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Deviations between intra-operative navigation data and post-operative weight-bearing X-rays.

I Livshetz1, Y S Brin, C Holcroft

  • 1Department of Orthopaedic Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.

Computer Aided Surgery : Official Journal of the International Society for Computer Aided Surgery
|June 5, 2010
PubMed
Summary

Computer navigation in total knee arthroplasty (TKA) may not prevent outliers. Post-operative X-rays revealed significant deviations from intra-operative navigation data, indicating navigation alone is insufficient for precise alignment.

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Area of Science:

  • Orthopedic Surgery
  • Medical Technology

Background:

  • Computer navigation is increasingly used in total knee arthroplasty (TKA) to improve implant alignment and reduce outliers.
  • Existing studies suggest navigation systems enhance surgical accuracy.

Purpose of the Study:

  • To evaluate the accuracy of intra-operative computer navigation data against post-operative radiographic measurements in TKA.
  • To determine the incidence of outliers beyond a 3-degree threshold in navigated TKA.

Main Methods:

  • Thirty-one patients underwent TKA using a computer navigation system.
  • Intra-operative data (HKA angle, coronal implant angles) were compared with measurements from post-operative X-rays using CAD software.
  • Statistical analysis was performed to identify significant deviations.

Main Results:

  • Statistically significant differences were found between intra-operative and post-operative measurements for tibial cut (1.29° ± 1.35°) and HKA angle (1.59° ± 2.36°).
  • Outliers exceeding 3° were observed in 9.6% of tibial implants, 6.4% of femoral implants, and 29% of HKA angles.
  • The navigation system alone did not consistently prevent outliers.

Conclusions:

  • Intra-operative computer navigation data in TKA may not perfectly correlate with post-operative radiographic alignment.
  • Navigation alone appears insufficient to guarantee outlier prevention within a 3-degree margin for all TKA parameters.