral intramedullary guides in total knee arthroplasty

Reed, Stephen C.; Gollish, Jeffrey

doi:10.1016/s0883-5403(97)90141-8

Cited by 121 publications

(82 citation statements)

References 11 publications

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“…Most, but not all, studies have shown that alignment of the mechanical axis in the coronal plane within a range of 3°v arus/valgus is associated with improved long-term function and increased survival rates [13,23,35,[41][42][43]. However, conventional manual implantation of TKA reportedly results in only 28% to 85% of cases achieving a mechanical leg alignment deviation within 3°varus/valgus [29].…”

Section: Introductionmentioning

confidence: 99%

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

Song

Seon

Yim

et al. 2013

Clinical Orthopaedics &Amp; Related Research

307

295

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Background Several studies have shown mechanical alignment influences the outcome of TKA. Robotic systems have been developed to improve the precision and accuracy of achieving component position and mechanical alignment. Questions/purposes We determined whether roboticassisted implantation for TKA (1) improved clinical outcome; (2) improved mechanical axis alignment and implant inclination in the coronal and sagittal planes; (3) improved the balance (flexion and extension gaps); and (4) reduced complications, postoperative drainage, and operative time when compared to conventionally implanted TKA over an intermediate-term (minimum 3-year) followup period. MethodsWe prospectively randomized 100 patients who underwent unilateral TKA into one of two groups: 50 using a robotic-assisted procedure and 50 using conventional manual techniques. Outcome variables considered were postoperative ROM, WOMAC scores, Hospital for Special Surgery (HSS) knee scores, mechanical axis alignment, flexion/extension gap balance, complications, postoperative drainage, and operative time. Minimum followup was 41 months (mean, 65 months; range, 41-81 months). Results There were no differences in postoperative ROM, WOMAC scores, and HSS knee scores. The roboticassisted group resulted in no mechanical axis outliers ([ ± 3°from neutral) compared to 24% in the conventional group. There were fewer robotic-assisted knees

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Section: Introductionmentioning

confidence: 99%

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

Song

Seon

Yim

et al. 2013

Clinical Orthopaedics &Amp; Related Research

307

295

View full text Add to dashboard Cite

show abstract

“…They found an alignment of more than ±3°varus/valgus in 25% of cases, independent of the surgeon's experience. Although various guiding tools for alignment have been designed to improve accuracy, several limitations of these instruments have been reported [11][12][13][14]. Errors may be due to variations in the bony anatomy, visual misjudgement by the surgeon or limitations of the technique.…”

Section: Introductionmentioning

confidence: 99%

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

Lüring

Kauper

Bäthis

et al. 2011

International Orthopaedics (SICOT)

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Purpose Computer-assisted knee surgery has become established in routine clinical practice. Still, there is no study investigating midterm clinical outcome after five to seven years postoperatively. We aimed to test the hypothesis that there is no difference either for subjective [Western Ontario and McMaster Universities (WOMAC) scores] or for objective (Knee Society Score, degree of flexion) criteria between computer-assisted total knee replacement (TKR) and freehand TKR after 5.6-7.3 years. Methods We performed a matched-pair analysis; 100 patients who received a primary TKR were investigated after a median follow-up of 6.25 years. Group A was operated on with the support of a computer system, while surgery on patients in group B was performed with the freehand technique. We determined WOMAC Score, Knee Society Score and degree of flexion.

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“…Greater than 3°varus or valgus mal-alignment in total knee replacement (TKR) can result in higher failure rates whilst correct alignment has been associated with improved clinical outcome [7,11,19]. Several authors have shown that traditional hand-guided alignment systems can produce potential errors in the bone cutting process even when used by experienced surgeons [1,2,14,[16][17][18]21]. Recently, Manley et al showed that patients undergoing TKR in low volume hospitals (1-25 procedures/year) had a higher risk of early revision at five and eight years compared with those performed in the highest volume hospitals (>200 procedures/year) [15].…”

Section: Introductionmentioning

confidence: 99%

Relationship between cutting errors and learning curve in computer-assisted total knee replacement

Manzotti

Cerveri

Momi

et al. 2009

International Orthopaedics (SICOT)

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Computer-assisted total knee replacement (TKR) has been shown to improve radiographic alignment. Continuous feedback from the navigation system allows accurate adjustment of the bone cuts, thus reducing errors. The aim of this study was to determine the impact of experience both with computer navigation and knee replacement surgery on the frequency of errors in intraoperative bone cuts and implant alignment. Three homogeneous patient groups undergoing computer assisted TKR were included in the study. Each group was treated by one of three surgeons with varying experience in computer-aided and knee replacement surgery. Surgeon A had extensive experience in knee replacement and computer-assisted surgery. Surgeon B was an experienced knee replacement surgeon. A general orthopaedic surgeon with limited knee replacement surgery experience performed all surgeries in group C. The cutting errors and the number of re-cuts were determined intraoperatively. The complications and mean surgical time were collected for each group. The postoperative frontal femoral component angle, frontal tibial component angle, hip-knee-ankle angle and component slopes were evaluated. The results showed that the number of cutting errors were lowest for TKR performed by the surgeon with experience in navigation. This difference was statistically significant when compared to the general orthopaedic surgeon. A statistically significant superior result was achieved in final mechanical axis alignment for the surgeon experienced in computerguided surgery compared to the other two groups (179.3°c ompared to 178.9°and 178.1°). However, the total number of outliers was similar, with no statistically significant differences among the three surgeons. Experience with navigation significantly reduced the surgical time.

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The accuracy of femoral intramedullary guides in total knee arthroplasty

Cited by 121 publications

References 11 publications

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

Robotic-assisted TKA Reduces Postoperative Alignment Outliers and Improves Gap Balance Compared to Conventional TKA

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

Relationship between cutting errors and learning curve in computer-assisted total knee replacement

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