Assessing whether preoperative templates and planning can replace intraoperative computer-assisted surgery...

It is incumbent on the orthopedic community to assess current technologies available to predict the size of implants used for total knee arthroplasty (TKA) and whether they can accurately represent what will be visualized by surgeons intraoperatively. This study highlights the traditional practice of TKA by applying digitization software to streamline existing knowledge preoperatively in an effort to more accurately dimension the implants. The primary goal of the study was to assess the predictive value of a digitized templating system for TKA. The secondary goal was to ascertain whether varus, valgus, and flexion deformities were accurately predicted to intraoperative measures using computer-assisted surgery. Forty-three patients were prospectively assessed using standard-of-care 36-inch anteroposterior evaluations for determining mechanical angle and flexion contractures. Simultaneously, traditional radiographs were used as a sizing tool for the digitized software program. Statistical evaluation was completed by 2-tailed t test with incorporation of a varied window of acceptance (± 3° and ± 2° in mechanical angle and flexion contracture measurements, respectively). This study showed a poor correlation between the predictive value of the digitization software; just one-third of the cases were accurately predicted.