Computer-assisted and conventional total knee replacement

Lützner, Jörg; Krummenauer, Frank; Wolf, Christopher; Günther, Klaus‐Peter; Kirschner, S.

doi:10.1302/0301-620x.90b8.20553

Cited by 119 publications

(68 citation statements)

References 48 publications

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“…However, other studies have failed to show a significant difference [[23],[24]]. In this comparative study, there were no significant differences in most variables for patients who underwent simultaneous bilateral primary TKAs.…”

Section: Discussioncontrasting

confidence: 51%

Sagittal component alignment is less reliable than coronal component alignment in a Chinese population undergoing navigated TKA

et al. 2014

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BackgroundThe purpose of our study was to determine whether postoperative sagittal component alignments of primary total knee arthroplasty (TKA) using the conventional and navigated technique differed significantly. Additionally, we determined whether the use of navigation systems resulted in hyperextension of the femoral components in Chinese patients.MethodsThis retrospective study reviewed 36 consecutive patients (72 knees) who underwent simultaneous bilateral primary TKAs at our hospital from February 2011 to March 2012. One knee was replaced using a computer-assisted navigation system, and the contralateral knee was replaced with the conventional technique. The radiographic and clinical results of both groups were compared. The relationship between preoperative anatomic angles and component alignments in conventional TKA and navigated TKA was examined.ResultsThe radiographic results showed statistically significant differences only between the navigated and conventional groups for individual femoral coronal and sagittal component alignment. Femoral sagittal component alignment showed less deviation and tended to have hyperextension using the navigated technique (−0.35°) compared with the conventional technique (2.77°). There was no significant difference observed for the Knee Society Score (KSS) between the two groups at 2 years postoperatively.ConclusionsThe sagittal component alignment of primary TKA obtained using the conventional and navigated techniques differed significantly. Navigated TKAs resulted in a higher risk of hyperextension of the femoral components in Chinese patients.

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Section: Discussioncontrasting

confidence: 51%

Sagittal component alignment is less reliable than coronal component alignment in a Chinese population undergoing navigated TKA

et al. 2014

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“…We have previously reported our results of rotational alignment of the femoral and tibial component after navigated and conventional TKA using postoperative CT scans [19]. In this study we used these CT scans to measure femoro-tibial rotational mismatch in order to investigate which tibial landmark (the medial border or the medial third of the tibial tubercle) is the most reliable for a correct femoro-tibial rotational alignment.…”

Section: Introductionmentioning

confidence: 99%

Rotational alignment of the tibial component in total knee arthroplasty is better at the medial third of tibial tuberosity than at the medial border

Lützner

Krummenauer

Günther

et al. 2010

BMC Musculoskelet Disord

101

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BackgroundCorrect rotational alignment of the femoral and tibial component is an important factor for successful TKA. The transepicondylar axis is widely accepted as a reference for the femoral component. There is not a standard reference for the tibial component. CT scans were used in this study to measure which of 2 tibial landmarks most reliably reproduces a correct femoro-tibial rotational alignment in TKA.Methods80 patients received a cemented, unconstrained, cruciate-retaining TKA with a rotating platform. CT scans were performed 5-7 days postoperatively but before discharge. The rotational mismatch between the femoral and tibial components was measured. Furthermore, the rotational variance between the transepicondylar line, as a reference for the orientation of the femoral component and different tibial landmarks, was measured.ResultsThere was notable rotational mismatch between the femoral and tibial components. The median mismatch was 0° (range: 16.2 degrees relative external to 14.4 degrees relative internal rotation of the femoral component).Using the transepicondylar line as a reference for femoral rotational alignment and the medial third of the tuberosity as a reference for tibial rotational alignment, 67.5% of all TKA had a femoro-tibial variance within ± 5 degrees, 85% within ± 10 degrees and 97.5% within ± 20 degrees. Using the medial border of the tibial tubercle as a reference this variance was greater, only 3.8% had a femoro-tibial variance within ± 5 degrees, 15% within ± 10 degrees and 68.8% within ± 20 degrees.ConclusionUsing fixed bone landmarks for rotational alignment leads to a notable variance between femoral and tibial components. Referencing the tibial rotation on a line from the medial third of the tibial tubercle to the center of the tibial tray resulted in a better femoro-tibial rotational alignment than using the medial border of tibial tubercle as a landmark. Surgeons using fixed bearings with a high rotational constraint between the inlay and the femoral component should be aware of this effect to avoid premature polyethylene wear.Trial RegistrationClinical trials registry NCT01022099

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“…We used computer-assisted instrumentation to ensure consistent implant alignment [23, 24]. We noted an anomaly in the clinical data, the baseline KSS-F scores being 10 points lower for the patients properly randomized to the MB group.…”

Section: Discussionmentioning

confidence: 99%

One Year After Navigated Total Knee Replacement, No Clinically Relevant Difference Found Between Fixed Bearing and Mobile Bearing Knee Replacement in a Double-Blind Randomized Controlled Trial

Lampe

Sufi-Siavach²,

Bohlen³

et al. 2011

TOORTHJ

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Background:The mobile bearing designs have not yet been shown to improve clinical outcome of total knee arthroplasty (TKA). In this prospective randomized study, we compared the short-term clinical results of a mobile bearing implant with those of the fixed bearing version of the same implant.Methods:We randomized 100 knees into two double-blind groups who received either the fixed (FB, 52 knees) or the mobile bearing (MB, 48 knees) version of the same implant. We used navigation to standardize the surgical technique. For up to one year, we recorded the Knee Society (KSS) and Oxford (OXF) scores. We performed an exploratory analysis of variance (ANOVA) to determine the influence of baseline scores as covariate and the extent of improvement in clinical outcome over time.Results:After one year, we did not detect any statistically significant difference between the two groups. The KSS scores differed by 2 points, the OXF scores by 1.1 points.Conclusion:Even with identical geometry of implant surfaces and a navigated surgical technique, first-year results do not support a preference for either a fixed or a mobile design.

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Computer-assisted and conventional total knee replacement

Cited by 119 publications

References 48 publications

Sagittal component alignment is less reliable than coronal component alignment in a Chinese population undergoing navigated TKA

Sagittal component alignment is less reliable than coronal component alignment in a Chinese population undergoing navigated TKA

Rotational alignment of the tibial component in total knee arthroplasty is better at the medial third of tibial tuberosity than at the medial border

One Year After Navigated Total Knee Replacement, No Clinically Relevant Difference Found Between Fixed Bearing and Mobile Bearing Knee Replacement in a Double-Blind Randomized Controlled Trial

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