Rotation fémorale par navigation sur la base d’un scanner préopératoire dans l’arthroplastie totale de genou : à propos de 70 cas

Rotational alignment of the distal femur: anthropometric measurements with CT-based patient-specific instruments planning show high variability of the posterior condylar angle

“…Recently, some surgeons advocated preoperative CT for TKA planning to obtain the individual PCA for each patient. The advantage of preoperative CT scan is the potential to measure the angle between a reliable intraoperative reference line like the PCL and a CT-derived optimal axis (SEA) [1,29,49]. The data found in this study show that even in the same patient, an individual PCA exists with different angles between the left and the right knee therefore confirming the advantage of adequate preoperative planning.…”

A computed tomography based study on rotational alignment accuracy of the femoral component in total knee arthroplasty using computer-assisted orthopaedic surgery

“…A systematic error of 3° was found using the same navigation module by Van der Linden et al [30]. Several authors [13, 20] concluded that, because of this problem, preoperative CT scanning is a more appropriate method because of the fact that using computer navigation, rotation is still based on a controversial intraoperative identification of the axes. Also, averaging the different alignment axes will not solve this problem.…”

Abnormal rate of intraoperative and postoperative implant positioning outliers using “MRI-based patient-specific” compared to “computer assisted” instrumentation in total knee replacement

“…Three months after surgery, hip‐knee‐ankle angle (HKA), frontal (FFMA, FTMA), and sagittal (SFMA, STMA) alignments were measured with full weight‐bearing radiographs. Rotation of the femoral component was assessed with axial CT images by comparing the posterior condylar axis of the implants and the anatomical transepicondylar axis [21].…”

“…The initial target position of the implants was set to restore the mechanical alignment of the lower extremity in the coronal plane at 0° flexion from the mechanical axis of the femur and at 3° posterior slope to the mechanical axis of the tibia in the sagittal plane. Femoral component rotation was set at 2° relative to the anatomical transepicondylar axis [21]. All cutting block models were made from Nylon-12 and delivered in a sterile pack.…”

“…Coronal, sagittal, and rotational plane outliers have been shown to be associated with inferior function after total knee arthroplasty (TKA) [1, 2, 4, 7, 8, 22, 26, 31]. Computer‐assisted surgery (CAS) TKA was introduced to minimize these outliers in component positioning and alignment [21]. However, navigated TKAs usually take a longer time than conventional methods, and potentially increase the risk of infection and pin site complications [6, 9, 24].…”