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Comparing alignment of proximal tibia first cut between narrow and wide saw blade in CAS TKA
Pawaris Sungkhun1, Viroj Larbpaiboonpong, Thana Turajane
1Department of Orthopaedic Surgery, Police General Hospital, Bangkok, Thailand. pae_pawaris@hotmail.com
Objective:
The primary aim of the present study is to comparison between using narrow and wide saw blade of proximal tibial bone cut in close slot cutting block guide verified by computer navigation system.
Material And Method:
The authors evaluated 80 knees in 80 patients. After cutting the proximal tibia, the cutting surface was validated using the navigated cutting block adapter, and the angular difference between the cutting surface and that preoperatively planned in the sagittal and coronal planes was recorded.
Results:
The average cutting error of all knees was 1.8 degrees +/- 2.7 degrees in use narrow blade and 1.2 degrees +/- 2.2 degrees in use wide blade. The authors did not find statistically significant difference between the first 40 patients and the next 40 patients. The average cutting error of sclerotic bone was 2.3 degrees +/- 2.7 degrees in use narrow blade and 1.1 degrees +/- 2.1 degrees in use wide blade. The authors find statistically significant. The average error in the coronal plane was 1.5 degrees +/- 1.1 degrees in valgus and 2 (2.5%) in varus of the 80 knees had a malalignment of more than 1 degrees with respect to the targeted cutting plan.
Discussion:
Alignment of cutting surface should be checked after cut proximal tibia and recut to reach target alignment and should be cut with wide saw blade especially in sclerotic bone.
Insights
Using a wide saw blade for proximal tibial bone cuts in knee surgery resulted in less cutting error, especially in sclerotic bone. Post-operative alignment checks and adjustments are recommended for optimal results.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
Background:
- Accurate bone cuts are crucial for successful knee arthroplasty.
- Navigated systems offer precision in surgical cuts.
- Saw blade width may influence bone cut accuracy.
Purpose of the Study:
- To compare the accuracy of narrow versus wide saw blades for proximal tibial bone cuts.
- To evaluate bone cut accuracy using a computer navigation system.
Main Methods:
- 80 knees in 80 patients undergoing proximal tibial bone cuts were evaluated.
- Computer navigation verified the accuracy of the bone cuts.
- Angular differences in sagittal and coronal planes were recorded.
Main Results:
- The wide saw blade group showed a lower average cutting error (1.2° ± 2.2°) compared to the narrow blade group (1.8° ± 2.7°).
- In sclerotic bone, the wide blade group had significantly less error (1.1° ± 2.1°) than the narrow blade group (2.3° ± 2.7°).
- 2.5% of knees had a malalignment greater than 1°.
Conclusions:
- Wide saw blades are recommended for proximal tibial bone cuts, particularly in sclerotic bone.
- Verifying and adjusting bone cut alignment post-operatively is essential to achieve the planned surgical target.
