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ObjectiveTo evaluate the usefulness of an application when planning total knee arthroplasties (TKA), besides the accuracy when measuring the anatomical-mechanical femoral angle (AMFA), comparing, also, the time spent during planning a TKA manually and by using the application.MethodsAn interdisciplinary team involving health and computer science areas established activities in order to develop the application. After development, 24 physicians underwent an application usability test. Each one planned a primary total knee arthroplasty (TKA) initially, in a conventional manner and then by using the application. Data concerning AMFA measurement and time spent during planning were collected, in both manners. The Mann–Whitney and Wilcoxon tests were used to evaluate statistical significance related to angle and time.ResultsUsers considered it important checking AMFA and drawing the bone cut lines orthogonal to the mechanical axis, when planning TKAs. They also assessed that the application could be useful for training surgeons and for specialists. There was no statistically significant difference between the AMFA, as measured by the application and by the conventional manner. The planning time was shorter when the application was used (39% of the time spent manually).ConclusionsThe application has proved to be useful in planning TKAs and has revealed accuracy when measuring the AMFA when it was compared to the manual form of preoperative planning. The application was able to reduce planning time by more than half and it demonstrated reliability in measuring the AMFA.

Resumo Objetivo Avaliar os resultados pré e pós-operatórios em relação à depressão, dor, limitações funcionais e episódios de queda em pacientes diagnosticados com osteoartrite (OA) grave do joelho submetidos a uma artroplastia total do joelho (ATJ), usando um implante móvel com uma plataforma rotativa e removendo o ligamento cruzado posterior. Métodos O questionário de Lequesne foi utilizado para avaliar a dor e as limitações funcionais antes e após a ATJ. Além disso, a escala de depressão geriátrica (EDG) também foi utilizada. Os episódios de quedas antes e após a cirurgia foram estimados. Resultados O escore médio de Lequesne antes da cirurgia foi de 15,95 e após a cirurgia foi de 6,5. Esse resultado foi estatisticamente significativo (p < 0,001). O escore médio da EDG antes da cirurgia foi de 7,43 e após a ATJ foi de 2,22 (p < 0,001). O número médio de ocorrências de queda antes do procedimento, em um período de 1 ano, foi de 1,22 e após a ATJ foi de 0,27 (p = 0,004). Foi encontrada uma relação direta entre os escores de Lequesne antes da cirurgia e os escores da EDG (p = 0,004). Conclusões A ATJ resultou em melhora da dor e limitação funcional, diminuição ou desaparecimento da condição depressiva e diminuição das taxas de queda nos pacientes avaliados.

Preoperative planning is routinely recommended prior to total knee arthroplasty (TKA). We introduce a methodology for planning TKA based on mechanical alignment. A methodology for planning total knee arthroplasty was discussed among experienced knee surgeons. A rational methodology for planning TKA was stablished and it was setted to an application for mobile devices. It has proved to be useful and revealed accuracy compared to the manual form of preoperative planning. It was able to reduce planning time by more than a half and it was still reliable in measuring the anatomical-mechanical femoral angle (MAFÂ). This chapter introduces a TKA planning method based on mechanical alignment and GAP balancing principles. Kinematic alignment and strategies for soft-tissue balancing in special situations are cited as well.