Navigation-Assisted Total Knee Arthroplasty for Patients with Extra-Articular Deformity

Abstract

PurposeSince the existence of an extra-articular deformity seriously alters the normal geometry and kinetics around the knee joint, difficulties are often encountered in total knee arthroplasty (TKA) using a standard surgical technique. The purpose of this study was to evaluate the usefulness of surgical navigation system as a treatment option for osteoarthritic knees with extra-articular deformity.Materials and MethodsThe authors retrospectively reviewed medical records of the patients who underwent primary TKA between 2007 and 2012. Knees with preoperative radiography showing an angular deformity within the region from the middle third of the femur to the middle third of the tibia in the ipsilateral limb of the arthritic knees were considered as cases having extra-articular deformity. Thirteen knees of the 13 patients were found to have undergone TKA using a navigation system for osteoarthritis with ipsilateral extra-articular deformity. The hip-knee-ankle angle, Knee Society score (KSS), and range of motion were measured before and after the operation to evaluate the improvement.ResultsThe mean hip-knee-ankle angle in the coronal plane was improved to 0.2°±4.5° in valgus alignment postoperatively. The KSS was improved to 89.6±4.6 points postoperatively at the last follow-up, with over 90% of good and excellent results. The range of motion was improved to 118.5°±10.5° postoperatively.ConclusionsNavigation-assisted TKA is a good treatment option of osteoarthritic knees with extra-articular deformity.

Total knee arthroplasty in patients with extra-articular deformity: which strategy to choose? (case report and literature review)

“…Summary of published literature on TKA in extra-articular deformity is presened in Table 3 and 4. Table 3 Outcomes of TKA in bone deformity using computer navigation and neglecting extra-articular deformity Authors Calvin et al [10] Chou иet al [11] Liu et al [12] Mullaji et al [13] Rhee et al [14] Shao et al [15] Tigani et al [16] Bottros et al [17] Klein et al [18] Catani et al [19] Year FS functional score; HTO high tibial osteotomy. Table 4 Outcomes of TKA combined with corrective osteotomy Deschamps и соавт.…”

Preoperative planning software in vertebrology: issues and outlook

“…According to the forecast of Gartner Inc. MIS of the 4th generation should have been implemented and MIS of the 5th generation should have appeared by 2016. In Russia among the most popular preoperative planning systems, which by its functionality are beyond the scope of the requirements imposed on the MIS 1st, 2nd and 3rd generation are: TraumaCAD [4][5][6][7], MediCAD (http://www.hectec.de/content/index.php/us), OrthoView [8][9][10], Sectra AB (http://www.sectra.com/medical/osteoporosis/index.html), Surgimap [11,12] IMPAX orthopedic instruments (http://www.agfahealthcare.com). The aim of this study is the identification of the key challenges arising during the implementation of the preoperative planning systems in the practice of spine surgeons.…”

Total knee arthroplasty in patients with extra-Articular deformity: A critical analysis

“…Authors reported their immediate postoperative alignment by IAC with various system including computer assisted navigation (Klein et al [12] , Hamada et al [13] , Catani et al [14] , Tigani et al [9] , Rhee et al [5] , Bottros et al [15] ), Extra Medullary Jig guidance (Wang et al [16] ), Patient Specific Instrumentation (Thienpont et al [17] ). All the studies reported post-operative alignment between 0.2*-1.5*.…”

“…Eleven studies where case reports. Three where level -IV, and case series studies Extra atricular deformity Extra articular deformity is defined as one with preoperative radiograph showing uniplanar or multiplanar deformity in shaft of femur or tibia resulting in gross alteration of limb neutral mechanical axis leads to secondary osteoarthritis of knee joint [5] . Most of the extra articular deformity in review results from previous fracture malunion.…”