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Total knee arthroplasty with a computer-navigated saw: a pilot study.

Kevin L Garvin¹, Andres Barrera, Craig R Mahoney

¹Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, 981080 University of Nebraska Medical Center, Omaha, NE 68198-1080, USA.

Clinical Orthopaedics and Related Research

|September 14, 2012

Summary

Navigated freehand bone cutting (NFC) offers a simpler, faster approach to total knee arthroplasty (TKA) alignment. This method shows promise for improving surgical outcomes and reducing costs.

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Area of Science:

Orthopedic Surgery
Surgical Technology
Biomedical Engineering

Background:

Computer-aided surgery (CAS) in total knee arthroplasty (TKA) has limited adoption due to complex instrumentation.
Navigated freehand bone cutting (NFC) is a novel approach designed for wider acceptance.
NFC aims to simplify TKA by eliminating the need for specialized jigs and expensive navigation systems.

Purpose of the Study:

To evaluate the cutting time, bone cut quality, and implant fit and alignment using NFC on synthetic femoral specimens.
To assess the feasibility and implant alignment of TKA performed with NFC technology in cadaveric specimens.

Main Methods:

Seven surgeons performed bone cuts on synthetic femurs using a custom NFC system.
Quantitative assessments included CT surface scanning and computational measurements for alignment and fit.

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A single surgeon completed TKA on two cadaveric specimens using NFC, with analysis via radiographs and CT.

Main Results:

94% of synthetic specimens achieved coronal alignment within ±2° of neutral.
Rotational alignment was within ±1° of the epicondylar axis in 97% of specimens.
Mean cutting time improved from 13 to 9 minutes, and TKA in cadavers showed good implant alignment without complications.

Conclusions:

Total knee arthroplasty (TKA) is feasible using NFC, demonstrating a rapid learning curve.
NFC technology has the potential to enhance TKA alignment, decrease operative time, and reduce instrument usage and costs.