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Alignment of resection planes in total knee replacement obtained with the conventional technique, as assessed by a modern computer‐based navigation system
Author(s) -
Belvedere C.,
Ensini A.,
Leardini A.,
Bianchi L.,
Catani F.,
Giannini S.
Publication year - 2007
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.131
Subject(s) - valgus , femur , intramedullary rod , tibia , total knee replacement , resection , navigation system , computer assisted surgery , medicine , orientation (vector space) , knee replacement , orthodontics , computer science , surgery , arthroplasty , artificial intelligence , mathematics , geometry
Background To improve the anatomy‐based alignment of prosthetic components in total knee replacement, surgical navigation systems have recently been developed, based on anatomical reference frame definitions through landmark digitations and functional calibration. In this study, femoral and tibial resection plane alignments, obtained by conventional tecnique, were measured intraoperatively during total knee replacements by a navigation system to quantify potential errors in conventional bone preparation techniques. Methods Femoral and tibial resection plane alignments, obtained by conventional femoral intramedullary and tibial extramedullary cutting guides, were measured intraoperatively in 25 primary total knee replacements by a navigation system. This system enabled the surgeon to calculate, before definitive bone sawing, the final position and orientation of all resection planes. Results The measurements revealed unsatisfactory alignments in nearly all anatomical planes. Except for tibial varus/valgus, final plane orientations were considerably different from those targeted by the surgeon via the navigation system, respectively 7° , 8° and 10° apart in varus‐valgus and flexion‐extension at the femur, and in flexion‐extension at the tibia. Conclusion Modern computer‐aided surgery in total knee replacement, once relevant precision has been established in all femur and tibia anatomical planes, can in the future limit the current critical component misalignments. Copyright © 2007 John Wiley & Sons, Ltd.