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EVOLUTION OF COMPUTER-ASSISTED NAVIGATION IN TOTAL KNEE REPLACEMENT



Abstract

The success of total knee replacement depends on several factors, however, surgical technique is particularly important. In fact mistakes in alignment of prosthtic components are common causes of aseptic loosening.

Serious improper alignment (more than 3°) was found out, according to several papers, in about 10% of the implants; this appears not correlated with surgeon’s experience when they use mechanical alignment devices either extra medullary or intra medullary. The development of computer-based systems to achieve correct prosthetic components alignement has the purpose to solve the problems of traditional mechanical alignement systems. At present computer-assisted navigation systems, either they areimage-free or imege-based, are widely empolied while robotic systems are not so commonly used. The Authors describe in this paper the features of the computer-assisted navigation system they at present employ. They moreover emphasize its precision and the reproducibility of the results they can achive. The features of this system (it is based on an image-free navigation method; it allows quantification of the kinematics of the knee; it allows the use of either specially designed cutting bolcks or standar instruments), are an intresting evolution of computer-assisted navigation systems for knee replacement.

Correspondence should be addressed to Richard Komistek, PhD, International Society for Technology in Arthroplasty, PO Box 6564, Auburn, CA 95604, USA. E-mail: ista@pacbell.net