Accuracy of side-cutting implantation instruments for total knee arthroplasty

Abstract

A new generation of implantation instruments were developed for quadriceps sparing surgical approaches during total knee arthroplasty (TKA). There is little information on the accuracy of the bone cuts performed with the side-cutting technique. A total of 100 patients were randomized to undergo computer-assisted TKA or non-navigated TKA using a mini-subvastus surgical approach and side-cutting implant instrumentation. The radiographic parameters, clinical outcomes and knee scores were evaluated 3 months postoperative. The mechanical axis of the limb was within 3 degrees varus/valgus in 76% of the patients who had navigated procedures versus 66% of patients who had conventional surgery. The tibial slope showed a rate of inaccuracy of 3 degrees or less for 78% of the patients in the navigated total knee arthroplasty group versus 66% of the patients in the conventional group. Clinical outcomes and knee scores were similar in both groups. The navigation technique could not compensate for shortcomings of the implantation instruments.

Clinical Outcomes After Computer-assisted Versus Conventional Total Knee Arthroplasty

“…After applying those to selection criteria, 21 articles with clinical outcomes were included in this metaanalysis. Among these studies, 11 studies 1,4,6,18-25 with an adequate method of randomization generation and a low risk of bias were placed in Group A, and 10 studies [26][27][28][29][30][31][32][33][34][35] with a relatively high risk of bias were placed in Group B. All included trials adequately performed and reported the results of follow-up.…”

“…Seven studies reporting operative time were included. 1, 19,21,26,28,31,32 In total, the meta-analysis was performed on 743 patients. Of these patients, 374 patients were operated on using computer-assisted TKA and 369 patients using conventional TKA.…”

“…Among the included trials, group A included 3 trials 1,19,21 and group B included 4 trials, 26,28,31,32 so subgroup meta-analyses was performed of these trials. In group A, the operative time of computer-assisted TKA was significantly longer than that of conventional TKA (mean standard difference, 13.70; 95% CI, 7.58 to 19.82; P,.0001, random model) ( Figure 2).…”

Clinical Outcomes of Patients with Valgus Deformity Undergoing Minimally Invasive Total Knee Arthroplasty Through the Medial Approach

“…The mini-subvastus approach was used in 45 knees, and the mini-parapatellar approach was used in 5 knees without eversion of the patella. The MIS Quad-Sparing instrumentation (Zimmer Biomet Holdings Inc., Warsaw, IN, USA) was used when cutting the femur and tibia from the medial side [13, 14]. The posterior cruciate ligament (PCL) was sacrificed, and the patella was resurfaced in all cases.…”

Review Article: Patellar Instability after Total Knee Arthroplasty

“…Compared to conventional methods, computer-assisted navigation improves orientation and alignment of the components, [12][13][14] although other studies found no significant differences between them. [15][16][17] Cementation and impaction of the components can introduce a considerable error in alignment, regardless of the accuracy of the resection planes. 18 Computer-assisted navigation improves the accuracy and reproducibility of prosthetic component orientation, 19,20 although there was no significant difference in clinical outcome or complication rates.…”