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Kinematic TKA using navigation: Surgical technique and initial results.

J R B Hutt1, M-A LeBlanc1, V Massé1

  • 1Université de Montréal, Hôpital Maisonneuve-Rosemont, Department of Surgery, 5415 boulevard de l'Assomption, Montréal, QC H1T 2M4, Canada.

Orthopaedics & Traumatology, Surgery & Research : OTSR
|January 19, 2016
PubMed
Summary

Computer navigation in total knee arthroplasty (TKA) helps reproduce native anatomy and simplify ligament balance. This technique leads to significant improvements in patient function and satisfaction scores.

Keywords:
KinematicKnee ArthroplastyNavigationOutcomesTKATechnique

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Kinematic alignment in total knee arthroplasty (TKA) aims to improve patient outcomes.
  • Previous methods like patient-specific instrumentation are costly, while standard instrumentation lacks intraoperative feedback on resection alignment.

Purpose of the Study:

  • To evaluate computer navigation's ability to replicate native knee anatomy during TKA.
  • To assess if computer navigation simplifies ligament balancing and improves functional scores post-surgery.

Main Methods:

  • Computer navigation was employed for kinematic distal femoral and proximal tibial cuts in 100 TKAs.
  • Resections were adjusted if angles fell outside pre-defined safe ranges.
  • Pre- and postoperative radiographic measurements (HKA, LDFA, MPTA) and clinical scores (WOMAC, KOOS) were analyzed.

Main Results:

  • Postoperative alignment showed no significant change in LDFA (P=0.41) but a significant change in MPTA (P=0.03).
  • Significant improvements were observed in WOMAC (P<0.001) and KOOS (P<0.001) scores.
  • 5% of knees required additional ligament release, and 2% needed lateral retinacular release for patellar tracking.

Conclusions:

  • Computer navigation offers surgeons precise control and feedback during kinematic TKA.
  • This technique allows for partial correction of challenging anatomy while preserving ligament isometry.
  • Satisfactory improvements in functional outcomes were achieved in the early postoperative period.