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Navigation knee replacement

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Abstract

Total knee replacement (TKR) achieves an immediate and exceptional restoration in the quality of life that is comparable only to a few other procedures. It has been suggested that the most common cause of revision TKR is error in surgical technique, from malpositioning of the components which results in a poorer post-operative outcome. Based on the theoretical assumption that the use of computer-assisted systems (CAS) in TKRs may improve implant alignment and thus implant longevity, the use of this technology is becoming increasingly popular. This article (a) reviews whether computer-assisted TKR (CASTKR) results in improved prosthesis alignment compared with the conventional technique, (b) assesses the functional and clinical outcomes of CASTKR and (c) evaluates the cost-effectiveness of using this technology.

Résumé

La prothèse totale du genou (TKR) permet de restaurer une qualité de vie comparable à peu d’autres techniques. Il est courant de penser que la cause la plus habituelle de reprise des prothèses du genou est secondaire à une erreur technique du fait d’un mauvais positionnement des composants. Sur le plan théorique, l’utilisation de la navigation (CAS) permet d’améliorer l’alignement des implants et donc la longévité de la prothèse. Cette technique devenant de plus en plus populaire. Cet article permet d’analyser les résultats en fonction de l’utilisation de la navigation comparée à une technique conventionnelle, avec évaluation clinique, fonctionnelle (CATKR) ainsi que le rapport coût/utilité de cette technique.

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References

  1. Bathis H, Perlick L, Tingart M, Luring C, Perlick C, Grifka J (2004) Radiological results of image-based and non-image-based computer-assisted total knee arthroplasty. Int Orthop 28:87–90

    Article  PubMed  CAS  Google Scholar 

  2. Bauwens K, Matthes G, Wich M, Gebhard F, Hanson B, Ekkernkamp A, Stengel D (2007) Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 89:261–269

    Article  PubMed  Google Scholar 

  3. Bejek Z, Solyom L, Szendroi M (2007) Experiences with computer navigated total knee arthroplasty. Int Orthop 31:617–622

    Article  PubMed  Google Scholar 

  4. Bierbaum BE, Callaghan JJ, Galante JO, Rubash HE, Tooms RE, Welch RB (1999) An analysis of blood management in patients having a total hip or knee arthroplasty. J Bone Joint Surg Am 81:2–10

    PubMed  CAS  Google Scholar 

  5. Chauhan SK, Scott RG, Breidahl W, Beaver RJ (2004) Computer-assisted knee arthroplasty versus a conventional jig-based technique. A randomised, prospective trial. J Bone Joint Surg Br 86:372–377

    Article  PubMed  CAS  Google Scholar 

  6. Chiu KY, Yau WP, Ng TP, Tang WM (2008) The accuracy of extramedullary guides for tibial component placement in total knee arthroplasty. Int Orthop 32:467–471

    Article  PubMed  CAS  Google Scholar 

  7. Church JS, Scadden JE, Gupta RR, Cokis C, Williams KA, Janes GC (2007) Embolic phenomena during computer-assisted and conventional total knee replacement. J Bone Joint Surg Br 89:481–485

    Article  PubMed  CAS  Google Scholar 

  8. Dong H, Buxton M (2006) Early assessment of the likely cost-effectiveness of a new technology: a Markov model with probabilistic sensitivity analysis of computer-assisted total knee replacement. Int J Technol Assess Health Care 22:191–202

    Article  PubMed  Google Scholar 

  9. Hart R, Janecek M, Chaker A, Bucek P (2003) Total knee arthroplasty implanted with and without kinematic navigation. Int Orthop 27:366–369

    Article  PubMed  CAS  Google Scholar 

  10. Hawker G, Wright J, Coyte P, Paul J, Dittus R, Croxford R, Katz B, Bombardier C, Heck D, Freund D (1998) Health-related quality of life after knee replacement. J Bone Joint Surg Am 80:163–173

    PubMed  CAS  Google Scholar 

  11. Insall JN, Scuderi GR, Komistek RD, Math K, Dennis DA, Anderson DT (2002) Correlation between condylar lift-off and femoral component alignment. Clin Orthop Relat Res 403:143–152

