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CT JOINT ANALYSIS COMBINED WITH COMPUTER NAVIGATED SURGERY FOR COMPLEX KNEE ARTHROPLASTY IN POST TRAUMATIC OR DEFORMED LIMB PATIENT



Abstract

Reconstructive knee arthroplasty in patients with limb deformity can be a daunting and complex task. These patients are often younger and so post traumatic osteoarthritis poses a real challenge. In view of their relative youth, bone preservation would be favourable; however accurate implantation of components is essential. Formulation of a well calculated plan and accurate execution is essential for successful surgery.

We report on a novel method which combines 3D CT joint analysis and computer navigation to define the deformity present pre-operatively and determine whether the proposed reconstruction is feasible. If the reconstructive surgery is feasible, an accurate calculation the correction required is performed. The planned surgery is executed using computer aided navigation surgery.

Eight patients have benefited from the technique. Four patients presented with isolated medial compartment osteoarthritis and intact anterior cruciate ligament. These patients underwent 3D CT joint analysis and computer assisted navigation surgery to accurately implant unicondylar knee replacements.

Four Patients presented with two or three compartment disease. These patients underwent similar 3D CT analysis and navigated Total Knee Replacement.

The series demonstrates the merits of 3D CT joint analysis to accurately define deformity and therefore determine pre-operatively feasibility of corrective surgery proposed. The technique is then complimented by computer assisted navigation surgery to ensure the proposed surgical plan is accurately executed.

Correspondence should be addressed to Mr K Deep, Consultant Orthopaedic Surgeon, Golden Jubilee National Hospital NHS Trust, Beardmore Street, Clydebank, Glasgow G81 4HX, Scotland. Email: caosuk@gmail.com