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Erschienen in: Clinical Orthopaedics and Related Research® 1/2012

01.01.2012 | Symposium: Papers Presented at the Annual Meetings of The Knee Society

Improved Accuracy of Alignment With Patient-specific Positioning Guides Compared With Manual Instrumentation in TKA

verfasst von: Vincent Y. Ng, MD, Jeffrey H. DeClaire, MD, Keith R. Berend, MD, Bethany C. Gulick, RT (R), Adolph V. Lombardi Jr, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 1/2012

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Abstract

Background

Coronal malalignment occurs frequently in TKA and may affect implant durability and knee function. Designed to improve alignment accuracy and precision, the patient-specific positioning guide is predicated on restoration of the overall mechanical axis and is a multifaceted new tool in achieving traditional goals of TKA.

Questions/purposes

We compared the effectiveness of patient-specific positioning guides to manual instrumentation with intramedullary femoral and extramedullary tibial guides in restoring the mechanical axis of the extremity and achieving neutral coronal alignment of the femoral and tibial components.

Methods

We retrospectively reviewed 569 TKAs performed with patient-specific positioning guides and 155 with manual instrumentation by two surgeons using postoperative long-leg radiographs. For all patients, we assessed the zone in which the overall mechanical axis passed through the knee, and for one surgeon’s cases (105 patient-specific positioning guide, 55 manual instrumentation), we also measured the hip-knee-ankle angle and the individual component angles with respect to their mechanical axes.

Results

The overall mechanical axis passed through the central third of the knee more often with patient-specific positioning guides (88%) than with manual instrumentation (78%). The overall mean hip-knee-ankle angle for patient-specific positioning guides (180.6°) was similar to manual instrumentation (181.1°), but there were fewer ± 3° hip-knee-ankle angle outliers with patient-specific positioning guides (9%) than with manual instrumentation (22%). The overall mean tibial (89.9° versus 90.4°) and femoral (90.7° versus 91.3°) component angles were closer to neutral with patient-specific positioning guides than with manual instrumentation, but the rate of ± 2° outliers was similar for both the tibia (10% versus 7%) and femur (22% versus 18%).

Conclusions

Patient-specific positioning guides can assist in achieving a neutral mechanical axis with reduction in outliers.

