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. 2017:3:50.
doi: 10.1051/sicotj/2017034. Epub 2017 Jul 28.

Computer assisted navigation in total knee and hip arthroplasty

Kamal Deep  1 , Shivakumar Shankar  1 , Ashish Mahendra  2
Affiliations

Computer assisted navigation in total knee and hip arthroplasty

Kamal Deep et al. SICOT J. 2017.

Abstract

Introduction: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures.

Methods: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction.

Results: Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years.

Conclusion: Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a standard practice in the future in various forms like navigation or robotics.

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Figures

Figure 1.
Figure 1.
The implant size and positioning of the rotational position of femoral cutting jig.
Figure 2.
Figure 2.
The change in coronal deformity (X axis) of knee femoro-tibial mechanical alignment angle, as the knee flexes (Y axis): first part showing before the surgery valgus deformity first increases and then decreases as the knee flexes (Type 4A in Deep’s classification) and second part showing the axis achieved after surgery of same patient (Neutral alignment).
Figure 3.
Figure 3.
Australian Joint registry report 2016.
See this image and copyright information in PMC

References

    1. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK et al. (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United State. Part I. Arthritis Rheum 58(1), 15–25. - PubMed
    1. Charnley J (1972) The long-term results of low-friction arthroplasty of the hip performed as a primary intervention. J Bone Joint Surg Br 54(1), 61–76. - PubMed
    1. Ethgen O, Bruyere O, Richy F, Dardennes C, Reginster J-Y (2004) Health-related quality of life in total hip and total knee arthroplasty. A qualitative and systematic review of the literature. J Bone Joint Surg Am 86–A(5), 963–974. - PubMed
    1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4), 780–785. - PubMed
    1. Briggs TW (2012) Getting it right first time. Improving the quality of orthopaedic care within the National health service in England, https://www.boa.ac.uk/pro-practice/review-of-orthopaedics-in-england/.

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