Total knee arthroplasty with computer-assisted navigation: an analysis of 200 cases

Luzo, Marcus Vinicius Malheiros; Ambra, Luiz Felipe Morlin; Debieux, Pedro; Franciozi, Carlos Eduardo da Silveira; Costi, Raquel Ribeiro; Petrilli, Marcelo de Toledo; Kubota, Marcelo Seiji; Albertoni, Leonardo José Bernardes; Queiroz, Antônio Altenor Bessa de; Ferreira, Fábio Pacheco; Granata Júnior, Geraldo Sérgio de Mello; Carneiro Filho, Mário

doi:10.1016/j.rboe.2014.03.001

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Revista Brasileira de Ortopedia

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Original Articles • Rev. bras. ortop. 49 (02) • Mar-Apr 2014 • https://doi.org/10.1016/j.rboe.2014.03.001 copy

Total knee arthroplasty with computer-assisted navigation: an analysis of 200 cases^☆ ☆ Please cite this article as: Luzo MVM, Ambra LFM, Debieux P, Franciozi CES, Costi RR, Petrilli MT, et al. Artroplastia total do joelho auxiliada por navegação: análise de 200 casos. Rev Bras Ortop. 2014;49:149-153. ,^☆☆ ☆☆ Work performed in the Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

OBJECTIVE:

to evaluate the results from surgery with computer-assisted navigation in cases of total knee arthroplasty.

METHOD:

a total of 196 patients who underwent total knee arthroplasty with computer-assisted navigation were evaluated. The extension and flexion spaces (gaps) were evaluated during the operation and the alignment after the operation was assessed. The Knee Society Score (KSS) questionnaire for assessing patient's function was applied preoperatively and postoperatively after a mean follow-up of 22 months.

RESULTS:

in all, 86.7% of the patients presented good alignment of the mechanical axis (less than 3^◦ of varus or valgus in relation to the mechanical axis) and 96.4% of the patients presented balanced flexion and extension gaps. Before the operation, 97% of the patients presented poor or insufficient KSS, but after the operation, 77.6% presented good or excellent KSS.

CONCLUSION:

the navigation system made it possible to achieve aligned and balanced implants, with notable functional improvement among the patients. It was found to be useful in assessing, understanding and improving knowledge in relation to performing arthroplasty procedures.

Arthroplasty replacement Knee; Computer-assisted surgery

Variable	n	%

Balancing of the flexion gap
No	5	2.6
Yes	191	97.4
Balancing of the extension gap
No	2	1.0
Yes	194	99.0
Alignment of the mechanical axis
No	26	13.3
Yes	170	86.7
Balancing of the flexion/extension gap
No	7	3.6
Yes	189	96.4
Balancing of the gap and alignment of the mechanical axis
No	33	16.8
Yes	163	83.2
Total	196	100


Variable	Mean	SD	Median	Minimum	Maximum	n	p

Pre-op KSS	44.13	11.58	45	15	70	196	<0.001
Post-op KSS	76.85	13.15	80	30	100	196


KSS	Preoperative			Postoperative		p

	n	%		n	%

Poor	173	88.3	19		9.7	<0.001
Insufficient	17	8.7	25		12.8
Good	6	3.1	78		39.8
Excellent	0	0.0	74		37.8
Total	196	100	196		100


Preoperative KSS							Postoperative KSS

		Poor		Insufficient			Good		Excellent	Total		p

	n	%	n	%		n	%	n	%	n	%

Poor	17	8.7	21	10.7	68		34.7	67	34.2	173	88.3	<0.001
Insufficient	1	0.5	3	1.5	7		3.6	6	3.1	17	8.7
Good	1	0.5	1	0.5	3		1.5	1	0.5	6	3.1
Excellent	0	0.0	0	0.0	0		0.0	0	0.0	0	0.0
Total	19	9.7	25	12.8	78		39.8	74	37.8	196	100

Sociedade Brasileira de Ortopedia e Traumatologia Al. Lorena, 427 14º andar, 01424-000 São Paulo - SP - Brasil, Tel.: 55 11 2137-5400 - São Paulo - SP - Brazil
E-mail: rbo@sbot.org.br

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[1] ^* Corresponding author: E-mail: felipeambra71@gmail.com(L.F.M. Ambra)