Level of Evidence

Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literatur
1.
Zurück zum Zitat Anderson KC, Buehler KC, Markel DC. Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. J Arthroplasty. 2005;20:132–138.PubMedCrossRef Anderson KC, Buehler KC, Markel DC. Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. J Arthroplasty. 2005;20:132–138.PubMedCrossRef
2.
Zurück zum Zitat Bartel DL, Burstein AH, Santavicca EA, Insall JN. Performance of the tibial component in total knee replacement. J Bone Joint Surg Am. 1982;64:1026–1033.PubMed Bartel DL, Burstein AH, Santavicca EA, Insall JN. Performance of the tibial component in total knee replacement. J Bone Joint Surg Am. 1982;64:1026–1033.PubMed
3.
Zurück zum Zitat Bathis H, Perlick L, Tingart M, Luring C, Grifka J. CT-free computer-assisted total knee arthroplasty versus the conventional technique: radiographic results of 100 cases. Orthopedics. 2004;27:476–480.PubMed Bathis H, Perlick L, Tingart M, Luring C, Grifka J. CT-free computer-assisted total knee arthroplasty versus the conventional technique: radiographic results of 100 cases. Orthopedics. 2004;27:476–480.PubMed
4.
Zurück zum Zitat Bathis H, Perlick L, Tingart M, Luring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty: a comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br. 2004;86:682–687.PubMedCrossRef Bathis H, Perlick L, Tingart M, Luring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty: a comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br. 2004;86:682–687.PubMedCrossRef
5.
Zurück zum Zitat Berend ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Faris GW, Davis KE. Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res. 2004;428:26–34.PubMedCrossRef Berend ME, Ritter MA, Meding JB, Faris PM, Keating EM, Redelman R, Faris GW, Davis KE. Tibial component failure mechanisms in total knee arthroplasty. Clin Orthop Relat Res. 2004;428:26–34.PubMedCrossRef
6.
Zurück zum Zitat Berger RA, Crossett LS. Determining rotation of the femoral and tibial components in total knee arthroplasty: a computer tomography technique. Operative Tech Orthop. 1998;8:128–133.CrossRef Berger RA, Crossett LS. Determining rotation of the femoral and tibial components in total knee arthroplasty: a computer tomography technique. Operative Tech Orthop. 1998;8:128–133.CrossRef
7.
Zurück zum Zitat Bertsch C, Holz U, Konrad G, Vakili A, Oberst M. Early clinical outcome after navigated total knee arthroplasty. Comparison with conventional implantation in TKA: a controlled and prospective analysis. Orthopade. 2007;36:739–745.PubMedCrossRef Bertsch C, Holz U, Konrad G, Vakili A, Oberst M. Early clinical outcome after navigated total knee arthroplasty. Comparison with conventional implantation in TKA: a controlled and prospective analysis. Orthopade. 2007;36:739–745.PubMedCrossRef
8.
Zurück zum Zitat Biasca N, Wirth S, Bungartz M. Mechanical accuracy of navigated minimally invasive total knee arthroplasty (MIS TKA). Knee. 2009;16:22–29.PubMedCrossRef Biasca N, Wirth S, Bungartz M. Mechanical accuracy of navigated minimally invasive total knee arthroplasty (MIS TKA). Knee. 2009;16:22–29.PubMedCrossRef
9.
Zurück zum Zitat Bohling U, Schamberger H, Grittner U, Scholz J. Computerised and technical navigation in total knee-arthroplasty. J Orthop Traumatol. 2005;6:69–75.CrossRef Bohling U, Schamberger H, Grittner U, Scholz J. Computerised and technical navigation in total knee-arthroplasty. J Orthop Traumatol. 2005;6:69–75.CrossRef
10.
Zurück zum Zitat Bonutti P, Dethmers D, Stiehl JB. Case report: femoral shaft fracture resulting from femoral tracker placement in navigated TKA. Clin Orthop Relat Res. 2008;466:1499–1502.PubMedCrossRef Bonutti P, Dethmers D, Stiehl JB. Case report: femoral shaft fracture resulting from femoral tracker placement in navigated TKA. Clin Orthop Relat Res. 2008;466:1499–1502.PubMedCrossRef
11.
Zurück zum Zitat Bonutti PM, Dethmers D, Ulrich SD, Seyler TM, Mont MA. Computer navigation-assisted versus minimally invasive TKA: benefits and drawbacks. Clin Orthop Relat Res. 2008;466:2756–2762.PubMedCrossRef Bonutti PM, Dethmers D, Ulrich SD, Seyler TM, Mont MA. Computer navigation-assisted versus minimally invasive TKA: benefits and drawbacks. Clin Orthop Relat Res. 2008;466:2756–2762.PubMedCrossRef
12.
Zurück zum Zitat Bonutti PM, Dethmers DA, McGrath MS, Ulrich SD, Mont MA. Navigation did not improve the precision of minimally invasive knee arthroplasty. Clin Orthop Relat Res. 2008;466:2730–2735.PubMedCrossRef Bonutti PM, Dethmers DA, McGrath MS, Ulrich SD, Mont MA. Navigation did not improve the precision of minimally invasive knee arthroplasty. Clin Orthop Relat Res. 2008;466:2730–2735.PubMedCrossRef
13.
Zurück zum Zitat Chang CW, Yang CY. Kinematic navigation in total knee replacement-experience from the first 50 cases. J Formos Med Assoc. 2006;105:468–474.PubMedCrossRef Chang CW, Yang CY. Kinematic navigation in total knee replacement-experience from the first 50 cases. J Formos Med Assoc. 2006;105:468–474.PubMedCrossRef
14.
