Intraoperative Assessment of Bone Cuts to Guide Surgical Technique During Total Knee Arthroplasty
| Autor: | Melinda K. Harman, Sabine Schmitt, Scott A. Banks, Kim H. Mitchell, W. Andrew Hodge |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Total knee arthroplasty Prosthesis Intraoperative Period Deformity Humans Medicine Orthopedics and Sports Medicine Femur Arthroplasty Replacement Knee Aged Aged 80 and over Tibia business.industry General Medicine Middle Aged Arthroplasty Surgery Orthopedic surgery Calipers Female Implant medicine.symptom business |
| Zdroj: | Journal of Bone and Joint Surgery. 89:137-143 |
| ISSN: | 1535-1386 0021-9355 |
| DOI: | 10.2106/jbjs.g.00585 |
| Popis: | Correction of deformity with bone resection matched to the thickness of the prosthesis is a required surgical placement (Fig. 1). Current instrumentation used during total Cstrategy to achieve a well-functioning total knee re-knee arthroplasty consists of external jigs that surgeons manually align to achieve proper bone cuts and implant position. However, alignment errors of 3° to 5° can occur, contributing to improper component and limb alignment. Verification of templating and instrument alignment can be approached intraoperatively with a low-tech method (i.e., measuring the removed bone with calipers and recording the measurement on a pathway grid) or a high-tech method (i.e., computer-assisted surgical navigation). Such intraoperative measurement of bone resection during total knee arthroplasty creates a pathway for identifying surgical errors early in the decision-making process, when it is easy to make compensatory adjustments with the remaining cuts. This aids the identification of the location and timing of compounding errors. The objectives of this study were (1) to verify instrument alignment in total knee arthroplasty by monitoring femoral and tibial bone cuts with use of either caliper (low-tech) or navigation (high-tech) methods; (2) to create a generalized and traceable bone-cut pathway, independent of surgical instruments and technique; and (3) to assess intraoperatively the cumulative effects of tibial and femoral bone resection on balancing and alignment for total knee arthroplasty. In this study, approved by our institutional review board, two surgical techniques were evaluated in two patient populations who underwent total knee arthroplasty with the same prosthetic design (3D Knee; Encore Medical, Austin, Texas) (Table I). The bone cut group consisted of fifty-eight knees in which intraoperative measurements of resected bone were completed with use of handheld calipers. The bone cut + navigation group consisted of twenty-three knees in which intraoperative measurements of resected bone were completed with use of handheld calipers … |
| Databáze: | OpenAIRE |
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