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Minimally invasive imageless computer-navigated knee surgery: initial results.

Sivashankar Chandrasekaran¹, Robert B Molnar

¹Department of Orthopaedic Surgery, Sutherland Hospital, Sutherland NSW, Australia.

The Journal of Arthroplasty

|March 25, 2008

Summary

Imageless computer-aided surgery (CAS) combined with minimally invasive surgery (MIS) for total knee arthroplasty (TKA) accurately aligns components. Initial results show no significant learning curve for this combined approach in TKA procedures.

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Area of Science:

Orthopedic Surgery
Surgical Technology
Biomedical Engineering

Background:

Minimally invasive surgery (MIS) for total knee arthroplasty (TKA) aims to reduce surgical trauma.
Computer-aided surgery (CAS) offers potential for enhanced precision in orthopedic procedures.
The combination of imageless CAS with MIS for TKA has not been previously reported.

Purpose of the Study:

To evaluate the feasibility and accuracy of combining imageless CAS with MIS for TKA.
To assess component alignment in the coronal plane using this combined technique.
To determine if there is a learning curve associated with this novel surgical approach.

Main Methods:

The study included the initial 30 TKA procedures performed by a senior author using imageless CAS and MIS.

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Coronal alignment of femoral and tibial components was measured against the lower limb's mechanical axis.

Tourniquet time was recorded to assess procedural efficiency.

Main Results:

All implants achieved acceptable component positions.
Mean coronal tibial alignment was 90.35 degrees (range, 88-93 degrees).
Mean coronal femoral alignment was 90.10 degrees (range, 88-93 degrees).
Average tourniquet time was 90 minutes (range, 60-118 minutes), with no significant reduction observed with increasing experience.

Conclusions:

Imageless CAS combined with MIS for TKA can maintain accurate component alignment.
The technique demonstrates a high level of precision comparable to traditional methods.
Initial findings suggest no significant learning curve for surgeons adopting this combined approach.