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Navigated total knee arthroplasty: is it error-free?

Kerk Hsiang Zackary Chua¹, Yongsheng Chen, Krishna Lingaraj

¹Division of Hip and Knee Surgery, National University Health System, 1E Kent Ridge Road, NUHS Tower Block, Level 11, Singapore, 119228, Singapore.

Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA

|September 25, 2013

Summary

Errors can occur in navigated total knee arthroplasty (TKA) due to manual steps. Computer navigation should verify bone resection and implant placement for improved accuracy in TKA procedures.

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Area of Science:

Orthopedic Surgery
Biomedical Engineering
Surgical Navigation Systems

Background:

Computer navigation is increasingly used in total knee arthroplasty (TKA) to improve accuracy.
Potential for errors exists in navigated procedures, particularly in manual steps.
Understanding error sources is crucial for optimizing TKA outcomes.

Purpose of the Study:

To investigate the occurrence of errors in navigated total knee arthroplasty (TKA).
To identify whether bone resection or implantation errors contribute to inaccuracies in navigated TKA.

Main Methods:

A series of 20 TKAs were analyzed using computer navigation.
Coronal and sagittal alignments of cutting guides, bone resections, and final implants were compared.
Post-implantation mechanical limb alignment was assessed.

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Main Results:

Median deviations in cutting guide and bone resection alignments were observed in both coronal and sagittal planes.
Deviations between bone resection and final implant alignment were noted, particularly in the sagittal plane for the tibia.
The median post-implantation mechanical limb alignment was within acceptable ranges.

Conclusions:

Manual, non-navigated steps in TKA can introduce errors even with navigation guidance.
Increased cutting errors were found in the sagittal plane for both femur and tibia.
Computer navigation should be utilized for verifying bone resection and implant positioning in TKA.