    Article  PubMed  Google Scholar 

  12. Jenny JY, Boeri C (2001) Computer-assisted implantation of total knee prostheses: a case-control comparative study with classical instrumentation. Comput Aided Surg 6:217–220

    Article  PubMed  CAS  Google Scholar 

  13. Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK (2005) Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 20:832–839

    Article  PubMed  Google Scholar 

  14. Jonsson B, Aström J (1988) Alignment and long-term clinical results of a semiconstrained knee prosthesis. Clin Orthop Relat Res 226:124–128

    PubMed  Google Scholar 

  15. Kalairajah Y, Cossey AJ, Verrall GM, Ludbrook G, Spriggins AJ (2006) Are systemic emboli reduced in computer-assisted knee surgery?: a prospective, randomised, clinical trial. J Bone Joint Surg Br 88:198–202

    PubMed  CAS  Google Scholar 

  16. Kalairajah Y, Simpson D, Cossey AJ, Verrall GM, Spriggins AJ (2005) Blood loss after total knee replacement: effects of computer-assisted surgery. J Bone Joint Surg Br 87:1480–1482

    Article  PubMed  CAS  Google Scholar 

  17. Kim YH, Kim JS, Yoon SH (2007) Alignment and orientation of the components in total knee replacement with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br 89:471–476

    Article  PubMed  Google Scholar 

  18. Krackow KA, Phillips MJ, Bayers-Thering M, Serpe L, Mihalko WM (2003) Computer-assisted total knee arthroplasty: navigation in TKA. Orthopedics 26:1017–1023

    PubMed  Google Scholar 

  19. Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89:780–785

    Article  PubMed  Google Scholar 

  20. Luring C, Bathis H, Tingart M, Perlick L, Grifka J (2006) Computer assistance in total knee replacement—a critical assessment of current health care technology. Comput Aided Surg 11:77–80

    Article  PubMed  CAS  Google Scholar 

  21. Ma HM, Lu YC, Ho FY, Huang CH (2005) Long-term results of total condylar knee arthroplasty. J Arthroplasty 20:580–584

    Article  PubMed  Google Scholar 

  22. Macule-Beneyto F, Hernandez-Vaquero D, Segur-Vilalta JM, Colomina-Rodriguez R, Hinarejos-Gomez P, Garcia-Forcada I, Seral GB (2006) Navigation in total knee arthroplasty. A multicenter study. Int Orthop 30:536–540

    Article  PubMed  CAS  Google Scholar 

  23. Manzotti A, Confalonieri N, Pullen C (2007) Unicompartmental versus computer-assisted total knee replacement for medial compartment knee arthritis: a matched paired study. Int Orthop 31:315–319

    Article  PubMed  CAS  Google Scholar 

  24. Matsumoto T, Tsumura N, Kurosaka M, Muratsu H, Kuroda R, Ishimoto K, Tsujimoto K, Shiba R, Yoshiya S (2004) Prosthetic alignment and sizing in computer-assisted total knee arthroplasty. Int Orthop 28:282–285

    Article  PubMed  Google Scholar 

  25. Mielke RK, Clemens U, Jens JH, Kershally S (2001) Navigation in knee endoprosthesis implantation—preliminary experiences and prospective comparative study with conventional implantation technique (in German). Z Orthop Ihre Grenzgeb 139:109–116

    Article  PubMed  CAS  Google Scholar 

  26. Moran CG, Horton TC (2000) Total knee replacement: the joint of the decade. A successful operation, for which there’s a large unmet need. BMJ 320:820

    Article  PubMed  CAS  Google Scholar 

  27. Morawa LG, Manley MT, Edidin AA, Reilly DT (1996) Transesophageal echocardiographic monitored events during total knee arthroplasty. Clin Orthop Relat Res 331:192–198

    Article  PubMed  Google Scholar 

  28. NIH Consensus Panel (2004) NIH Consensus Statement on total knee replacement December 8–10, 2003. J Bone Joint Surg Am 86-A:1328–1335

    Google Scholar 

  29. Nizard R (2002) Computer assisted surgery for total knee arthroplasty. Acta Orthop Belg 68:215–230

    PubMed  CAS  Google Scholar 

  30. Ong SM, Taylor GJ (2003) Can knee position save blood following total knee replacement? Knee 10:81–85

    Article  PubMed  Google Scholar 

  31. Rasanen P, Paavolainen P, Sintonen H, Koivisto AM, Blom M, Ryynanen OP, Roine RP (2007) Effectiveness of hip or knee replacement surgery in terms of quality-adjusted life years and costs. Acta Orthop 78:108–115

