Technical and surgical causes of outliers after computer navigated total knee arthroplasty.
Background: Navigated total knee arthroplasty (TKA) improves implant and limb alignment but outliers continue to exist. This study aimed to determine the technical and surgical causes of outliers. Methods: This retrospective cohort study included 208 patients who had undergone navigated TKA. Limb an...
| Publicado en: | Journal of Orthopaedics Vol. 18; pp. 171 - 177 |
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| Autores principales: | , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Professor PK Surendran Memorial Education Foundation
Mar/Apr2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=142822070&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 142822070 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 25899082 1CUL jtl: Journal of Orthopaedics issn: 25899082 maglogo: N pubinfo: dt: Mar/Apr2020 vid: 18 pid: 24594 pub: Professor PK Surendran Memorial Education Foundation artinfo: ui: 142822070 142822070 142822070 10.1016/j.jor.2019.10.016 142822070 ppf: 171 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Technical and surgical causes of outliers after computer navigated total knee arthroplasty. aug: au: Shah, Siddharth M. Sciberras, Nadia C. Allen, David J. Picard, Frederic affil: Department of Orthopaedics, Golden Jubilee National Hospital, Clydebank, UK sug: subj: Arthroplasty, Replacement, Knee Surgery, Computer-Assisted Treatment Outcomes Human Retrospective Design Tibia Femur Descriptive Statistics ab: Background: Navigated total knee arthroplasty (TKA) improves implant and limb alignment but outliers continue to exist. This study aimed to determine the technical and surgical causes of outliers. Methods: This retrospective cohort study included 208 patients who had undergone navigated TKA. Limb and implant alignment indices were measured on post-operative CT scans: mechanical femoro-tibial angle (MFTA); coronal femoral angle (CFA); coronal tibial angle (CTA); sagittal femoral angle (SFA); and sagittal tibial angle (STA). Values outside 0° ± 3° for MFTA and SFA, 90° ± 3° for CFA, CTA and STA were considered outliers. Intraoperative navigation data and CT scans were evaluated to categorize the causes of sagittal and coronal plane outliers into hip centre error; ankle centre error; heterogeneous tibial cement mantle; malalignment accepted by surgeon; suboptimal knee balance; and no obvious explanation. Results: Of the 1040 measurements (five per TKA), the overall incidence of outliers was 10.4% (n = 108). Femoral component outliers (CFA + SFA, n = 51) were all attributable to hip centre error. Tibial component outliers (CTA + STA, n = 43) were attributable to ankle centre error (n = 6), heterogeneous cement mantle (n = 20), malalignment accepted by the surgeon (n = 6) and no obvious cause (n = 11). MFTA outliers were attributable to hip centre error (n = 4) or suboptimal knee balance (n = 10). Conclusions: Surgeon related errors can be minimized by a meticulous operative technique. These results indicate scope for additional technical improvement, especially in hip centre acquisition, which may further reduce the incidence of outliers. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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