Accuracy of computer-assisted total knee arthroplasty related to extra-articular tibial deformities. (25th October 2013)

• Record Type: Journal Article
• Authors: Tantavisut, Saran; Tanavalee, Aree; Ngarmukos, Srihatach; Yuktanandana, Pongsak; Wilairatana, Vajara; Wangroongsub, Yongsak
• Is Part Of: Computer aided surgery. Volume 18:Number 5/6(2013:Sep./Nov.)
• Page Start: 166
• Page End: 171
• Publication Date: 2013-10-25
• Subjects: Accuracy -- computer-assisted arthroplasty -- computer navigation -- knee arthroplasty -- alignment -- tibia deformity; Computer-assisted surgery -- Periodicals; Imaging systems in medicine -- Periodicals; Surgery, Operative -- Computer simulation -- Periodicals; Surgical technology -- Periodicals; Medical technology -- Periodicals; 617.90285
• DOI: 10.3109/10929088.2013.840803
• Languages: English
• ISSNs: 1092-9088

Abstract

Abstract: Objective: To compare the accuracy of postoperative mechanical alignment in computer-assisted total knee arthroplasties (CAS-TKA) related to various degrees of extra-articular tibial deformity. Methods: We performed CAS-TKA on 30 knee models in which extra-articular proximal tibial deformities were preset to have malalignments ranging from 30° of varus to 30° of valgus. The knees were assigned to two groups, designated Group A (knees with ≤15° preoperative malalignment) and Group B (knees with >15° preoperative malalignment), and the postoperative mechanical alignment in the two groups was compared using a computer-assisted surgery (CAS) system. Resected bone pieces from the distal femurs and proximal tibias were measured with a digital Vernier caliper and the results compared with the CAS calculations to evaluate the execution accuracy of the bone resection. Results: There was no outlier in either group when a ±3° deviation from neutral mechanical alignment was set as the acceptance criterion. Interestingly, Group B showed significantly more outliers when the acceptance criterion was a deviation of ±2° (26.67%, p = 0.0317) or ±1° (6.67%, p = 0.0007) from neutral alignment. There was no statistical difference between the groups in terms of the execution accuracy of the bone resection. Discussion: The CAS-TKA approach provided significantly less alignment accuracy in tibia with greater preoperative frontal deformity, despite there being no outliers beyond ±3°.