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

다국어 초록 (Multilingual Abstract)

Purpose: Since 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 Methods: The 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. Results: The mean hip-knee-ankle angle in the coronal plane was improved to 0.2o±4.5o 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 118.5o±10.5o postoperatively.Conclusions: Navigation-assisted TKA is a good treatment option of osteoarthritic knees with extra-articular deformity.

참고문헌 (Reference)

1 Fehring TK, "When computer-assisted knee replacement is the best alternative" 452 : 132-136, 2006

2 Wasielewski RC, "Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty" 299 : 31-43, 1994

3 Luring C, "Two year follow-up comparing computer assisted versus freehand TKR on joint stability, muscular function and patients satisfaction" 17 : 228-232, 2009

4 Klein GR, "Total knee arthroplasty using computer-assisted navigation in patients with deformities of the femur and tibia" 21 : 284-288, 2006

5 Hart R, "Total knee arthroplasty implanted with and without kinematic navigation" 27 : 366-369, 2003

6 Wang JW, "Total knee arthroplasty for arthritis of the knee with extra-articular deformity" 84 : 1769-1774, 2002

7 Bottros J, "The use of navigation in total knee arthroplasty for patients with extra-articular deformity" 23 : 74-78, 2008

8 Whiteside LA, "The anteroposterior axis for femoral rotational alignment in valgus total knee arthroplasty" 321 : 168-172, 1995

9 Lonner JH, "Simultaneous femoral osteotomy and total knee arthroplasty for treatment of osteoarthritis associated with severe extra-articular deformity" 82 : 342-348, 2000

10 Oswald MH, "Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty" 8 : 419-426, 1993

11 Garg, "Prediction of total knee motion using a three-dimensional computer-graphics model" 23 : 45-58, 1990

12 Sparmann M, "Positioning of total knee arthroplasty with and without navigation support : a prospective, randomised study" 85 : 830-835, 2003

13 Suk Ha Jeon, "Efficacy of Extramedullary Femoral Component Alignment Guide System for Blood Saving after Total Knee Arthroplasty" 대한슬관절학회 24 (24): 99-103, 2012

14 Berger RA, "Determining the rotational alignment of the femoral component in total knee arthroplasty using the epicondylar axis" 286 : 40-47, 1993

15 Jenny JY, "Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system : a case-control study of 235 cases compared with 235 conventionally implanted prostheses" 20 : 832-839, 2005

16 Chauhan SK, "Computer-assisted knee arthroplasty versus a conventional jig-based technique : a randomised, prospective trial" 86 : 372-377, 2004

17 Bolognesi M, "Computer navigation versus standard instrumentation for TKA : a single-surgeon experience" 440 : 162-169, 2005

18 Kalairajah Y, "Are systemic emboli reduced in computer-assisted knee surgery? : a prospective, randomised, clinical trial" 88 : 198-202, 2006

19 Bathis H, "Are computer assisted total knee replacements more accurately placed? A meta-analysis of comparative studies" 35 : 1056-1065, 2006

20 Ensini A, "Alignments and clinical results in conventional and navigated total knee arthroplasty" 457 : 156-162, 2007

21 Bathis H, "Alignment in total knee arthroplasty : a comparison of computer-assisted surgery with the conventional technique" 86 : 682-687, 2004