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. 2004 Aug;28(4):193-7.
doi: 10.1007/s00264-004-0549-y. Epub 2004 Mar 6.

Minimally invasive unicompartmental knee replacement with a nonimage-based navigation system

L Perlick  1 , H Bäthis, M Tingart, C Perlick, C Lüring, J Grifka
Affiliations

Minimally invasive unicompartmental knee replacement with a nonimage-based navigation system

L Perlick et al. Int Orthop. 2004 Aug.

Abstract
in English, French

In a prospective study, two groups of 20 unicompartmental knee replacements (UKR) each were operated either using a CT-free navigation system or the conventional minimal invasive technique. Radiographic assessment of postoperative alignment was performed by long-leg coronal and lateral radiographs. The results revealed a significant difference between the two groups in favor of navigation. In the computer-assisted group, 95% of UKRs were in a range of 4-0 degrees varus (mechanical axis) compared with 70% in the conventional group. The only inconvenience was a prolonged operation time (+19 min). Due to the limited exposure, the navigation system is helpful in achieving a more precise component orientation. The danger of overcorrection is diminished by real-time information about the leg axis at each step during the operation.

Dans une étude prospective, deux groupes de 20 prothèses unicompartimentales de genou ont été opérés soit en utilisant un système de navigation sans scanner, soit par une technique mini-invasive habituelle. L’estimation de l’alignement postopératoire a été faite avec des grandes radiographies frontales et sagittales coronales. Les résultats ont révélé une différence notable entre les deux groupes en faveur de la navigation. Dans le groupe aidé par ordinateur, 95% des cas étaient dans une gamme de 0° à 4° de varus comparé à 70% dans le groupe conventionnel. Le seul inconvénient était un temps d’opération prolongé (+19 min). En raison de l’exposition limitée, le système de navigation est utile pour donner une orientation plus précise aux implants. Le danger d’hyper-correction est diminué par l’information en temps réel sur l’axe du membre à chaque temps de l’opération.

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Figures

Fig. 1
Fig. 1
Planning module. The planning proposal for component orientation can be adapted in all planes to the surgeon’s preferences
Fig. 2
Fig. 2
Analysis of kinematics before performing the first cut. The surgeon is informed about the contact area over the range of motion (red line)
Fig. 3
Fig. 3
Intraoperative setting. Reference frames with reflecting marker spheres (1) are attached to the distal femur and proximal tibia. The cutting plane is visualized in the adapted bone model and in numerical values. The dedicated fine, adjustable, tibial cutting block (2) facilitates the plane adjustment
Fig. 4
Fig. 4
Distribution of postoperative mechanical limb axis. Comparison between the computer-assisted (navigation) and the conventional group
See this image and copyright information in PMC

References

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