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Handheld computer-navigated constrained total knee arthroplasty for complex extra-articular deformities.

M Pietsch1, M Hochegger2, O Djahani2

  • 1Department of Orthopaedic Surgery, Orthopaedic Hospital Stolzalpe (LKH Murtal), Stolzalpe 38, 8852, Stolzalpe, Austria. martin.pietsch@lkh-stolzalpe.at.

Archives of Orthopaedic and Trauma Surgery
|July 13, 2021
PubMed
Summary
This summary is machine-generated.

Computer-assisted surgery (CAS) with modular stems effectively realigns complex knee deformities during total knee arthroplasty (TKA), improving patient function and limb alignment.

Keywords:
AlignmentComputer navigationComputer-assisted surgeryConstrained total knee arthroplastyExtra-articular deformityTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Reconstructive Surgery

Background:

  • Complex extra-articular deformities (EADs) present significant challenges in total knee arthroplasty (TKA).
  • Accurate limb alignment and component positioning are crucial for successful TKA outcomes.

Purpose of the Study:

  • To evaluate the postoperative alignment and clinical results of TKA in patients with EADs using computer-assisted surgery (CAS) and modular stem extensions.
  • To assess the efficacy of CAS in managing complex knee deformities.

Main Methods:

  • Retrospective analysis of ten patients with EADs undergoing CAS-guided constrained TKA.
  • Preoperative templating and assessment of mechanical axis deviation using a handheld CAS system.
  • Analysis of component positioning, stem usage, and clinical outcomes at an average follow-up of 3.3 years.

Main Results:

  • Postoperative mechanical axis was within ±3.0° of neutral in nine out of ten patients.
  • Significant improvements were observed in Knee Society score (KSS) and range of motion for all patients.
  • Modular stem selection required adjustments, with varied stem lengths and types used for femur and tibia components.

Conclusions:

  • Handheld CAS system provides excellent management for complex EADs during constrained TKA.
  • Preoperative templating with CAS effectively identifies potential stem length issues, preventing anatomical conflicts.
  • Surgery resulted in significant improvements in limb alignment and patient function with no complications.