[Interest of non invasive navigation in total knee arthroplasty]

During surgery of total knee arthroplasty, we use a computerized non invasive navigation (Brainlab Victor Vision CT-free) to assess the accuracy of the bone cuts (navigation expresse). The purpose of this study is to evaluate non invasive navigation when a total knee arthroplasty is achieved by conventional instrumentation. The study is based on forty total knee arthroplasties. The accuracy of the tibial and distal femoral bone cuts, checked by non invasive navigation, is evaluated prospectively. In our clinical series, we have obtained, with the conventional instrumentation, a correction of the mechanical axis only in 90 % of cases (N = 36). With non invasive navigation, we improved the positioning of implants and obtained in all cases the desired axiometry in the frontal plane. Although operative time is increased by about 15 minutes, the non invasive navigation does not induce intraoperative or immediate postoperative complications. Despite the cost of this technology, we believe that the reliability of the procedure is enhanced by a simple and reproducible technique.