    Article  PubMed  Google Scholar 

  32. Robertsson O, Knutson K, Lewold S, Lidgren L (2001) The Swedish Knee Arthroplasty Register 1975–1997: an update with special emphasis on 41,223 knees operated on in 1988–1997. Acta Orthop Scand 72:503–513

    Article  PubMed  CAS  Google Scholar 

  33. Robinson CM, Ludlam CA, Ray DC, Swann DG, Christie J (2001) The coagulative and cardiorespiratory responses to reamed intramedullary nailing of isolated fractures. J Bone Joint Surg Br 83:963–973

    Article  PubMed  CAS  Google Scholar 

  34. Samama CM (2004) A direct antifibrinolytic agent in major orthopedic surgery. Orthopedics 27(6 Suppl):s675–s680

    PubMed  Google Scholar 

  35. Seon JK, Park SJ, Lee KB, Li G, Kozanek M, Song EK (2008) Functional comparison of total knee arthroplasty performed with and without a navigation system. Int Orthop

  36. Seon JK, Song EK (2005) Functional impact of navigation-assisted minimally invasive total knee arthroplasty. Orthopedics 28(10 Suppl):s1251–s1254

    PubMed  Google Scholar 

  37. Spencer JM, Chauhan SK, Sloan K, Taylor A, Beaver RJ (2007) Computer navigation versus conventional total knee replacement: no difference in functional results at two years. J Bone Joint Surg Br 89:477–480

    Article  PubMed  CAS  Google Scholar 

  38. Stulberg SD, Loan P, Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg Am 84-A(Suppl 2):90–98

    PubMed  Google Scholar 

  39. Stulberg SD, Yaffe MA, Koo SS (2006) Computer-assisted surgery versus manual total knee arthroplasty: a case-controlled study. J Bone Joint Surg Am 88(Suppl 4):47–54

    Article  PubMed  Google Scholar 

  40. Tennant A, Fear J, Pickering A, Hillman M, Cutts A, Chamberlain MA (1995) Prevalence of knee problems in the population aged 55 years and over: identifying the need for knee arthroplasty. BMJ 310:1291–1293

    PubMed  CAS  Google Scholar 

  41. Tew M, Waugh W (1985) Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg Br 67:551–556

    PubMed  CAS  Google Scholar 

  42. van Strien T, van der Linden-van der Zwaag, Kaptein B, van Erkel A, Valstar E, Nelissen R (2008) Computer assisted versus conventional cemented total knee prostheses alignment accuracy and micromotion of the tibial component. Int Orthop

  43. Weinrauch P, Myers N, Wilkinson M, Dodsworth J, Fitzpatrick P, Whitehouse S (2006) Comparison of early postoperative rehabilitation outcome following total knee arthroplasty using different surgical approaches and instrumentation. J Orthop Surg (Hong Kong) 14:47–52

    CAS  Google Scholar 

  44. Werner FW, Ayers DC, Maletsky LP, Rullkoetter PJ (2005) The effect of valgus/varus malalignment on load distribution in total knee replacements. J Biomech 38:349–355

    Article  PubMed  Google Scholar 

  45. Zorman D, Etuin P, Jennart H, Scipioni D, Devos S (2005) Computer-assisted total knee arthroplasty: comparative results in a preliminary series of 72 cases. Acta Orthop Belg 71:696–702

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, East Surrey Hospital, Canada Road, Redhill, RH1 5RH, UK

    Rupen Dattani, Surendra Patnaik, Avadhoot Kantak & Georgis Tselentakis

  2. 98a Oaklands Grove, London, W12 0JB, UK

    Rupen Dattani

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  1. Rupen Dattani
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  2. Surendra Patnaik
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  3. Avadhoot Kantak
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  4. Georgis Tselentakis
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Correspondence to Rupen Dattani.

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Dattani, R., Patnaik, S., Kantak, A. et al. Navigation knee replacement. International Orthopaedics (SICO 33, 7–10 (2009). https://doi.org/10.1007/s00264-008-0671-3

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