Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Knee Surgery, Sports Traumatology, Arthroscopy
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 10/2013

01.10.2013 | Knee

Less femoral lift-off and better femoral alignment in TKA using computer-assisted surgery

verfasst von: Seong Hwan Kim, Han-Jun Lee, Ho-Joong Jung, Jae Sung Lee, Ki Seong Kim

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 10/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

A comparison has been made between navigation-assisted and conventional measured resection total knee arthroplasty (TKA), under the hypothesis that navigation assistance would improve the precision and consistency of component alignment and femoral component rotation.

Methods

The following radiographic parameters were measured: mechanical femorotibial angle, coronal and sagittal component angle, and femoral component rotation. Femoral condylar lift-off was checked by axial radiographs, and thresholds for outliers were set at 1.0 mm.

Results

Clinical results obtained using Knee Society and Hospital for Special Surgery systems were not statistically different. The mean mechanical femorotibial angle was 2.2° (SD: 0.9) in the conventional group and 1.7° (SD: 0.7) in navigation group (p = 0.001). The mean coronal femoral component angle was 89.2° (SD: 2.2) in conventional group and 90.4° (SD: 1.8) in navigation group (p = 0.006). The mean transepicondylar-posterior condylar axis angle was 1.7° (SD: 0.9) in conventional group and 1.2° (SD: 0.5) in navigation group (p = 0.008). Femoral condylar lift-off greater than 1 mm occurred more frequently (p = 0.000) in conventional group.

Conclusion

Coronal plane stability and precision of femoral component rotation were impacted by navigation system. The use of a navigation system with measured resection TKA can help optimize coronal stability and parallel component position.

