Pinless navigation in total knee arthroplasty: Navigation reduced by the maximum?

Maderbacher, Guenther and Schaumburger, Jens and Keshmiri, Armin and Barthel, Magdalena and Springorum, Hans-Robert and Craiovan, Benjamin and Grifka, Joachim and Baier, Clemens (2015) Pinless navigation in total knee arthroplasty: Navigation reduced by the maximum? INTERNATIONAL ORTHOPAEDICS, 39 (3). pp. 455-460. ISSN 0341-2695, 1432-5195

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Abstract

Purpose Restoring a neutral mechanical axis in total knee arthroplasty (TKA) (within +/- 3 degrees of varus/valgus) is associated with superior functional outcome and reduced early implant failure. Using conventional alignment jigs results in malalignment in >20 % of cases. In this study, we investigated the reduction of outliers within the threshold of +/- 3 degrees of leg alignment using a "pinless" navigation system in comparison with conventional alignment jigs investigated. Methods In this randomised prospective study, 80 patients were randomly assigned/allocated to the pinless or conventional control group. After surgery, the two groups were compared regarding outliers>+/- 3 degrees by means of hip-knee-ankle angle (HKA), mechanical medial proximal tibia angle (mMPTA), mechanical lateral distal femoral angle (mLDFA) and duration of surgery. Student's unpaired t test was used for quantitative variables, Fisher's exact test compared groups (pinless vs. control) and a two-sided p value of <= 0.05 was considered statistically significant. Results In the pinless group, outliers regarding HKA and mLDFA>+/- 3 degrees was significantly reduced (p = 0.025 and p = 0.002 respectively). In the pinless group, the surgery duration was significantly longer (75.6 vs. 64.5 minutes, p < 0.001). Conclusion Pinless navigation is effective in reducing outliers>+/- 3 degrees regarding HKA without risking pin-related complications, such as fractures, infections or breaking screws. However, not all tools for conventional navigation in TKA, such as real-time measurements of the tibiofemoral axis and gap balancing, are available.

Item Type: Article
Uncontrolled Keywords: ALIGNMENT; SURGERY; SYSTEM; ACCURACY; Total knee arthroplasty; Alignment; Navigation; CAS; Pinless; TKA
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Orthopädie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 24 Jul 2019 08:36
Last Modified: 24 Jul 2019 08:36
URI: https://pred.uni-regensburg.de/id/eprint/5907

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