Femoral Component Alignment with a New Extramedullary Femoral Cutting Guide Technique

Ku, Ming-Chou; Chen, Wei-Jen; Lo, Chien-Sheng; Chuang, Chang-Han; Ho, Zih-Ping; Kumar, Atul

doi:10.4103/ortho.ijortho_119_17

Cited by 6 publications

(4 citation statements)

References 28 publications

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“…Our study corroborates a growing body of evidence that shows CATKAs are associated with lower odds of postoperative in-hospital complications, but the adoption of this technology does not reflect this. [7][8][9][10][11][12][13][31][32][33][34][35]39,40 In the current study, CATKA represented slightly less than 10% of all TKAs. In another recent study of CATKA trends, modest increases were observed from 2010 to 2017.…”

Section: Discussionmentioning

confidence: 79%

“…Our results also showed that patients who had CATKAs had fewer pulmonary embolisms, potentially because of the use of computer-assisted alignment guides that lead to fewer emboli. 9 , 10 , 31 , 32 Previous studies have also reported that embolization that occurs during surgical procedures is associated with both intraoperative and postoperative cardiac complications. 8 , 33 - 35 As such, utilization of CATKAs may prevent emboli from occurring, therefore reducing emboli-related cardiac complications.…”

Section: Discussionmentioning

confidence: 99%

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Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based Study

et al. 2022

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Background:Population-based studies showing the advantage of computer-assisted total knee arthroplasty (CATKA) over conventional total knee arthroplasty (TKA) are outdated. More recent institution-based studies with relatively small sample sizes may hinder wider adoption. This cohort-based study aimed to compare postoperative CATKA and TKA in-hospital complications and 90-day all-cause readmissions using 2017-2018 data.Methods:Patients who underwent a primary unilateral CATKA or TKA were identified in the New York Statewide Planning and Research Cooperative System database. In-hospital complications were defined based on the 2020 Centers for Medicare & Medicaid Services total hip arthroplasty and TKA complications measure. Ninety-day readmissions were identified using unique patient identifiers. Logistic regression with a generalized estimating equation was used to assess associations of computer assistance with in-hospital complications and 90-day all-cause readmissions.Results:A total of 80,468 TKAs were identified during the study period, of which 7,395 (9.2%) were CATKAs. Significantly fewer complications occurred among patients who had CATKAs compared with conventional TKAs (0.4% of total CATKAs vs 2.6% of total conventional TKAs, P < 0.001); patients who had CATKAs had fewer 90-day all-cause readmissions compared with those who underwent TKAs (363 vs 4,169 revisits, P < 0.01). Computer assistance was associated with significantly lower odds of in-hospital complications (odds ratio, 0.15, 95% confidence interval, 0.09 to 0.24; P < 0.05) but not 90-day all-cause readmissions.Conclusion:Patients undergoing CATKAs had markedly lower odds of in-hospital complications, compared with patients having TKAs, which has implications for both patient outcomes and hospital reimbursement. These more recent cohort-based findings encourage wider CATKA adoption.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based Study

et al. 2022

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“…In all patients, an air tourniquet was applied after elevation of the leg without elastic bandage exsanguination [22]. The patella was replaced with an inset-type component [23]. Periarticular injection of analgesics, including Marcaine 20 mL, morphine 5 mg, ketorolac 30 mg, epinephrine 0.1 mg and transamin 500 mg were given routinely [24].…”

Section: Surgical Technique and Postoperative Nursing Carementioning

confidence: 99%

After Total Knee Arthroplasty, Monitored Active Ankle Pumping Improves Lower Leg Circulation More Than Unmonitored Pumping: A Pilot Study

