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Navigation in total knee arthroplasty. A multicenter study

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Abstract

We carried out a multicentre study to compare the postoperative femorotibial radiographic axis in two total knee replacement groups; one using manual instrumentation and the other using navigation. In the latter group, three navigation systems were used: Stryker, Orthopilot and Navitrack. The prior circumstances of patients in terms of age, weight, aetiology, epicondylar perimeter, patellar tendon length and knee deformity was similar in both groups. The duration of the operation was longer in the group with navigation (16.7 min). A normal femorotibial axis was more frequently obtained in the group with a navigator compared to the manual group (48.1% and 30%, respectively). A varus axis was most common in the manual group (42.2 and 26.9%, respectively). When we analysed the final postoperative radiographic axis, taking 180° to be a normal result, we noted that cases where manual instrumentation was used deviated by 1.19° more than those carried out with navigation, with this difference being statistically significant (P<0.001). No significant differences were found in the final angle of the extremity with the different navigation systems. The navigation systems used in this study improve the frontal angle of the arthroplasty.

Résumé

Nous avons réalise une étude multicentrique pour comparer l’axe fémoro-tibial post-opératoire dans deux groupes de prothèses totales du genou, réalisée soit avec détermination instrumentale manuelle de l’axe ou avec navigation. Dans le deuxième groupe, trois systèmes de navigation ont été réalisés : le système de Stryker, l’Orthopilot et le Navitrack. Les paramètres concernant l’âge, le poids, l’étiologie, la déformation du genou, la longueur du tendon rotulien, l’axe épicondylien sont similaires dans les deux groupes. Le temps opératoire est plus long dans le groupe avec navigation (16,7 min). Un axe fémoro-tibial normal est plus couramment rencontré dans le groupe navigation comparé au groupe avec détermination manuelle de l’axe (48,1% contre 30%). Cependant, la présence d’un axe en varus est plus fréquente dans le groupe avec détermination manuelle de l’axe (42,2% contre 26,9%). Lorsque nous analysons la radiographie finale post-opératoire, en prenant 180° comme axe normal, nous devons noter que pour le groupe utilisant la détermination manuelle instrumentale la déviation axiale est de 1,19° de plus que ceux traités avec navigation. Il s’agit d’une différence statistiquement significative (p<0.01). Nous considérons que le système de navigation améliore la détermination de l’angle frontal en post-opératoire.

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Authors and Affiliations

  1. Knee Surgery Unit, Hospital Clinic, Barcelona, Spain

    F. Maculé-Beneyto & J. M. Segur-Vilalta

  2. Department of Orthopaedic Surgery, School of Medicine, Oviedo, Spain

    D. Hernández-Vaquero

  3. Consorcio Hospital General Universitario, Valencia, Spain

    R. Colomina-Rodríguez

  4. Hospital IMAS, Barcelona, Spain

    P. Hinarejos-Gomez

  5. Hospital Juan XXIII, Tarragona, Spain

    I. García-Forcada

  6. Hospital Clínico Universitario, Zaragoza, Spain

    B. Seral Garcia

  7. Apartado de Correos 341, 33400, Aviles, Spain

    D. Hernández-Vaquero

Authors
  1. F. Maculé-Beneyto
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  2. D. Hernández-Vaquero
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  3. J. M. Segur-Vilalta
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  4. R. Colomina-Rodríguez
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  5. P. Hinarejos-Gomez
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  6. I. García-Forcada
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  7. B. Seral Garcia
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Correspondence to D. Hernández-Vaquero.

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Maculé-Beneyto, F., Hernández-Vaquero, D., Segur-Vilalta, J.M. et al. Navigation in total knee arthroplasty. A multicenter study. International Orthopaedics (SICOT) 30, 536–540 (2006). https://doi.org/10.1007/s00264-006-0126-7

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  • DOI: https://doi.org/10.1007/s00264-006-0126-7

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