Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
MANFRIN, Federico G. y MAESTU, Rodrigo. Our experience in total knee arthroplasty with navigation assistance. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2009, vol.74, n.4, pp. 341-346. ISSN 1852-7434.
Background: At the end of the eighties and the early nineties, various proposals arose in order to assist surgeons in performing Total Knee Arthroplasties (TKA) of different degrees of complexity, using an appropriate computer software. At the end of the nineties, the first image-free navigation system was presented. We describe here the proper technique and the overall results obtained. Methods: From December 2003 to January 2006, we performed 40 total knee arthroplasties in 38 patients using a computer- assisted navigation system (Orthopilot/ Software TK 4.0) and the same prosthesis implant (Search Evolution, B-Braun/ Aesculap). We describe the technique used and the conceptual foundations of the computer software. Results: We present the clinical and radiographic results using the HSS and Knee Society scores respectively, at a minimum 18 month follow-up. According to the parameters evaluated by HSS, the results are between excellent and good, while Knee Society scores predict great durability. We have found no early mechanical loosening in our navigated series, although a removal had to be performed due to an acute infection. Conclusions: We conclude that the TKA surgery with computer-assisted navigation provides accuracy and safety to surgical cuts. The use of the navigated technique significantly improves the implant alignment and allows doctors to control it intraoperatively. It also enables the surgeon to perform the ligament balancing which reduces technical errors of alignment and stability along with the certain chance of early mechanical loosening.
Palabras clave : Total knee arthroplasty; Navigation assistance; Mechanical axis; Anatomial axis.