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MEDACTA COMPUTER NAVIGATION SYSTEM IN KNEE ARTHROPLASTY



Abstract

The Gpsystem Medacta vision system is composed of an infrared camera that produces and receives infrared rays reflected by almost 3 reflectors mounted on different rigid body devices (F=femoral, T=tibial, G=guide), in order to determine its position with an error lower than 0.35mm. Data received from this vision system are than elaborated by the Cinetique Gpsystem Version 1.0 system in order to determine the correct cutting guide positioning both for the femur and the tibia. The cutting guide is moved on different planes by 5 electric engines applied on 5 no ending screws.

The first step of this system is determining, with the F and the T rigid bodies, patient’s lower limb kinematic in order to evaluate its mechanical axis, its flexion-extension range of movement and its pathological deviations. The second step is evaluating anatomical landmarks to find out the correct degrees of tibial and femoral cuts: these landmarks are the medial and lateral tibial glena, the distal femoral condyles, the posterior femoral condyles, the anterior femoral cortex, the tibial tuberosity, the Whiteside line and the epycondilar axis (each anatomical landmark is identified by multiple points in order to decrease possible errors). The third step is applying the cutting guide and the Grigid body on the femoral clamp in order to estimate the correct level for the tibial cut than, once the tibial osteotomy is done the vision system controls its correct execution and the soft tissue balancing of the knee. The fourth step is calculating with the Gpsystem the correct orientation of the femoral cutting guide and checking its positioning and cutting execution. The last step is applying the test-prosthesis verifying the mechanical axis of the knee and than assembling the definitive prosthesis.

Since now we have applied 10 Cinetique knee prosthesis with the Medacta computer navigation system with good results and good positioning of the prosthesis

Medacta computer navigation system for Cinetique knee arthroplasty is innovative for its simple cutting guide and movement device both in their hardware than in their way of using and for a simpler software interface; these characteristics allows faster surgeon technique learning, shortening of surgical time and a better prosthesis positioning.

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