Skip to main content

01.03.2012 | Knee | Ausgabe 3/2012

Knee Surgery, Sports Traumatology, Arthroscopy 3/2012

Navigation-assisted total knee arthroplasty in knees with osteoarthritis due to extra-articular deformity

Knee Surgery, Sports Traumatology, Arthroscopy > Ausgabe 3/2012
Fabio Catani, Vitantonio Digennaro, Andrea Ensini, Alberto Leardini, Sandro Giannini



Extra-articular post-traumatic deformity may make difficult the implantation of total knee arthroplasty (TKA). Staged surgical procedures, including femoral or tibial osteotomy, can be required to restore proper alignment. These procedures may be inappropriate because of high rate of complications. Intra-articular resection is an alternative procedure, but it is limited by the potential compromise of collateral knee ligaments. Conventional instrumentation cannot be used in patients with previous trauma and residual bone deformity. We want to assess whether computer-assisted surgery may be a good alternative to traditional techniques.


Twenty consecutive TKAs were performed in 20 patients (12 men and 8 women) with knee arthritis due to extra-articular deformity. The mean age was 52 years. According to Moreland method, the mean (± standard deviation) of the pre-operative hip–knee–ankle angle was 10.4° ± 8.3° in varus. In all cases, an image-free knee navigation system was used because of the severe deformity or the presence of retained hardware that prevented the use of the intramedullary rod. The average follow-up was 3.1 years.


One month after surgery, the mean hip–knee–ankle angle was 0.8° ± 1.2° in varus. At follow-up, the Knee Society Score increased from an average of 48 pre-operatively to 91 (P < 0.05) post-operatively, with over 90% of excellent and good results. Mean range of motion improved from a 7°–74° mean range pre-operatively to 0°–94° post-operatively.


The general value of navigation systems in achieving accurate bone cuts and restoring the mechanical axis has been established in the literature for standard TKA but not yet for extra-articular deformity. Our findings at mid-term follow-up on a large cohort of these patients showed that these systems used for intra-articular resection are a very effective alternative to previous techniques.

Level of evidence

Prospective study, Level IV.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 3/2012

Knee Surgery, Sports Traumatology, Arthroscopy 3/2012 Zur Ausgabe
  1. Das kostenlose Testabonnement läuft nach 14 Tagen automatisch und formlos aus. Dieses Abonnement kann nur einmal getestet werden.

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.