Zurück zum Zitat Chauhan S, Clark G, Lloyd S, Scott R, Breidahl W, Sikorski J. Computer-assisted total knee replacement: a controlled cadaver study using a multi-parameter quantitative CT assessment of alignment (the Perth CT protocol). J Bone Joint Surg Br. 2004;86:818–823.PubMedCrossRef Chauhan S, Clark G, Lloyd S, Scott R, Breidahl W, Sikorski J. Computer-assisted total knee replacement: a controlled cadaver study using a multi-parameter quantitative CT assessment of alignment (the Perth CT protocol). J Bone Joint Surg Br. 2004;86:818–823.PubMedCrossRef
15.
Zurück zum Zitat Cheung KW, Chiu KH. Imageless computer navigation in total knee arthroplasty. Hong Kong Med J. 2009;15:353–358.PubMed Cheung KW, Chiu KH. Imageless computer navigation in total knee arthroplasty. Hong Kong Med J. 2009;15:353–358.PubMed
16.
Zurück zum Zitat Chin PL, Yang KY, Yeo SJ, Lo NN. Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. J Arthroplasty. 2005;20:618–626.PubMedCrossRef Chin PL, Yang KY, Yeo SJ, Lo NN. Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation versus conventional technique. J Arthroplasty. 2005;20:618–626.PubMedCrossRef
17.
Zurück zum Zitat Choong PF, Dowsey MM, Stoney JD. Does accurate anatomical alignment result in better function and quality of life? Comparing conventional and computer-assisted total knee arthroplasty. J Arthroplasty. 2009;24:560–569.PubMedCrossRef Choong PF, Dowsey MM, Stoney JD. Does accurate anatomical alignment result in better function and quality of life? Comparing conventional and computer-assisted total knee arthroplasty. J Arthroplasty. 2009;24:560–569.PubMedCrossRef
18.
Zurück zum Zitat Chotanaphuti T, Ongnamthip P, Teeraleekul K, Kraturerk C. Comparative study between computer assisted-navigation and conventional technique in minimally invasive surgery total knee arthroplasty, prospective control study. J Med Assoc Thai. 2008;91:1382–1388.PubMed Chotanaphuti T, Ongnamthip P, Teeraleekul K, Kraturerk C. Comparative study between computer assisted-navigation and conventional technique in minimally invasive surgery total knee arthroplasty, prospective control study. J Med Assoc Thai. 2008;91:1382–1388.PubMed
19.
Zurück zum Zitat Chung BJ, Kang YG, Chang CB, Kim SJ, Kim TK. Differences between sagittal femoral mechanical and distal reference axes should be considered in navigated TKA. Clin Orthop Relat Res. 2009;467:2403–2413.PubMedCrossRef Chung BJ, Kang YG, Chang CB, Kim SJ, Kim TK. Differences between sagittal femoral mechanical and distal reference axes should be considered in navigated TKA. Clin Orthop Relat Res. 2009;467:2403–2413.PubMedCrossRef
20.
Zurück zum Zitat Confalonieri N, Manzotti A, Pullen C, Ragone V. Computer-assisted technique versus intramedullary and extramedullary alignment systems in total knee replacement: a radiological comparison. Acta Orthop Belg. 2005;71:703–709.PubMed Confalonieri N, Manzotti A, Pullen C, Ragone V. Computer-assisted technique versus intramedullary and extramedullary alignment systems in total knee replacement: a radiological comparison. Acta Orthop Belg. 2005;71:703–709.PubMed
21.
Zurück zum Zitat Daubresse F, Vajeu C, Loquet J. Total knee arthroplasty with conventional or navigated technique: comparison of the learning curves in a community hospital. Acta Orthop Belg. 2005;71:710–713.PubMed Daubresse F, Vajeu C, Loquet J. Total knee arthroplasty with conventional or navigated technique: comparison of the learning curves in a community hospital. Acta Orthop Belg. 2005;71:710–713.PubMed
22.
Zurück zum Zitat Dennis DA, Channer M, Susman MH, Stringer EA. Intramedullary versus extramedullary tibial alignment systems in total knee arthroplasty. J Arthroplasty. 1993;8:43–47.PubMedCrossRef Dennis DA, Channer M, Susman MH, Stringer EA. Intramedullary versus extramedullary tibial alignment systems in total knee arthroplasty. J Arthroplasty. 1993;8:43–47.PubMedCrossRef
23.
Zurück zum Zitat Dutton AQ, Yeo SJ, Yang KY, Lo NN, Chia KU, Chong HC. Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty: a prospective, randomized study. J Bone Joint Surg Am. 2008;90:2–9.PubMedCrossRef Dutton AQ, Yeo SJ, Yang KY, Lo NN, Chia KU, Chong HC. Computer-assisted minimally invasive total knee arthroplasty compared with standard total knee arthroplasty: a prospective, randomized study. J Bone Joint Surg Am. 2008;90:2–9.PubMedCrossRef
24.
Zurück zum Zitat Ek ET, Dowsey MM, Tse LF, Riazi A, Love BR, Stoney JD, Choong PF. Comparison of functional and radiological outcomes after computer-assisted versus conventional total knee arthroplasty: a matched-control retrospective study. J Orthop Surg (Hong Kong). 2008;16:192–196. Ek ET, Dowsey MM, Tse LF, Riazi A, Love BR, Stoney JD, Choong PF. Comparison of functional and radiological outcomes after computer-assisted versus conventional total knee arthroplasty: a matched-control retrospective study. J Orthop Surg (Hong Kong). 2008;16:192–196.
25.
Zurück zum Zitat Engh GA, Peterson TL. Comparative experience with intramedullary and extramedullary alignment in total knee arthroplasty. J Arthroplasty. 1990;5:1–8.PubMedCrossRef Engh GA, Peterson TL. Comparative experience with intramedullary and extramedullary alignment in total knee arthroplasty. J Arthroplasty. 1990;5:1–8.PubMedCrossRef
