Low incidence of postoperative complications due to pin placement in computer-navigated total knee arthroplasty

Computer-navigated joint arthroplasty surgery using optical tracking systems requires arrays fixated to bone via pins. Reports of fractures at pin sites have raised concern about safety. We reviewed the postoperative complications occurring in a single-surgeon series of 984 consecutive primary total knee arthroplasties. All pins were placed unicortically and connected by a dual pin array. Femoral pins were placed into the medial epicondyle, and tibial pins were placed in the shaft 10 cm inferior to the joint line. There were no fractures. Seventeen (1.7%) patients had minor pin-related complications. Twelve patients had a superficial infection around the tibial pin sites, which resolved with antibiotics. None of the infections required readmission or reoperation. We believe pin placement to be safe and effective with proper technique.