10 Years of Computer-assisted Total Knee Replacement –A Gimmick or Still an Emerging Technology?

Abstract

Abstract
About a decade ago, computer navigation began to be introduced into orthopaedic surgery to improve accuracy in surgical procedures and to reduce outliers. Apart from its applications in spinal surgery, computer navigation is most popular in total knee arthroplasty (TKA). In TKA, image-free, kinematic-based systems are standard and available for routine use for most common implants. Although the use of navigation is still under discussion, some benefits have become clear over the last few years. Many studies have shown reliable and reproducible results for mechanical leg axes in TKA using computer navigation, with higher precision than achieved with the manual technique. Continuous developments in software, navigation hardware and dedicated instruments have made navigation applicable in routine use. In addition to improvements in anteroposterior and sagittal alignment, navigated soft-tissue balancing has been integrated into navigation systems in the last few years to optimise coronal alignment and functional results of TKA. Current developments are navigated patella tracking and navigated TKA revision surgery.

Keywords
Total knee arthroplasty (TKA), computer navigation, minimally invasive, patella tracking, revision total knee arthropathy, computer-assisted surgery (CAS)

Disclosure: Thomas Mattes is a paid consultant for Zimmer. Wolfhart Puhl and Ralf Decking have no conflicts of interest to declare.
Acknowledgement: Image material for total knee arthroplasty revision surgery was provided by Aesculap.
Received: 7 March 2010 Accepted: 19 April 2010 Citation: European Musculoskeletal Review, 2010;5(1):48–52
Correspondence: Thomas Mattes, Head, Department of Orthopaedics, Klinik für Orthopädie und Unfallchirurgie, Klinik am Eichert, Eicherstrasse 3, 73035 Göppingen, Germany. E: thomas.mattes@kae.de