26.
Zurück zum Zitat Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S. Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2007;457:156–162.PubMed Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S. Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2007;457:156–162.PubMed
27.
Zurück zum Zitat Fang DM, Ritter MA, Davis KE. Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty. 2009;24:39–43.PubMedCrossRef Fang DM, Ritter MA, Davis KE. Coronal alignment in total knee arthroplasty: just how important is it? J Arthroplasty. 2009;24:39–43.PubMedCrossRef
28.
Zurück zum Zitat Green GV, Berend KR, Berend ME, Glisson RR, Vail TP. The effects of varus tibial alignment on proximal tibial surface strain in total knee arthroplasty: the posteromedial hot spot. J Arthroplasty. 2002;17:1033–1039.PubMedCrossRef Green GV, Berend KR, Berend ME, Glisson RR, Vail TP. The effects of varus tibial alignment on proximal tibial surface strain in total knee arthroplasty: the posteromedial hot spot. J Arthroplasty. 2002;17:1033–1039.PubMedCrossRef
29.
Zurück zum Zitat Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res. 2005;433:152–159.PubMedCrossRef Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res. 2005;433:152–159.PubMedCrossRef
31.
Zurück zum Zitat Hasegawa M, Yoshida K, Wakabayashi H, Sudo A. Minimally invasive total knee arthroplasty: comparison of jig-based technique versus computer navigation for clinical and alignment outcome. Knee Surg Sports Traumatol Arthrosc. 2011;19:904–910.PubMedCrossRef Hasegawa M, Yoshida K, Wakabayashi H, Sudo A. Minimally invasive total knee arthroplasty: comparison of jig-based technique versus computer navigation for clinical and alignment outcome. Knee Surg Sports Traumatol Arthrosc. 2011;19:904–910.PubMedCrossRef
32.
Zurück zum Zitat Hernandez-Vaquero D, Suarez-Vazquez A, Sandoval-Garcia MA, Noriega-Fernandez A. Computer assistance increases precision of component placement in total knee arthroplasty with articular deformity. Clin Orthop Relat Res. 2010;468:1237–1241.PubMedCrossRef Hernandez-Vaquero D, Suarez-Vazquez A, Sandoval-Garcia MA, Noriega-Fernandez A. Computer assistance increases precision of component placement in total knee arthroplasty with articular deformity. Clin Orthop Relat Res. 2010;468:1237–1241.PubMedCrossRef
33.
Zurück zum Zitat Howell SM, Kuznik K, Hull ML, Siston RA. Results of an initial experience with custom-fit positioning total knee arthroplasty in a series of 48 patients. Orthopedics. 2008;31:857–863.PubMedCrossRef Howell SM, Kuznik K, Hull ML, Siston RA. Results of an initial experience with custom-fit positioning total knee arthroplasty in a series of 48 patients. Orthopedics. 2008;31:857–863.PubMedCrossRef
34.
Zurück zum Zitat Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, Iguchi T, Kurosaka M, Kuroda R. Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19:1107–1112.PubMedCrossRef Ishida K, Matsumoto T, Tsumura N, Kubo S, Kitagawa A, Chin T, Iguchi T, Kurosaka M, Kuroda R. Mid-term outcomes of computer-assisted total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2011;19:1107–1112.PubMedCrossRef
35.
Zurück zum Zitat Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991;73:709–714.PubMed Jeffery RS, Morris RW, Denham RA. Coronal alignment after total knee replacement. J Bone Joint Surg Br. 1991;73:709–714.PubMed
36.
Zurück zum Zitat Jenny JY, Boeri C. Computer-assisted implantation of total knee prostheses: a case-control comparative study with classical instrumentation. Comput Aided Surg. 2001;6:217–220.PubMedCrossRef Jenny JY, Boeri C. Computer-assisted implantation of total knee prostheses: a case-control comparative study with classical instrumentation. Comput Aided Surg. 2001;6:217–220.PubMedCrossRef
37.
Zurück zum Zitat Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK. 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. 2005;20:832–839.PubMedCrossRef Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK. 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. 2005;20:832–839.PubMedCrossRef
38.
Zurück zum Zitat Katz JN, Barrett J, Mahomed NN, Baron JA, Wright RJ, Losina E. Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Joint Surg Am. 2004;86:1909–1916.PubMedCrossRef Katz JN, Barrett J, Mahomed NN, Baron JA, Wright RJ, Losina E. Association between hospital and surgeon procedure volume and the outcomes of total knee replacement. J Bone Joint Surg Am. 2004;86:1909–1916.PubMedCrossRef
39.
Zurück zum Zitat Kim SJ, MacDonald M, Hernandez J, Wixson RL. Computer assisted navigation in total knee arthroplasty: improved coronal alignment. J Arthroplasty. 2005;20:123–131.PubMedCrossRef Kim SJ, MacDonald M, Hernandez J, Wixson RL. Computer assisted navigation in total knee arthroplasty: improved coronal alignment. J Arthroplasty. 2005;20:123–131.PubMedCrossRef
40.
Zurück zum Zitat Kim YH, Kim JS, Choi Y, Kwon OR. Computer-assisted surgical navigation does not improve the alignment and orientation of the components in total knee arthroplasty. J Bone Joint Surg Am. 2009;91:14–19.PubMedCrossRef Kim YH, Kim JS, Choi Y, Kwon OR. Computer-assisted surgical navigation does not improve the alignment and orientation of the components in total knee arthroplasty. J Bone Joint Surg Am. 2009;91:14–19.PubMedCrossRef
41.
Zurück zum Zitat Kim YH, Kim JS, Yoon SH. Alignment and orientation of the components in total knee replacement with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br. 2007;89:471–476.PubMedCrossRef Kim YH, Kim JS, Yoon SH. Alignment and orientation of the components in total knee replacement with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br. 2007;89:471–476.PubMedCrossRef
42.
Zurück zum Zitat Klatt BA, Goyal N, Austin MS, Hozack WJ. Custom-fit total knee arthroplasty (OtisKnee) results in malalignment. J Arthroplasty. 2008;23:26–29.PubMedCrossRef Klatt BA, Goyal N, Austin MS, Hozack WJ. Custom-fit total knee arthroplasty (OtisKnee) results in malalignment. J Arthroplasty. 2008;23:26–29.PubMedCrossRef
43.
Zurück zum Zitat Lee DH, Park JH, Song DI, Padhy D, Jeong WK, Han SB. Accuracy of soft tissue balancing in TKA: comparison between navigation-assisted gap balancing and conventional measured resection. Knee Surg Sports Traumatol Arthrosc. 2010;18:381–387.PubMedCrossRef Lee DH, Park JH, Song DI, Padhy D, Jeong WK, Han SB. Accuracy of soft tissue balancing in TKA: comparison between navigation-assisted gap balancing and conventional measured resection. Knee Surg Sports Traumatol Arthrosc. 2010;18:381–387.PubMedCrossRef
44.
Zurück zum Zitat Liau JJ, Cheng CK, Huang CH, Lo WH. The effect of malalignment on stresses in polyethylene component of total knee prostheses—a finite element analysis. Clin Biomech (Bristol, Avon). 2002;17:140–146.CrossRef Liau JJ, Cheng CK, Huang CH, Lo WH. The effect of malalignment on stresses in polyethylene component of total knee prostheses—a finite element analysis. Clin Biomech (Bristol, Avon). 2002;17:140–146.CrossRef
45.
Zurück zum Zitat Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics. 2008;31:927–930.PubMedCrossRef Lombardi AV Jr, Berend KR, Adams JB. Patient-specific approach in total knee arthroplasty. Orthopedics. 2008;31:927–930.PubMedCrossRef
46.
Zurück zum Zitat Lombardi AV Jr, Emerson RH Jr, Pietrzak WS. Signature Personalized Patient Care for total knee arthroplasty: a mechanical alignment cadaveric study. Internal Study. 2008:1–3. Lombardi AV Jr, Emerson RH Jr, Pietrzak WS. Signature Personalized Patient Care for total knee arthroplasty: a mechanical alignment cadaveric study. Internal Study. 2008:1–3.
47.
Zurück zum Zitat Longstaff LM, Sloan K, Stamp N, Scaddan M, Beaver R. Good alignment after total knee arthroplasty leads to faster rehabilitation and better function. J Arthroplasty. 2009;24:570–578.PubMedCrossRef Longstaff LM, Sloan K, Stamp N, Scaddan M, Beaver R. Good alignment after total knee arthroplasty leads to faster rehabilitation and better function. J Arthroplasty. 2009;24:570–578.PubMedCrossRef
48.
Zurück zum Zitat Lotke PA, Ecker ML. Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977;59:77–79.PubMed Lotke PA, Ecker ML. Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg Am. 1977;59:77–79.PubMed
49.
Zurück zum Zitat Luring C, Beckmann J, Haibock P, Perlick L, Grifka J, Tingart M. Minimal invasive and computer assisted total knee replacement compared with the conventional technique: a prospective, randomised trial. Knee Surg Sports Traumatol Arthrosc. 2008;16:928–934.PubMedCrossRef Luring C, Beckmann J, Haibock P, Perlick L, Grifka J, Tingart M. Minimal invasive and computer assisted total knee replacement compared with the conventional technique: a prospective, randomised trial. Knee Surg Sports Traumatol Arthrosc. 2008;16:928–934.PubMedCrossRef
50.
Zurück zum Zitat Lutzner J, Krummenauer F, Wolf C, Gunther KP, Kirschner S. Computer-assisted and conventional total knee replacement: a comparative, prospective, randomised study with radiological and CT evaluation. J Bone Joint Surg Br. 2008;90:1039–1044.PubMedCrossRef Lutzner J, Krummenauer F, Wolf C, Gunther KP, Kirschner S. Computer-assisted and conventional total knee replacement: a comparative, prospective, randomised study with radiological and CT evaluation. J Bone Joint Surg Br. 2008;90:1039–1044.PubMedCrossRef
51.
Zurück zum Zitat Macule-Beneyto F, Hernandez-Vaquero D, Segur-Vilalta JM, Colomina-Rodriguez R, Hinarejos-Gomez P, Garcia-Forcada I, Seral Garcia B. Navigation in total knee arthroplasty: a multicenter study. Int Orthop. 2006;30:536–540.PubMedCrossRef Macule-Beneyto F, Hernandez-Vaquero D, Segur-Vilalta JM, Colomina-Rodriguez R, Hinarejos-Gomez P, Garcia-Forcada I, Seral Garcia B. Navigation in total knee arthroplasty: a multicenter study. Int Orthop. 2006;30:536–540.PubMedCrossRef
52.
Zurück zum Zitat Mahoney OM. The role of alignment in TKR survivorship. Presented at Orthopedics Today Hawaii 2010. January 10–13, 2010. Kohala Coast, HI. Mahoney OM. The role of alignment in TKR survivorship. Presented at Orthopedics Today Hawaii 2010. January 10–13, 2010. Kohala Coast, HI.
53.
Zurück zum Zitat Martin A, Wohlgenannt O, Prenn M, Oelsch C, von Strempel A. Imageless navigation for TKA increases implantation accuracy. Clin Orthop Relat Res. 2007;460:178–184.PubMed Martin A, Wohlgenannt O, Prenn M, Oelsch C, von Strempel A. Imageless navigation for TKA increases implantation accuracy. Clin Orthop Relat Res. 2007;460:178–184.PubMed
54.
Zurück zum Zitat Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty. 2007;22:1097–1106.PubMedCrossRef Mason JB, Fehring TK, Estok R, Banel D, Fahrbach K. Meta-analysis of alignment outcomes in computer-assisted total knee arthroplasty surgery. J Arthroplasty. 2007;22:1097–1106.PubMedCrossRef
55.
Zurück zum Zitat Massai F, Conteduca F, Vadala A, Iorio R, Basiglini L, Ferretti A. Tibial stress fracture after computer-navigated total knee arthroplasty. J Orthop Traumatol. 2010;11:123–127.PubMedCrossRef Massai F, Conteduca F, Vadala A, Iorio R, Basiglini L, Ferretti A. Tibial stress fracture after computer-navigated total knee arthroplasty. J Orthop Traumatol. 2010;11:123–127.PubMedCrossRef
56.
Zurück zum Zitat Matsumoto T, Tsumura N, Kurosaka M, Muratsu H, Kuroda R, Ishimoto K, Tsujimoto K, Shiba R, Yoshiya S. Prosthetic alignment and sizing in computer-assisted total knee arthroplasty. Int Orthop. 2004;28:282–285.PubMedCrossRef Matsumoto T, Tsumura N, Kurosaka M, Muratsu H, Kuroda R, Ishimoto K, Tsujimoto K, Shiba R, Yoshiya S. Prosthetic alignment and sizing in computer-assisted total knee arthroplasty. Int Orthop. 2004;28:282–285.PubMedCrossRef
57.
Zurück zum Zitat Matziolis G, Adam J, Perka C. Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement. Arch Orthop Trauma Surg. 2010;130:1487–1491.PubMedCrossRef Matziolis G, Adam J, Perka C. Varus malalignment has no influence on clinical outcome in midterm follow-up after total knee replacement. Arch Orthop Trauma Surg. 2010;130:1487–1491.PubMedCrossRef
58.
Zurück zum Zitat Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C. 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. 2007;89:236–243.PubMedCrossRef Matziolis G, Krocker D, Weiss U, Tohtz S, Perka C. 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. 2007;89:236–243.PubMedCrossRef
59.
Zurück zum Zitat Mizu-uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y. The evaluation of post-operative alignment in total knee replacement using a CT-based navigation system. J Bone Joint Surg Br. 2008;90:1025–1031.PubMedCrossRef Mizu-uchi H, Matsuda S, Miura H, Okazaki K, Akasaki Y, Iwamoto Y. The evaluation of post-operative alignment in total knee replacement using a CT-based navigation system. J Bone Joint Surg Br. 2008;90:1025–1031.PubMedCrossRef
60.
Zurück zum Zitat Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69:745–749.PubMed Moreland JR, Bassett LW, Hanker GJ. Radiographic analysis of the axial alignment of the lower extremity. J Bone Joint Surg Am. 1987;69:745–749.PubMed
61.
Zurück zum Zitat Mullaji A, Kanna R, Marawar S, Kohli A, Sharma A. Comparison of limb and component alignment using computer-assisted navigation versus image intensifier-guided conventional total knee arthroplasty: a prospective, randomized, single-surgeon study of 467 knees. J Arthroplasty. 2007;22:953–959.PubMedCrossRef Mullaji A, Kanna R, Marawar S, Kohli A, Sharma A. Comparison of limb and component alignment using computer-assisted navigation versus image intensifier-guided conventional total knee arthroplasty: a prospective, randomized, single-surgeon study of 467 knees. J Arthroplasty. 2007;22:953–959.PubMedCrossRef
62.
Zurück zum Zitat Novak EJ, Silverstein MD, Bozic KJ. The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. J Bone Joint Surg Am. 2007;89:2389–2397.PubMedCrossRef Novak EJ, Silverstein MD, Bozic KJ. The cost-effectiveness of computer-assisted navigation in total knee arthroplasty. J Bone Joint Surg Am. 2007;89:2389–2397.PubMedCrossRef
63.
Zurück zum Zitat Oberst M, Bertsch C, Konrad G, Lahm A, Holz U. CT analysis after navigated versus conventional implantation of TKA. Arch Orthop Trauma Surg. 2008;128:561–566.PubMedCrossRef Oberst M, Bertsch C, Konrad G, Lahm A, Holz U. CT analysis after navigated versus conventional implantation of TKA. Arch Orthop Trauma Surg. 2008;128:561–566.PubMedCrossRef
64.
Zurück zum Zitat Oberst M, Bertsch C, Wurstlin S, Holz U. [CT analysis of leg alignment after conventional vs. navigated knee prosthesis implantation: initial results of a controlled, prospective and randomized study] [in German]. Unfallchirurg. 2003;106:941–948.PubMed Oberst M, Bertsch C, Wurstlin S, Holz U. [CT analysis of leg alignment after conventional vs. navigated knee prosthesis implantation: initial results of a controlled, prospective and randomized study] [in German]. Unfallchirurg. 2003;106:941–948.PubMed
65.
