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Ist die Navigation bei der Schlittenprothese sinnvoll?

Eine Pilotstudie am Leichenknie

Is computernavigation a usefull tool in unicompartmental knee arthroplasty?

A pilot cadaver study

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Zusammenfassung

Wir führten diese Pilotstudie am Leichenknie durch, um die Effektivität eines Navigationssystems bezüglich der Implantatpositionierung beim minimal-invasiven unikompartimentellen Kniegelenkersatz im Vergleich zum konventionellen Op.-Technik zu überprüfen. Wir untersuchten die Genauigkeit der Implantatpositionierung nach unikompartimentellem Kniegelenkersatz. Auf einer Seite wurde Standardinstrumentarium operiert auf der Gegenseite wurde ein Navigationssystem verwendet. Die radiologische Auswertung zeigte, dass mit beiden Methoden eine genaue Implantatposition erreicht wurde. Die Resektionshöhe im Bereich der proximalen Tibia war in der navigierten Gruppe etwas geringer als in der manuellen Gruppe. Die Positionierung der Femurkomponente war mittels Navigation genauso gut wie in der manuellen Gruppe mit intramedullärer Ausrichtung. Die Pilotstudie zeigte, dass die Computernavigation genauso exakte Implantationsergebnisse liefern kann wie die manuelle Op.-Technik. Insgesamt zeigt die Navigation die gleiche Genauigkeit wie das Standardinstrumentarium und kann zusätzlich die Orientierung des Operateurs bei minimal-invasivem Zugang verbessern.

Abstract

We conducted this pilot cadaver study to investigate whether the use of a navigation system during minimally invasive unicompartmental knee arthroplasty leads to more consistent results than the conventional hand-guided technique. We describe the accuracy of implant positioning in using standard instrumentation and computer navigation. Radiographic assessment showed that accurate component placement was achieved using both methods. These results were not statistically significant. The computer navigated femoral component placement without intramedullary (IM) rod was as accurate as the conventional method with IM rod. The study showed that computer navigation can produce accurate results even without an intramedullary rod. Image guidance can maintain the accuracy of the standard instrumentation and enhance 3D vision and the intraoperative orientation of the surgeon.

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Literatur

  1. Chatain F, Richard A et al. (2004) Revision total knee arthroplasty after unicompartmental femorotibial prosthesis: 54 cases. Rev Chir Orthop Reparatrice Appar Mot 90(1): 49–57

    PubMed  Google Scholar 

  2. DiGioia AM 3rd, Blendea S et al. (2004) Computer-assisted orthopaedic surgery: minimally invasive hip and knee reconstruction. Orthop Clin North Am 35(2): 183–189

    Article  PubMed  Google Scholar 

  3. Ecker ML, Lotke PA et al. (1987) Long-term results after total condylar knee arthroplasty. Significance of radiolucent lines. Clin Orthop Relat Res(216): 151–158

    Google Scholar 

  4. Jenny JY, Boeri C (2003) Unicompartmental knee prosthesis implantation with a non-image-based navigation system: rationale, technique, case-control comparative study with a conventional instrumented implantation. Knee Surg Sports Traumatol Arthrosc 11(1): 40–45

    PubMed  Google Scholar 

  5. Lewold S, Robertsson O et al. (1998) Revision of unicompartmental knee arthroplasty: outcome in 1,135 cases from the Swedish Knee Arthroplasty study. Acta Orthop Scand 69(5): 469–474

    PubMed  Google Scholar 

  6. Meek RM, Masri BA et al. (2004) Minimally invasive unicompartmental knee replacement: rationale and correct indications. Orthop Clin North Am 35(2): 191–200

    Article  PubMed  Google Scholar 

  7. Mielke RK, Clemens U et al. (2001) [Navigation in knee endoprosthesis implantation — preliminary experiences and prospective comparative study with conventional implantation technique]. Z Orthop Ihre Grenzgeb 139(2): 109–116

    Article  PubMed  Google Scholar 

  8. Miller RK, Goodfellow JW et al. (1998) In vitro measurement of patellofemoral force after three types of knee replacement. J Bone Joint Surg Br 80(5): 900–906

