Intraoperative fluoroscopy improves surgical precision in conventional TKA.

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Radiology

Background:

• Accurate coronal alignment is crucial for successful total knee arthroplasty (TKA).
• Conventional TKA techniques can face challenges in achieving precise coronal limb alignment.
• Intraoperative imaging modalities are being explored to enhance surgical accuracy.

Purpose of the Study:

• To evaluate the efficacy of intraoperative fluoroscopy in achieving the target coronal limb alignment during conventional TKA.
• To determine if fluoroscopy-assisted TKA leads to improved alignment compared to standard techniques.
• To assess the impact of intraoperative fluoroscopy on malalignment rates in TKA.

Main Methods:

• A randomized controlled trial involving 106 patients undergoing conventional cemented TKA.
• Patients were assigned to either a fluoroscopy-assisted or non-assisted surgical group.
• Fluoroscopy guided adjustments to femoral and tibial resections to correct mechanical axis deviation errors exceeding 0.5°.

Main Results:

• Fluoroscopy-assisted TKA showed a trend towards reduced malalignment (>3°), though not statistically significant (RR 0.7).
• Mean fluoroscopy time was minimal (3 seconds), but operative time increased (69 vs. 60 minutes, p < 0.001).
• No significant difference in American Knee Society Scores at 1-year follow-up between groups.

Conclusions:

• Intraoperative fluoroscopy appears to be an effective tool for enhancing the precision of TKA coronal plane alignment.
• This technique offers a potential method to improve accuracy in TKA surgery.
• Further research may explore optimizing fluoroscopy use to balance precision gains with operative time.