Alignment of resection planes in total knee replacement obtained with the conventional technique, as assessed by a modern computer-based navigation system

C. Belvedere, A. Ensini, A. Leardini, L. Bianchi, F. Catani, S. Giannini

Research output: Contribution to journalArticlepeer-review

Abstract

Background: To improve the anatomy-based alignment of prosthetic components in total knee replacement, surgical navigation systems have recently been developed, based on anatomical reference frame definitions through landmark digitations and functional calibration. In this study, femoral and tibial resection plane alignments, obtained by conventional tecnique, were measured intraoperatively during total knee replacements by a navigation system to quantify potential errors in conventional bone preparation techniques. Methods: Femoral and tibial resection plane alignments, obtained by conventional femoral intramedullary and tibial extramedullary cutting guides, were measured intraoperatively in 25 primary total knee replacements by a navigation system. This system enabled the surgeon to calculate, before definitive bone sawing, the final position and orientation of all resection planes. Results: The measurements revealed unsatisfactory alignments in nearly all anatomical planes. Except for tibial varus/valgus, final plane orientations were considerably different from those targeted by the surgeon via the navigation system, respectively 7°, 8° and 10° apart in varus-valgus and flexion-extension at the femur, and in flexion-extension at the tibia. Conclusion: Modern computer-aided surgery in total knee replacement, once relevant precision has been established in all femur and tibia anatomical planes, can in the future limit the current critical component misalignments.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalInternational Journal of Medical Robotics and Computer Assisted Surgery
Volume3
Issue number2
DOIs
Publication statusPublished - Jun 2007

Keywords

  • Computer aided surgery
  • Conventional total knee replacement
  • Femur/Tibia resection plane definition
  • Knee surgical navigation

ASJC Scopus subject areas

  • Biophysics
  • Computer Science Applications
  • Surgery

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