TITLE

Averaging Different Alignment Axes Improves Femoral Rotational Alignment in Computer-Navigated Total Knee Arthroplasty

AUTHOR(S)
Siston, Robert A.; Cromie, Melinda J.; Gold, Garry E.; Goodman, Stuart B.; Delp, Scott L.; Maloney, William J.; Giori, Nicholas J.
PUB. DATE
October 2008
SOURCE
Journal of Bone & Joint Surgery, American Volume;Oct2008, Vol. 90-A Issue 10, p2098
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Computer navigation systems generally establish the rotational alignment axis of the femoral component on the basis of user-defined anatomic landmarks. However, navigation systems can also record knee kinematics and average alignment axes established with multiple techniques. We hypothesized that establishing femoral rotational alignment with the use of kinematic techniques is more accurate and precise (repeatable) than the use of anatomic techniques and that establishing femoral rotational alignment by averaging the results of different alignment techniques is more accurate and precise than the use of a single technique. Methods: Twelve orthopaedic surgeons used three anatomic and two kinematic alignment techniques to establish femoral rotational alignment axes in a series of nine cadaver knees. The axes derived with the individual anatomic and kinematic techniques as well as the axes derived with six combination techniques-i.e., those involving averaging of the alignments established with two of the individual techniques-were compared against a reference axis established with computed tomography images of each femur. Results: The kinematic methods were not more accurate (did not have smaller mean errors) or more precise (repeatable) than the anatomic techniques. The combination techniques were accurate (five of the six had a mean error of <50) and significantly more precise than all but one of the single methods. The percentage of measurements with <5° of error as compared with the reference epicondylar axis was 37% for the individual anatomic techniques, 30% for the individual kinematic techniques, and 58% for the combination techniques. Conclusions: Averaging the results of kinematic and anatomic techniques, which is possible with computer navigation systems, appears to improve the accuracy of rotational alignment of the femoral component. The number of rotational alignment outliers was reduced when combination techniques were used; however, they are still a problem and continued improvement in methods to accurately establish rotation of the femoral component in total knee arthroplasty is needed.
ACCESSION #
34775824

 

Related Articles

  • Functional improvement after unicompartmental knee replacement: a follow-up study with a performance based knee test. Kleijn, Lucas; Hemert, Wouter; Meijers, Will; Kester, Arnold; Lisowski, Lukas; Grimm, Bernd; Heyligers, Ide // Knee Surgery, Sports Traumatology, Arthroscopy;Oct2007, Vol. 15 Issue 10, p1187 

    In literature no reports appear on functional recovery of unicompartmental knee replacement using both subjective and objective methods. Functional aspects are especially of importance, since prosthetic replacement is considered more often in younger patients, who require an optimal knee...

  • Patient function after a posterior stabilizing total knee arthroplasty: cam—post engagement and knee kinematics. Suggs, Jeremy; Hanson, George; Park, Sang; Moynihan, Angela; Li, Guoan // Knee Surgery, Sports Traumatology, Arthroscopy;Mar2008, Vol. 16 Issue 3, p290 

    Even though posterior substituting total knee arthroplasty has been widely used in surgery, how the cam–post mechanism (posterior substituting mechanism) affects knee joint kinematics and function in patients is not known. The objective of the present study was to investigate posterior...

  • Does ligament balancing technique affect kinematics in rotating platform, PCL retaining knee arthroplasties? Gamada, K.; Jayasekera, N.; Kashif, F.; Fennema, P.; Schmotzer, H.; Banks, S. // Knee Surgery, Sports Traumatology, Arthroscopy;Feb2008, Vol. 16 Issue 2, p160 

    The goal of this prospective, randomized, blinded trial was to determine if ligament balancing techniques for rotating platform TKA affect postoperative knee kinematics. Sixteen patients with unilateral rotating platform TKA consented to participate in this institutional review board approved...

  • Comparing in vivo kinematics of anterior cruciate-retaining and posterior cruciate-retaining total knee arthroplasty. Moro-oka, Taka-aki; Muenchinger, Marc; Canciani, Jean-Pierre; Banks, Scott // Knee Surgery, Sports Traumatology, Arthroscopy;Jan2007, Vol. 15 Issue 1, p93 

    The purpose of this study was to compare knee kinematics in patients with bi-cruciate preserving total knee arthroplasty and posterior cruciate ligament (PCL) preserving total knee arthroplasty. Five knees received PCL-retaining arthroplasty and nine knees received both cruciate-retaining...

  • Preoperative Templating and Biomechanics in Total Hip Arthroplasty. Schmalzried, Thomas P. // Orthopedics;Aug2005 Supplement, Vol. 28, ps849 

    Preoperative templating is an essential ingredient of a successful hip arthroplasty. The socket template is positioned first to establish the center of rotation of the reconstruction. For femoral templating, a surgeon should not only consider the part inside the bone (the size of the component),...

  • Lateral unicompartimental knee arthroplasty: indications, technique and short-medium term results. Volpi, Piero; Marinoni, Luca; Bait, Corrado; Galli, Marco; Denti, Matteo // Knee Surgery, Sports Traumatology, Arthroscopy;Sep2007, Vol. 15 Issue 8, p1028 

    Lateral unicompartmental knee arthroplasty (UKA) is a valid alternative treatment in the event of arthritis confined to the lateral compartment. This paper examines its indications, technique and short to medium-term results. A total of 159 Miller–Galante cemented UKA prostheses (Zimmer,...

  • Patellar tracking during total knee arthroplasty: an in vitro feasibility study. Belvedere, C.; Catani, F.; Ensini, A.; Moctezuma de la Barrera, J.; Leardini, A. // Knee Surgery, Sports Traumatology, Arthroscopy;Sep2007, Vol. 15 Issue 8, p985 

    Abnormal patellar tracking results in patello-femoral (PF) joint disorders and frequently in failure of total knee arthroplasty (TKA). It is fundamental to assess this tracking intra-operatively, i.e. since the implantation of the femoral and tibial components. The aim of this study was to...

  • Balancing the Flexion Gap: Relationship Between Tibial Slope and Posterior Cruciate Ligament Release and Correlation with Range of Motion. Lombardi, Jr., Adolph V.; Berend, Keith R.; Aziz-Jacobo, Jorge; Davis, Mark B. // Journal of Bone & Joint Surgery, American Volume;Nov2008 Supplement 4, Vol. 90-A, p121 

    The article reports on the results of research which was conducted in an effort to identify the relationship between the posterior tibial slope and the need for release of the posterior cruciate ligament in patients that have had total knee replacements, and to correlate these factors with the...

  • Early clinical and radiological results of total knee arthroplasty using patient-specific guides in obese patients. Anwar, Rahij; Kini, Sunil; Sait, Saif; Bruce, Warwick; Kini, Sunil Gurpur; Bruce, Warwick J M // Archives of Orthopaedic & Trauma Surgery;Feb2016, Vol. 136 Issue 2, p265 

    Purpose: Total knee arthroplasty (TKA) is a challenging procedure in patients with a high body mass index (BMI). The aim of our study was to assess the outcome and accuracy of restoration of mechanical alignment in TKA using patient-specific guides (PSG) involving patients with high...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics