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Published on: September 7, 2022
No difference in accuracy between pinless and conventional computer-assisted surgery in total knee arthroplasty
C Baier1, G Maderbacher, H R Springorum
1Orthopaedic Department, University of Regensburg, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Germany, dr.clemensbaier@gmail.com.
Summary
A new pinless computer-assisted surgery (CAS) for total knee arthroplasty (TKA) offers improved precision without increasing operation time or complications. This innovative approach maintains the benefits of traditional CAS while eliminating drawbacks associated with reference pins.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Surgical Navigation
Background:
- Computer-assisted surgery (CAS) enhances precision in total knee arthroplasty (TKA) but can prolong surgery and introduce pin-related complications.
- Conventional CAS utilizes reference pins, which can lead to fractures, neurovascular injuries, or necessitate abortion of the procedure.
Purpose of the Study:
- To evaluate the accuracy and efficiency of a pinless, CT-free knee navigation system.
- To determine if abandoning reference pins in CAS for TKA can maintain radiological accuracy while reducing operative time and risks.
Main Methods:
- A comparative study involving 30 patients undergoing TKA.
- Accuracy assessment of two CT-free knee navigation software versions (Brainlab Knee 2.1 and 2.5).
- Intraoperative comparison of bony resections between standard CAS and the novel pinless CAS, followed by postoperative radiographic evaluation of leg axis, femoral flexion, and tibial slope.
Main Results:
- Pinless CAS demonstrated comparable accuracy to standard CAS in femoral and tibial alignment, flexion, and slope.
- Mean deviations for coronal alignment and flexion/slope were minimal (e.g., 0.3° for femoral coronal alignment).
- The pinless CAS added less than 2 minutes to operative time, with all patients achieving the desired mechanical leg axis postoperatively.
Conclusions:
- Pinless CAS effectively combines the advantages of traditional CAS while mitigating its disadvantages.
- This technique reduces surgical time and avoids complications linked to reference pins, making it suitable for clinical routine.