Handheld computer-navigated constrained total knee arthroplasty for complex extra-articular deformities.
Alignment
Computer navigation
Computer-assisted surgery
Constrained total knee arthroplasty
Extra-articular deformity
Total knee arthroplasty
Journal
Archives of orthopaedic and trauma surgery
ISSN: 1434-3916
Titre abrégé: Arch Orthop Trauma Surg
Pays: Germany
ID NLM: 9011043
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
08
02
2021
accepted:
01
07
2021
pubmed:
14
7
2021
medline:
26
11
2021
entrez:
13
7
2021
Statut:
ppublish
Résumé
The present study aimed to assess the postoperative alignment and clinical outcomes of patients with complex extra-articular deformities (EADs) undergoing computer-assisted surgery (CAS) for constrained total knee arthroplasty (TKA) with modular stem extensions. From May 2015 to July 2018, ten patients with EADs scheduled for constrained TKA were enrolled retrospectively. The preoperative average deviation from neutral (= 180°) mechanical axis was 15.3° (range of coronal alignment: 150.9° varus-202.9° valgus). Alignment was assessed using an accelerometer-based handheld CAS system. On long-leg films, the positions of the components and possible stems were analysed and templated preoperatively. The average follow-up was 3.3 years (range: 2.0-4.6 years). The postoperative mechanical axis was within ± 3.0° from neutral in nine patients. In all patients, the Knee Society score (KSS) and range of motion improved significantly. A constrained condylar and a rotating hinge prosthesis were used in five patients each. In eight patients, the 100-mm cementless stem that was preferred by the authors was found to be unusable for the femur or the tibia in the planning stage. For the femur, a cementless 100-mm stem was used in three, and a cemented 30-mm stem in five patients; a femoral stem was not usable in two patients. For the tibia, a cementless 100-mm stem was used in six, and a cemented 30-mm stem in two patients; a monoblock rotating hinge tibia was used in two patients. Complex EADs were excellently managed during constrained TKA implantation using the handheld CAS system. Templating allowed the possible stem lengths to be identified and prevented anatomical conflict with the CAS-configured mechanical alignment. Limb alignment and function improved significantly after surgery. No intra- or postoperative complications occurred. Level IV, retrospective study.
Identifiants
pubmed: 34255171
doi: 10.1007/s00402-021-04053-1
pii: 10.1007/s00402-021-04053-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2245-2254Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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