Možnosti kinematické počítačové navigace u náhrad kolenního kloubu
| Title in English | The possibilities of kinematic computer navigation usage in knee replacement |
|---|---|
| Authors | |
| Year of publication | 2012 |
| Type | Article in Periodical |
| Magazine / Source | Ortopedie |
| MU Faculty or unit | |
| Citation | |
| Field | Traumatology and orthopaedic surgery |
| Keywords | digital templating; navigation; knee replacement; mechanical axis |
| Description | The objective of this study is to evaluate the benefits of computer technology in knee replacements. Material and methods: The authors compared the values of mechanical limb axis deviation and the size of components measured before and after a total knee replacement by mediCAD 2,06 with values that were measured by navigation during the operation. The authors also compared results obtained after the knee replacement with and without navigation. With navigation, the authors were able to distinguish between the “true” and “false” valgus knee deformity. Navigation was used to determine the height of the polyethylene inlay in the unicompartmental knee replacement. The benefits of navigation usage in knee replacement after the fracture of the femur were also evaluated. Results: Size match between the components planned by mediCAD 2,06 and those actually implanted was observed on the femur, tibia, and polyethylene inlay in 73%, 93%, and 42%, respectively. The match between the mFA-mTA values measured before the total knee replacement and the values measured with navigation was 55%. The mFA-mTA value up to 2deg. was achieved in 88% of cases with navigation usage, but only in 70% of cases without navigation. In the unicompartmental knee replacement without navigation, an over-correction of the mechanical limb axis to valgus occurred in 63% of cases, but only in 17% of cases with navigation. The kinematic navigation system is also beneficial in knee replacements after femoral fractures, when the intra-medullar targeting cannot be used. Discussion: In congruency with the authors observation, the majority of literature sources point out the significance of preoperative planning and computer navigation in knee replacements. Conclusion: Digital templating allows for a relatively accurate determination of the mechanical limb axis deviation and size of the tibial component, but determines the size of femoral component and the height of the polyethylene inlay only approximately. The importance of navigation usage in total knee replacements is in reducing the perioperative error. Computer navigation can help surgeons to choose the appropriate approach by identifying the nature of the valgus deformity. Navigation usage at unicompartmental knee replacements allows for avoiding excessive or insufficient correction of the mechanical limb axis. The navigation system is also beneficial in knee replacement implantations after the fracture of the femur. |