Zurück zum Zitat Pang CH, Chan WL, Yen CH, Cheng SC, Woo SB, Choi ST, Hui WK, Mak KH. Comparison of total knee arthroplasty using computer-assisted navigation versus conventional guiding systems: a prospective study. J Orthop Surg (Hong Kong). 2009;17:170–173. Pang CH, Chan WL, Yen CH, Cheng SC, Woo SB, Choi ST, Hui WK, Mak KH. Comparison of total knee arthroplasty using computer-assisted navigation versus conventional guiding systems: a prospective study. J Orthop Surg (Hong Kong). 2009;17:170–173.
66.
Zurück zum Zitat Park SE, Lee CT. Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty. J Arthroplasty. 2007;22:1054–1059.PubMedCrossRef Park SE, Lee CT. Comparison of robotic-assisted and conventional manual implantation of a primary total knee arthroplasty. J Arthroplasty. 2007;22:1054–1059.PubMedCrossRef
67.
Zurück zum Zitat Parratte S, Pagnano MW, Trousdale RT, Berry DJ. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am. 2010;92:2143–2149.PubMedCrossRef Parratte S, Pagnano MW, Trousdale RT, Berry DJ. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am. 2010;92:2143–2149.PubMedCrossRef
68.
Zurück zum Zitat Perlick L, Bathis H, Lerch K, Luring C, Tingart M, Grifka J. [Navigated implantation of total knee endoprostheses in secondary knee osteoarthritis of rheumatoid arthritis patients as compared to conventional technique] [in German]. Z Rheumatol. 2004;63:140–146.PubMedCrossRef Perlick L, Bathis H, Lerch K, Luring C, Tingart M, Grifka J. [Navigated implantation of total knee endoprostheses in secondary knee osteoarthritis of rheumatoid arthritis patients as compared to conventional technique] [in German]. Z Rheumatol. 2004;63:140–146.PubMedCrossRef
69.
Zurück zum Zitat Perlick L, Bathis H, Tingart M, Perlick C, Grifka J. Navigation in total-knee arthroplasty: CT-based implantation compared with the conventional technique. Acta Orthop Scand. 2004;75:464–470.PubMedCrossRef Perlick L, Bathis H, Tingart M, Perlick C, Grifka J. Navigation in total-knee arthroplasty: CT-based implantation compared with the conventional technique. Acta Orthop Scand. 2004;75:464–470.PubMedCrossRef
70.
Zurück zum Zitat Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Clin Orthop Relat Res. 1994;299:153–156.PubMed Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Clin Orthop Relat Res. 1994;299:153–156.PubMed
71.
Zurück zum Zitat Rosenberger R, Hoser C, Quirbach S, Attal R, Hennerbichler A, Fink C. Improved accuracy of component alignment with the implementation of image-free navigation in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2008;16:249–257.PubMedCrossRef Rosenberger R, Hoser C, Quirbach S, Attal R, Hennerbichler A, Fink C. Improved accuracy of component alignment with the implementation of image-free navigation in total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2008;16:249–257.PubMedCrossRef
72.
Zurück zum Zitat Saragaglia D, Picard F, Chaussard C, Montbarbon E, Leitner F, Cinquin P. [Computer-assisted knee arthroplasty: comparison with a conventional procedure: results of 50 cases in a prospective randomized study] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2001;87:18–28.PubMed Saragaglia D, Picard F, Chaussard C, Montbarbon E, Leitner F, Cinquin P. [Computer-assisted knee arthroplasty: comparison with a conventional procedure: results of 50 cases in a prospective randomized study] [in French]. Rev Chir Orthop Reparatrice Appar Mot. 2001;87:18–28.PubMed
73.
Zurück zum Zitat Schmitt J, Hauk C, Kienapfel H, Pfeiffer M, Efe T, Fuchs-Winkelmann S, Heyse TJ. Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study. BMC Musculoskelet Disord. 2011;12:16.PubMedCrossRef Schmitt J, Hauk C, Kienapfel H, Pfeiffer M, Efe T, Fuchs-Winkelmann S, Heyse TJ. Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study. BMC Musculoskelet Disord. 2011;12:16.PubMedCrossRef
74.
Zurück zum Zitat Seon JK, Park SJ, Lee KB, Li G, Kozanek M, Song EK. Functional comparison of total knee arthroplasty performed with and without a navigation system. Int Orthop. 2009;33:987–990.PubMedCrossRef Seon JK, Park SJ, Lee KB, Li G, Kozanek M, Song EK. Functional comparison of total knee arthroplasty performed with and without a navigation system. Int Orthop. 2009;33:987–990.PubMedCrossRef
75.
Zurück zum Zitat Seon JK, Song EK. Navigation-assisted less invasive total knee arthroplasty compared with conventional total knee arthroplasty: a randomized prospective trial. J Arthroplasty. 2006;21:777–782.PubMedCrossRef Seon JK, Song EK. Navigation-assisted less invasive total knee arthroplasty compared with conventional total knee arthroplasty: a randomized prospective trial. J Arthroplasty. 2006;21:777–782.PubMedCrossRef
76.
Zurück zum Zitat Seon JK, Song EK, Yoon TR, Park SJ, Bae BH, Cho SG. Comparison of functional results with navigation-assisted minimally invasive and conventional techniques in bilateral total knee arthroplasty. Comput Aided Surg. 2007;12:189–193.PubMed Seon JK, Song EK, Yoon TR, Park SJ, Bae BH, Cho SG. Comparison of functional results with navigation-assisted minimally invasive and conventional techniques in bilateral total knee arthroplasty. Comput Aided Surg. 2007;12:189–193.PubMed
77.
