Abstract
The observed errors in the position of the implanted prosthesis can be due to a number of potential causes. One of these is the potential error during execution of the bone cuts. However, there is only minimal information on this in the current literature. The amount of cutting errors in 40 consecutive total knee replacements was reported. All the operations were done by the same surgeon. The amount of cutting error was measured by the use of computer navigation system. It was hypothesized that there was no difference in the amount of error between bone cut through the cutting slot (slotted cutting) and bone cut done on the surface of the cutting guide (open cutting). It was found that the average absolute cutting error was 1º in the coronal plane and 1.4º in the sagittal plane. Significantly more outlier (more than 3º) was observed in the errors in the sagittal plane (P = 0.014, chi square test). Open cutting resulted in less error in the sagittal plane of the tibial cut when compared with slotted cutting (P = 0.031, Mann–Whitney U Test). This was attributed by the use of a thicker saw blade with higher stiffness in the open cutting method.
Similar content being viewed by others
References
Bathis H, Perlick L, Tingart M (2005) Intraoperative cutting errors in total knee arthroplasty. Arch Orthop Trauma Surg 125:16–20
Bono JV, Roger DJ, Laskin RS, Peterson MG, Paulsen CA (1995) Tibial intramedullary alignment in total knee arthroplasty. American J Knee Surg 8:7–11
Brys DA, Lombardi AV Jr, Mallory TH, Vaughn BK (1991) A comparison of intramedullary and extramedullary alignment systems for tibial component placement in total knee arthroplasty. Clin Orthop 263:175–179
Elloy MA, Manning MP, Johnson R (1992) Accuracy of intramedullary alignment in total knee replacement. J Biomed Eng 14:363–370
Insall JN, Binazzi R, Soudry M, Mestriner LA (1985) Total knee arthroplasty. Clin Orthop 192:13–22
Jeffery RS, Morris RW, Denham RA (1991) Coronal alignment after total knee replacement. J Bone Joint Surg Br 73-B:709–714
Ko PS, Tio MK, Ban CM, Mak YK, Ip FK, Lam JJ (2001) Radiologic analysis of the tibial intramedullary canal in Chinese varus knees Implications in total knee arthroplasty. J Arthroplasty 16:212–215
Maestro A, Harwin SF, Sandoval MG, Vaquero DH, Murcia A (1998) Influence of intramedullary versus extramedullary guides on final total knee arthroplasty component position: a radiographic analysis. J Arthroplasty 13:552–558
Plaskos C, Hodgson AJ, Inkpen K, McGraw RW (2002) Bone cutting errors in total knee arthroplasty. J Arthroplasty 17:698–705
Rand JA, Coventry MB (1988) Ten-year evaluation of geometric total knee arthroplasty. Clin Orthop 232:168–173
Ritter MA, Faris PM, Keating EM, Meding JB (1994) Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop 299:153–156
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(Supp 2):90–98
Teter KE, Bregman D, Colwell CWJ (1995) Accuracy of intramedullary versus extramedullary tibial alignment cutting systems in total knee arthroplasty. Clin Orthop 321:106–110
Yang SH, Liu TK (1998) Intramedullary versus extramedullary tibial alignment guides in total knee arthroplasty. J Formos Med Assoc 97:564–568
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Yau, W.P., Chiu, K.Y. Cutting errors in total knee replacement: assessment by computer assisted surgery. Knee Surg Sports Traumatol Arthr 16, 670–673 (2008). https://doi.org/10.1007/s00167-008-0550-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-008-0550-x