Tsai

Cheng

et al. 2022

Applied Sciences

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(1) Background: deep venous thrombosis (DVT) has long been recognized as the most devastating complication after total knee replacement (TKR). To prevent DVT, intermittent pneumatic compression to improve venous return in the lower leg has been advocated by surgeons. Physical activities such as active ankle pumping and early mobilization have been recommended as auxiliary measures to increase venous return in the lower leg and help in ambulation after TKR. In this study, in order to remind patients to exercise their ankle actively and efficiently after TKR, a foot band with motion sensor and reminder alarm was used. (2) Methods: The patients were randomly allocated into three groups according to the therapeutic protocols. The patients in group 1 conducted active ankle pumping without any reminders, those in group 2 underwent intermittent pneumatic compression, and those in group 3 conducted active ankle pumping with ankle motion sensor/reminder. The parameters of blood flow, namely, peak flow velocity and flow volume, in the bilateral common femoral vein and popliteal vein on the 1st, 3rd, and 14th days after surgery were measured using the echo technique, an index to evaluate the effect on promotion of venous return, among the three groups. (3) Results: The peak flow velocity and flow volume of the operative limb in group 3 (with motion sensor/reminder) were significantly higher than those in other groups. The peak flow velocity and flow volume in the popliteal vein in group 3 increased by 112% and 93.8%, respectively, compared to group 1 on the 14th day. No significant difference in peak flow velocity or flow volume was found in the nonoperative limb between the groups. (4) Conclusions: According to the results, a motion sensor/reminder with vibration alarms can improve the performance of active ankle pumping exercises in improving lower leg circulation, and hence may reduce the risk of DVT.

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“…Zahn et al [ 7 ] found that navigation intramedullary and extramedullary instrumentation provided equal precise positioning of the tibial component. Ku et al [ 8 ] performed a retrospective study and identified that extramedullary mechanical guide provides similar postoperative alignment as intramedullary mechanical guide but caused less blood loss.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intramedullary versus extramedullary alignment technique in total knee arthroplasty: A PRISMA-compliant meta-analysis

Li²,

Zhou³

et al. 2023

Medicine

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Background: This meta-analysis aimed to compare the efficacy of intramedullary and extramedullary femoral alignment technique in treating total knee arthroplasty (TKA) patients. Methods: PubMed, Embase, Cochrane library, Chinese National Knowledge Infrastructure, and Weipu databases were electronically searched. Potential clinical studies that investigated the effect and safety of intramedullary versus extramedullary femoral alignment technique in TKA patients were searched. The primary outcome was lower limb coronal alignment. Stata 12.0 was used for meta-analysis. Results: This meta-analysis included 12 prospective randomized controlled studies that reported data on 935 TKA patients. No significant difference was noted in lower limb coronal alignment, coronal alignment of femoral component, sagittal alignment of femoral component and tibial slope between intramedullary and extramedullary alignment techniques ( P > .05). Further, extramedullary alignment technique significantly decrease the total blood loss than intramedullary alignment technique (weighted mean difference: −86.52; 95% confidence interval: −115.05–−57.99; P = .000) and subsequently transfusion rate (risk ratio: 0.57; 95% confidence interval: 0.41–0.79; P = .000). Finally, there was no significant difference between intramedullary and extramedullary alignment techniques in terms of the total complications ( P > .05). Conclusions: The present meta-analysis showed that intramedullary and extramedullary femoral alignment technique had comparable precise profiles. And extramedullary femoral alignment technique could reduce blood loss and blood transfusion. Total complications were comparable between the groups. More randomized controlled trials with large samples are required to verify the comparison of intramedullary and extramedullary femoral alignment technique in TKA patients.

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Femoral Component Alignment with a New Extramedullary Femoral Cutting Guide Technique

Cited by 6 publications

References 28 publications

Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based Study

Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based Study

After Total Knee Arthroplasty, Monitored Active Ankle Pumping Improves Lower Leg Circulation More Than Unmonitored Pumping: A Pilot Study

Comparison of intramedullary versus extramedullary alignment technique in total knee arthroplasty: A PRISMA-compliant meta-analysis

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