Abstract
Introduction
Computer-assisted navigation is an established tool in hip and knee arthroplasty. This technology was introduced with the goals of greater precision in bone preparation and implant placement, potentially leading to improved clinical outcomes. Various navigation protocols exist, many of which require placement of temporary percutaneous pins in the operative field. Risks of pin placement have not been described.
Methods
We conducted a retrospective review of 352 consecutive patients undergoing elective hip and knee surgery using computer-assisted navigation between January 2013 and December 2015, all with a minimum follow-up of 90 days. Navigation pins were placed using a standardized protocol into the iliac crest for hip arthroplasty or into the femoral and tibial diaphysis for knee arthroplasty. Postoperatively, all patients were allowed to weight bear as tolerated. Patient records were reviewed for operative details and clinical outcomes. Outcome measures included any pin site complications including direct neurovascular damage, fracture through a pin site, and pin site infection.
Results
A total of 968 pin sites were included in the study. Two pin site complications were reported (0.21%). No neurovascular injuries were reported from pin placement (0.0%). No periprosthetic fractures through a pin site were reported (0.0%). Two patients developed a pin-site infection with purulent drainage (0.21%), both of which resolved with oral antibiotics and local wound care.
Conclusion
Potential benefits of navigation in hip and knee arthroplasty are still being investigated, however the placement of pins required for this technology are associated with minimal patient morbidity and should be considered a safe intervention with minimal added risk.
