PURPOSE: Many studies have demonstrated higher precision and better radiological results in Total knee arthroplasty (TKA) with computer-assisted surgery (CAS). On the other hand, studies revealed a lengthening of operation time up to 20 min for this technique and demonstrated rare additional complications as fractures and neurovascular injuries caused by the array pins and any intraoperative array dislocation leads to abortion of CAS. To combine the advantages and eliminate the disadvantages of standard CAS, we evaluated the accuracy of a so-called pinless CT-free version of knee navigation (pinless CAS) abandoning the reference pins and reducing the necessary workflow to a minimum. METHOD: The present study compares the accuracy of the reference methods of two different CT-free knee navigation software versions (Brainlab Knee 2.1 and Brainlab Knee Express 2.5). Thirty patients received TKA assisted by standard CAS. Intraoperatively, the proposed bony resections of standard CAS were matched with the new pinless CAS. Postoperatively, the results were checked by evaluating the radiographs concerning leg axis, femoral flexion and tibial slope. RESULTS: All results concerning precise cuts (femoral as well as tibial coronal/varus-valgus alignment, femoral flexion alignment and tibial slope, resection height) were comparable between both groups (n.s.). In femoral, we found a mean deviation of coronal alignment of 0.3° (SD 0.7) and flexion of 0.2° (SD 0.8). In tibial, we found a mean deviation of coronal alignment of 0.2° (SD 0.5) and slope of 0.2° (SD 0.6). The mean additional operation time for the pinless CAS was below 2 min. The postoperative mechanical leg axis was within the threshold of 3° in all patients, tibial slope and femoral flexion matched with CAS values. CONCLUSION: In clinical routine, pinless CAS can comprise the advantages of CAS leaving the disadvantages aside. It reduces surgical time and avoids complications associated with the tracking pins of conventional CAS.
PURPOSE: Many studies have demonstrated higher precision and better radiological results in Total knee arthroplasty (TKA) with computer-assisted surgery (CAS). On the other hand, studies revealed a lengthening of operation time up to 20 min for this technique and demonstrated rare additional complications as fractures and neurovascular injuries caused by the array pins and any intraoperative array dislocation leads to abortion of CAS. To combine the advantages and eliminate the disadvantages of standard CAS, we evaluated the accuracy of a so-called pinless CT-free version of knee navigation (pinless CAS) abandoning the reference pins and reducing the necessary workflow to a minimum. METHOD: The present study compares the accuracy of the reference methods of two different CT-free knee navigation software versions (Brainlab Knee 2.1 and Brainlab Knee Express 2.5). Thirty patients received TKA assisted by standard CAS. Intraoperatively, the proposed bony resections of standard CAS were matched with the new pinless CAS. Postoperatively, the results were checked by evaluating the radiographs concerning leg axis, femoral flexion and tibial slope. RESULTS: All results concerning precise cuts (femoral as well as tibial coronal/varus-valgus alignment, femoral flexion alignment and tibial slope, resection height) were comparable between both groups (n.s.). In femoral, we found a mean deviation of coronal alignment of 0.3° (SD 0.7) and flexion of 0.2° (SD 0.8). In tibial, we found a mean deviation of coronal alignment of 0.2° (SD 0.5) and slope of 0.2° (SD 0.6). The mean additional operation time for the pinless CAS was below 2 min. The postoperative mechanical leg axis was within the threshold of 3° in all patients, tibial slope and femoral flexion matched with CAS values. CONCLUSION: In clinical routine, pinless CAS can comprise the advantages of CAS leaving the disadvantages aside. It reduces surgical time and avoids complications associated with the tracking pins of conventional CAS.
Authors: Clemens Baier; Wolfgang Fitz; Ben Craiovan; Armin Keshmiri; Sebastian Winkler; Robert Springorum; Joachim Grifka; Johannes Beckmann Journal: Int Orthop Date: 2013-10-15 Impact factor: 3.075
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Authors: Jerry Yongqiang Chen; Pak Lin Chin; Zongxian Li; Andy Khye Soon Yew; Darren Keng Jin Tay; Shi-Lu Chia; Ngai Nung Lo; Seng Jin Yeo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-08-14 Impact factor: 4.342
Authors: S Schröter; C Ihle; D W Elson; S Döbele; U Stöckle; A Ateschrang Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-01-22 Impact factor: 4.342
Authors: Michael Casper; Riddhit Mitra; Rahul Khare; Branislav Jaramaz; Brian Hamlin; Brian McGinley; David Mayman; Jeff Headrick; Kenneth Urish; Mark Gittins; Stephen Incavo; Vivek Neginhal Journal: Comput Assist Surg (Abingdon) Date: 2018-12 Impact factor: 1.787