Computer assisted surgery. Its usefulness in different levels of pre-operative deformities

Rev Esp Cir Ortop Traumatol. Jul-Aug 2015;59(4):245-53. doi: 10.1016/j.recot.2014.10.002. Epub 2014 Dec 4.
[Article in English, Spanish]

Abstract

Objective: To compare the results obtained with computer assisted surgery with conventional techniques and evaluate the influence of navigation at different levels of preoperative deformity.

Material al method: A retrospective study was conducted on 100 cases with primary total knee arthroplasty performed with conventional or computer assisted surgery. A comparison was made of the post-operative mechanical axis of the lower limb between both groups and in terms of pre-operative deformity.

Results: Optimal alignment is most often obtained by using the navigation system (62%) than by a conventional technique (36%). Patients with deformities under 10° varus showed a mean post-operative alignment within the optimal range (0±3° deviation from the neutral mechanical axis), while those with more than 15° of varus show an alignment out of range, regardless of the technique used (p=.002). In those with a deformity of between 10 and 15° of pre-operative varus alignment, values were found closer to the neutral axis in the navigation group (178.7°) than in the conventional technique (175.5°), although these differences are not statistically significant (p=.127).

Conclusion: Post-operative alignment obtained with navigation is better than with the conventional technique, with a smaller percentage of cases out of range, and greater accuracy in placing implants. A potential benefit was observed in navigation for cases with deformities of between 10 and 15° of varus.

Keywords: Alineación postoperatoria; Artroplastia total de rodilla; Cirugía asistida por ordenador; Computer assisted surgery; Navegación; Navigation; Post-operative alignment; Total knee replacement.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroplasty, Replacement, Knee / methods*
  • Bone Malalignment / diagnosis
  • Bone Malalignment / etiology*
  • Bone Malalignment / pathology
  • Bone Malalignment / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / pathology*
  • Knee Joint / physiopathology
  • Knee Joint / surgery
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / complications
  • Osteoarthritis, Knee / pathology
  • Osteoarthritis, Knee / physiopathology
  • Osteoarthritis, Knee / surgery*
  • Preoperative Period
  • Range of Motion, Articular
  • Retrospective Studies
  • Surgery, Computer-Assisted / methods*