Level of evidence

Retrospective case control study, Level IV.
Literatur
1.
Akagi M, Yamashita E, Nakagawa T, Asano T, Nakamura T (2001) Relationship between frontal knee alignment and reference axes in the distal femur. Clin Orthop Relat Res 388:147–156CrossRefPubMed
2.
Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J (2004) Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 86(5):682–687CrossRefPubMed
3.
Bolognesi M, Hofmann A (2005) Computer navigation versus standard instrumentation for TKA: a single-surgeon experience. Clin Orthop Relat Res 440:162–169CrossRefPubMed
4.
Cheng T, Zhao S, Peng X, Zhang X (2012) Does computer-assisted surgery improve postoperative leg alignment and implant positioning following total knee arthroplasty? A meta-analysis of randomized controlled trials? Knee Surg Sports Traumatol Arthrosc 20(7):1307–1322CrossRefPubMed
5.
Chin PL, Yang KY, Yeo SJ, Lo NN (2005) Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. J Arthroplast 20(5):618–626CrossRef
6.
Dennis DA, Komistek RD, Walker SA, Cheal EJ, Stiehl JB (2001) Femoral condylar lift-off in vivo in total knee arthroplasty. J Bone Joint Surg Br 83(1):33–39CrossRefPubMed
7.
Dennis DA, Komistek RD, Kim RH, Sharma A (2010) Gap balancing versus measured resection technique for total knee arthroplasty. Clin Orthop Relat Res 468:102–107CrossRefPubMed
8.
D’Lima DD, Chen PC, Colwell CW Jr (2001) Polyethylene contact stresses, articular congruity, and knee alignment. Clin Orthop Relat Res 392:232–238CrossRefPubMed
9.
Figgie HE III, Goldberg VM, Heiple KG, Moller HS III, Gordon NH (1986) The influence of tibial-patellofemoral location on function of the knee in patients with the posterior stabilized condylar knee prosthesis. J Bone Joint Surg Am 68(7):1035–1040PubMed
10.
Figgie HE III, Goldberg VM, Figgie MP, Inglis AE, Kelly M, Sobel M (1989) The effect of alignment of the implant on fractures of the patella after condylar total knee arthroplasty. J Bone Joint Surg Am 71(7):1031–1039PubMed
11.
Freeman MA, Todd RC, Bamert P, Day WH (1978) ICLH arthroplasty of the knee: 1968–1977. J Bone Joint Surg Br 60-B(3):339–344PubMed
12.
Green GV, Berend KR, Berend ME, Glisson RR, Vail TP (2002) The effects of varus tibial alignment on proximal tibial surface strain in total knee arthroplasty: the posteromedial hot spot. J Arthroplast 17(8):1033–1039CrossRef
13.
Hernández-Vaquero D, Suarez-Vazquez A, Sandoval-Garcia MA, Noriega-Fernandez A (2010) Computer assistance increases precision of component placement in total knee arthroplasty with articular deformity. Clin Orthop Relat Res 468:1237–1241CrossRefPubMed
14.
Hvid I, Nielsen S (1984) Total condylar knee arthroplasty. Prosthetic component positioning and radiolucent lines. Acta Orthop Scand 55(2):160–165CrossRefPubMed
15.
Insall JN, Scott WN, Ranawat CS (1979) The total condylar prosthesis. A report of two hundred and twenty cases. J Bone Joint Surg Am 61(2):173–180PubMed
16.
Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, Iguchi T, Kurosaka M, Kuroda R (2011) Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 19(7):1107–1112CrossRefPubMed
17.
Jennings LM, Bell CI, Ingham E, Komistek RD, Stone MH, Fisher J (2007) The influence of femoral condylar lift-off on the wear of artificial knee joints. Proc Inst Mech Eng H 221(3):305–314CrossRefPubMed
18.
Kanekasu K, Kondo M, Kadoya Y (2005) Axial radiography of the distal femur to assess rotational alignment in total knee arthroplasty. Clin Orthop Relat Res 434:193–197CrossRefPubMed
19.
Kim YH, Kim JS, Yoon SH (2007) Alignment and orientation of the components in total knee replacement with and without navigation support. A prospective, randomized study. J Bone Joint Surg Br 89(4):471–476CrossRefPubMed
20.
Laskin RS (2008) The classic: total condylar knee replacement in patients who have rheumatoid arthritis. A ten-year follow-up study. 1990. Clin Orthop Relat Res 466:2589–2596CrossRefPubMed
21.
Lustig S, Lavoie F, Selmi TA, Servien E, Neyret P (2008) Relationship between the surgical epicondylar axis and the articular surface of the distal femur: an anatomic study. Knee Surg Sports Traumatol Arthrosc 16(7):674–682CrossRefPubMed
22.
Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CH, Allen PW (2001) The effect of surgeon experience on component positioning in 673 Press Fit Condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplast 16(5):635–640CrossRef
23.
Matsuda S, Miura H, Nagamine R, Mawatari T, Tokunaga M, Nabeyama R, Iwamoto Y (2004) Anatomical analysis of the femoral condyle in normal and osteoarthritic knees. J Orthop Res 22(1):104–109CrossRefPubMed
24.
Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C (2007) A prospective, randomized study of computer-assisted and conventional total knee arthroplasty. Three-dimensional evaluation of implant alignment and rotation. J Bone Joint Surg Am 89(2):236–243CrossRefPubMed
25.
Novotny J, Gonzalez MH, Amirouche FM, Li YC (2001) Geometric analysis of potential error in using femoral intramedullary guides in total knee arthroplasty. J Arthroplast 16(5):641–647CrossRef
26.
Reed SC, Gollish J (1997) The accuracy of femoral intramedullary guides in total knee arthroplasty. J Arthroplast 12(6):677–682CrossRef
27.
Rottman SJ, Dvorkin M, Gold D (2005) Extramedullary versus intramedullary tibial alignment guides for total knee arthroplasty. Orthopedics 28(12):1445–1448PubMed
28.
Sharkey PF, Hozack WJ, Rothman RH, Shastri S, Jacoby SM (2002) Insall Award paper. Why are total knee arthroplasties failing today? Clin Orthop Relat Res 404:7–13CrossRefPubMed
29.
Sikorski JM (2008) Alignment in total knee replacement. J Bone Joint Surg Br 90(9):1121–1127PubMed
30.
Tashiro Y, Uemura M, Matsuda S, Okazaki K, Kawahara S, Hashizume M, Iwamoto Y (2012) Articular cartilage of the posterior condyle can affect rotational alignment in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 20(8):1463–1469CrossRefPubMed
31.
Wasielewski RC, Galante JO, Leighty RM, Natarajan RN, Rosenberg AG (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop Relat Res 299:31–43PubMed
32.
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(2):349–355CrossRefPubMed
Metadaten
Titel
Less femoral lift-off and better femoral alignment in TKA using computer-assisted surgery
verfasst von
Seong Hwan Kim
Han-Jun Lee
Ho-Joong Jung
Jae Sung Lee
Ki Seong Kim
Publikationsdatum
01.10.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 10/2013
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2230-0

Weitere Artikel der Ausgabe 10/2013

Knee Surgery, Sports Traumatology, Arthroscopy 10/2013 Zur Ausgabe

Knee

Custom-fit minimally invasive total knee arthroplasty: effect on blood loss and early clinical outcomes

Knee

Patient-specific instruments: industry’s innovation with a surgeon’s interest

Knee

Rotational limb alignment changes following total knee arthroplasty

Knee

Centre of the posterior cruciate ligament and the sulcus between tubercle spines are reliable landmarks for tibial component placement

Knee

The unhappy total knee arthroplasty (TKA) patient: higher WOMAC and lower KSS in depressed patients prior and after TKA

Knee

Coronal alignment is a predictor of the rotational geometry of the distal femur in the osteo-arthritic knee

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise