Total knee replacement: intraoperative and postoperative kinematic assessment

Area of Science:

• Orthopedics
• Biomedical Engineering
• Medical Imaging

Background:

• Total knee arthroplasty (TKA) aims to alleviate pain and restore function in osteoarthritic knees.
• TKA failures are often linked to wear, loosening, and instability, stemming from imbalance and malalignment.
• Intraoperative and postoperative kinematic analysis can enhance surgical outcomes.

Purpose of the Study:

• To provide an overview of two highly accurate methods for evaluating total knee arthroplasty (TKA) kinematics.
• To present intraoperative and postoperative evaluation techniques used at Istituto Ortopedico Rizzoli.

Main Methods:

• An intraoperative navigation system utilizing an optoelectronic localizer, reference arrays, and a marked probe for 3D knee joint localization and kinematics tracking.
• Roentgen stereophotogrammetric analysis (RSA), a radiographic technique employing synchronized X-ray sources and digital flat-panels for precise kinematic evaluation.

Main Results:

• The navigation system facilitates easy intraoperative kinematic and alignment evaluation during TKA surgery.
• Roentgen stereophotogrammetric analysis (RSA) enables quantitative assessment of joint kinematics during the postoperative recovery period.

Conclusions:

• Both the navigation system and RSA are valuable tools for TKA evaluation.
• These methods contribute to improved understanding and management of TKA outcomes.