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Knee Surgery, Sports Traumatology, Arthroscopy

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01-12-2014 | Knee

Computer-assisted surgery improves rotational positioning of the femoral component but not the tibial component in total knee arthroplasty

Authors: Daniel Hernandez-Vaquero, Alfonso Noriega-Fernandez, Jose Manuel Fernandez-Carreira, Jose Manuel Fernandez-Simon, Jimena Llorens de los Rios

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2014

Abstract

Purpose

Computer-assisted surgery (CAS) may facilitate better positioning of total knee arthroplasty (TKA) along the coronal and lateral axes; however, there are doubts as to its usefulness in the rotational plane.

Methods

This is a prospective study of 95 TKAs comparing two groups: the CAS group and the standard equipment group. The series comprises 95 cases. A radiography of the lower limb and computer tomographies (CTs) of the femoral condylar region, the proximal end of the tibia and the ankle were performed to measure rotational angulation. A month after TKA surgery, the radiography and the CTs were repeated to analyze the position of the prosthetic components in the rotational plane.

Results

In the coronal axis, both CAS and mechanical technique improved femoro-tibial alignment, but when there are preexisting deformities ≥4°, CAS obtains better results. A strong correlation (R = 0.94, p = 0.001) was observed between the mean rotational axis measured with CT in the tibial plateau and that measured from the axis of the ankle. The mean initial femoral rotation of the complete series was 6.7° and 2.7° at 1-month follow-up (p < 0.001). In the standard instrumentation group, the femoral rotation went from 6.8° to 2.3°, whereas in the CAS group the femoral rotation went from 6.5° to 3.1° (p = 0.039), which is very close to the ideal 3° angle of external rotation. Tibial rotation changed by 5.28° for the entire patient population, but no differences were found when comparing CAS and standard instrumentation.

Conclusion

CAS improves frontal alignment in TKA, especially in the presence of preoperative deformities. In the femoral component, navigation most closely replicated the ideal 3° external rotation of the femoral component, but tibial rotation did not differ when comparing CAS to standard instrumentation.

Level of evidence

II.

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Title: Computer-assisted surgery improves rotational positioning of the femoral component but not the tibial component in total knee arthroplasty
Authors: Daniel Hernandez-Vaquero
Alfonso Noriega-Fernandez
Jose Manuel Fernandez-Carreira
Jose Manuel Fernandez-Simon
Jimena Llorens de los Rios
Publication date: 01-12-2014
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2014
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-3233-9

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Springer Medicine

Computer-assisted surgery improves rotational positioning of the femoral component but not the tibial component in total knee arthroplasty

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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