    Article  PubMed  Google Scholar 

  9. Mont MA, Stuchin SA et al. (2004) Different surgical options for monocompartmental osteoarthritis of the knee: high tibial osteotomy versus unicompartmental knee arthroplasty versus total knee arthroplasty: indications, techniques, results, and controversies. Instr Course Lect 53: 265–283

    PubMed  Google Scholar 

  10. Muller PE, Pellengahr C et al. (2004) Influence of minimally invasive surgery on implant positioning and the functional outcome for medial unicompartmental knee arthroplasty. J Arthroplasty 19(3): 296–301

    Article  PubMed  Google Scholar 

  11. Murray DW (2000) Unicompartmental knee replacement: now or never? Orthopedics 23(9): 979–980

    PubMed  Google Scholar 

  12. Murray DW, Goodfellow JW et al. (1998) The Oxford medial unicompartmental arthroplasty: a ten-year survival study. J Bone Joint Surg Br 80(6): 983–989

    Article  PubMed  Google Scholar 

  13. Oswald MH, Jakob RP et al. (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8(4): 419–426

    PubMed  Google Scholar 

  14. Perlick L, Bathis H et al. (2004) Minimally invasive unicompartmental knee replacement with a nonimage-based navigation system. Int Orthop 28(4): 193–197

    Article  PubMed  Google Scholar 

  15. Price AJ, Rees JL et al. (2004) Sagittal plane kinematics of a mobile-bearing unicompartmental knee arthroplasty at 10 years: A comparative in vivo fluoroscopic analysis. J Arthroplasty 19(5): 590–597

    Article  PubMed  Google Scholar 

  16. Price AJ, Webb J et al. (2001) Rapid recovery after oxford unicompartmental arthroplasty through a short incision. J Arthroplasty 16(8): 970–976

    Article  PubMed  Google Scholar 

  17. Rees JL, Price AJ et al. (2001) Medial unicompartmental arthroplasty after failed high tibial osteotomy. J Bone Joint Surg Br 83(7): 1034–1036

    Article  PubMed  Google Scholar 

  18. Robertsson O, Knutson K et al. (2001) The routine of surgical management reduces failure after unicompartmental knee arthroplasty. J Bone Joint Surg Br 83(1): 45–49

    Article  PubMed  Google Scholar 

  19. Sparmann M, Wolke B (2003) [Value of navigation and robot-guided surgery in total knee arthroplasty]. Orthopäde 32(6): 498–505

    Google Scholar 

  20. Sparmann M, Wolke B et al. (2003) Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br 85(6): 830–835

    PubMed  Google Scholar 

  21. Svard UC, Price AJ (2001) Oxford medial unicompartmental knee arthroplasty. A survival analysis of an independent series. J Bone Joint Surg Br 83(2): 191–194

    Article  PubMed  Google Scholar 

  22. Wasielewski RC, Galante JO et al. (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop(299): 31–43

    Google Scholar 

  23. Weale AE, Murray DW et al. (1999) The length of the patellar tendon after unicompartmental and total knee replacement. J Bone Joint Surg Br 81(5): 790–795

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Stiftung Orthopädische Universitätsklinik, Heidelberg

    P. R. Aldinger, U. Schlegel, M. Schneider & M. Clauss

  2. Oxford Orthopaedic Engineering Collaboration, University of Oxford, Oxford, UK

    H. S. Gill, J. W. Goodfellow & D. W. Murray

  3. Nuffield Orthopaedic Centre, Oxford, UK

    D. W. Murray

  4. Orthopaedic Department, University of Edinburgh, UK

    S. J. Breusch

  5. Stiftung Orthopädische Universitätsklinik, Schlierbacher Landstraße 200a, 69118, Heidelberg

    P. R. Aldinger

Authors
  1. P. R. Aldinger
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  2. H. S. Gill
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  3. U. Schlegel
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  4. M. Schneider
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  5. M. Clauss
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  6. J. W. Goodfellow
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  7. D. W. Murray
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  8. S. J. Breusch
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Correspondence to P. R. Aldinger.

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Aldinger, P.R., Gill, H.S., Schlegel, U. et al. Ist die Navigation bei der Schlittenprothese sinnvoll?. Orthopäde 34, 1094–1102 (2005). https://doi.org/10.1007/s00132-005-0883-9

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  • DOI: https://doi.org/10.1007/s00132-005-0883-9

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