Zurück zum Zitat Sikorski JM. Alignment in total knee replacement. J Bone Joint Surg Br. 2008;90:1121–1127.PubMed Sikorski JM. Alignment in total knee replacement. J Bone Joint Surg Br. 2008;90:1121–1127.PubMed
78.
Zurück zum Zitat Skowronski J, Bielecki M, Hermanowicz K, Skowronski R. The radiological outcomes of total knee arthroplasty using computer assisted navigation ORTHOPILOT. Chir Narzadow Ruchu Ortop Pol. 2005;70:5–8.PubMed Skowronski J, Bielecki M, Hermanowicz K, Skowronski R. The radiological outcomes of total knee arthroplasty using computer assisted navigation ORTHOPILOT. Chir Narzadow Ruchu Ortop Pol. 2005;70:5–8.PubMed
79.
Zurück zum Zitat SooHoo NF, Lieberman JR, Ko CY, Zingmond DS. Factors predicting complication rates following total knee replacement. J Bone Joint Surg Am. 2006;88:480–485.PubMedCrossRef SooHoo NF, Lieberman JR, Ko CY, Zingmond DS. Factors predicting complication rates following total knee replacement. J Bone Joint Surg Am. 2006;88:480–485.PubMedCrossRef
80.
Zurück zum Zitat Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A. Positioning of total knee arthroplasty with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br. 2003;85:830–835.PubMed Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A. Positioning of total knee arthroplasty with and without navigation support: a prospective, randomised study. J Bone Joint Surg Br. 2003;85:830–835.PubMed
81.
Zurück zum Zitat Spencer BA, Mont MA, McGrath MS, Boyd B, Mitrick MF. Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment. Int Orthop. 2009;33:1571–1575.PubMedCrossRef Spencer BA, Mont MA, McGrath MS, Boyd B, Mitrick MF. Initial experience with custom-fit total knee replacement: intra-operative events and long-leg coronal alignment. Int Orthop. 2009;33:1571–1575.PubMedCrossRef
82.
Zurück zum Zitat Stulberg SD, Picard F, Saragaglia D. Computer-assisted total knee replacement arthroplasty. Oper Tech Orthop. 2000;10:25–39.CrossRef Stulberg SD, Picard F, Saragaglia D. Computer-assisted total knee replacement arthroplasty. Oper Tech Orthop. 2000;10:25–39.CrossRef
83.
Zurück zum Zitat Swank ML, Alkire M, Conditt M, Lonner JH. Technology and cost-effectiveness in knee arthroplasty: computer navigation and robotics. Am J Orthop. 2009;38:32–36.PubMed Swank ML, Alkire M, Conditt M, Lonner JH. Technology and cost-effectiveness in knee arthroplasty: computer navigation and robotics. Am J Orthop. 2009;38:32–36.PubMed
84.
Zurück zum Zitat Tew M, Waugh W. Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg Br. 1985;67:551–556. PubMed Tew M, Waugh W. Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg Br. 1985;67:551–556. PubMed
85.
Zurück zum Zitat Tingart M, Luring C, Bathis H, Beckmann J, Grifka J, Perlick L. Computer-assisted total knee arthroplasty versus the conventional technique: how precise is navigation in clinical routine? Knee Surg Sports Traumatol Arthrosc. 2008;16:44–50.PubMedCrossRef Tingart M, Luring C, Bathis H, Beckmann J, Grifka J, Perlick L. Computer-assisted total knee arthroplasty versus the conventional technique: how precise is navigation in clinical routine? Knee Surg Sports Traumatol Arthrosc. 2008;16:44–50.PubMedCrossRef
86.
Zurück zum Zitat Victor J, Hoste D. Image-based computer-assisted total knee arthroplasty leads to lower variability in coronal alignment. Clin Orthop Relat Res. 2004;428:131–139.PubMedCrossRef Victor J, Hoste D. Image-based computer-assisted total knee arthroplasty leads to lower variability in coronal alignment. Clin Orthop Relat Res. 2004;428:131–139.PubMedCrossRef
87.
Zurück zum Zitat Yau WP, Chiu KY, Zuo JL, Tang WM, Ng TP. Computer navigation did not improve alignment in a lower-volume total knee practice. Clin Orthop Relat Res. 2008;466:935–945.PubMedCrossRef Yau WP, Chiu KY, Zuo JL, Tang WM, Ng TP. Computer navigation did not improve alignment in a lower-volume total knee practice. Clin Orthop Relat Res. 2008;466:935–945.PubMedCrossRef
88.
Zurück zum Zitat Yehyawi TM, Callaghan JJ, Pedersen DR, O’Rourke MR, Liu SS. Variances in sagittal femoral shaft bowing in patients undergoing TKA. Clin Orthop Relat Res. 2007;464:99–104.PubMed Yehyawi TM, Callaghan JJ, Pedersen DR, O’Rourke MR, Liu SS. Variances in sagittal femoral shaft bowing in patients undergoing TKA. Clin Orthop Relat Res. 2007;464:99–104.PubMed
89.
Zurück zum Zitat Zorman D, Etuin P, Jennart H, Scipioni D, Devos S. Computer-assisted total knee arthroplasty: comparative results in a preliminary series of 72 cases. Acta Orthop Belg. 2005;71:696–602. Zorman D, Etuin P, Jennart H, Scipioni D, Devos S. Computer-assisted total knee arthroplasty: comparative results in a preliminary series of 72 cases. Acta Orthop Belg. 2005;71:696–602.
Metadaten
Titel
Improved Accuracy of Alignment With Patient-specific Positioning Guides Compared With Manual Instrumentation in TKA
verfasst von
Vincent Y. Ng, MD
Jeffrey H. DeClaire, MD
Keith R. Berend, MD
Bethany C. Gulick, RT (R)
Adolph V. Lombardi Jr, MD
Publikationsdatum
01.01.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 1/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-011-1996-6

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