IS THE PRESSURE IN THE AXIS OF THE LOWER LIMB DURING TOTAL KNEE ARTHROPLASTY SUFFICIENT TO IMITATE WEIGHT-BEARING?
Authors:
Michal Baňas 1; Radek Hart 1,2; Pavel Šváb 1; Adel Safi 1
Authors place of work:
Departement of Orthopaedics and Traumatology, General Hospital Znojmo
1; Ortopedicko-traumatologické oddělení, Nemocnice Znojmo
1; Departement of Traumatology, Trauma Hospital Brno
2; Klinika traumatologie LF MU, Úrazová nemocnice Brno
2
Published in the journal:
Úraz chir. 22., 2014, č.1
Summary
INTRODUCTION:
Gonarthrosis is non-inflammatory degenerative disease affecting the cartilage of the knee, often associated with mechanical axis deviation of the limbs. The definitive restoration of the mechanical axis of the limb during total knee arthroplasty using navigation system occurs during surgery and in the final phase of the operation during the solidification of bone cement, when the weight-bearing is imitated by pressure to heel in the axis of the limb. The goal of the study was to clarify whether this imitation of weight-bearing of the limb is sufficient in determining the mechanical axis of the limb.
MATERIAL AND METHODS:
We investigated the mechanical axis of the limb before and after total knee arthroplasty from measurements from weight-bearing X-ray and from the navigation system. We enrolled 113 patients.
RESULTS:
Complete agreement between the data from X-ray and navigation system before total knee arthroplasty was found in 14 patients (12 %), 1–2 degrees difference was found in 36 patients (32 %), 3–4 degrees difference was found in 23 patients (20 %) and in 40 patients (35 %) difference was greater than 4 degrees. The average difference between the mechanical axes obtained from X-ray and navigation system before total knee arthroplasty was 4 degrees (maximum 17 degrees). The correspondence between the data from X-ray and navigation system after total knee arthroplasty was found in 35 patients (31 %), 1–2 degrees difference was found in 51 patients (45 %), 3–4 degrees difference was found in 22 patients (19 %) and in 5 patients (4 %) this difference was greater than 4 degrees. The average difference between the mechanical axis obtained from X-ray and navigation system after total knee arthroplasty was 2 degrees (maximum 11 degrees). T-test for post-operative X-ray data and post-operative navigation system data showed statistically significant difference (p = 0.02).
CONCLUSION:
The pressure in the axis of the limb to imitate weight-bearing during total knee arthroplasty is not sufficient.
KEY WORDS:
Total knee arthroplasty, navigation system, mechanical axis of the limb.
Zdroje
1. CHOI, W.C., LEE, S., AN, J.H., KIM, D. et al. Plain radiograph fails to reflect the alignment and advantages of navigation in total knee arthroplasty. J Arthroplasty. 2011, 26, 756–64. ISSN 0883-5403.
2. CHUNG, B.J., DILEEP, I., CHANG, C.B. et al. Novel approach to reducing discrepancies in radiographic and navigational limb alignments in computer-assisted TKA. Orthopedics. 2010, 33, 62–67. ISSN 1938-2367.
3. COOKE, T.D., SCUDAMORE, R.A., BRYANT, J.T. et al. A quantitative approach to radiography of the lower limb. Principles and applications. J Bone Joint Surg Br. 1991, 73, 715–720. ISSN 2044-5377.
4. COOKE, T.D., SLED, E.A., SCUDAMORE, R.A. Frontal plane knee alignment: a call for standardized measurement. J Rhematol. 2007, 34, 1796–1801. ISSN 1499-2752.
5. COVENTRY, B.M. Osteotomy about the knee for degenerative and rheumatoid arthritis. J Bone Joint Surg Am. 1973, 55, 23–48. ISSN 1535-1386.
6. DUNGL, P. a kol. Ortopedie. 1. vyd. Praha: Grada, 2005. 1280 str. ISBN 80-247-0550-8.
7. ENSINI, A., CATANI, F., LEARDINI, A. et al. Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res. 2007, 467, 156–162. ISSN 1528-1132.
8. HART, R., JANEČEK, M. Kinematická navigace kolenní endoprotézy. 1. vyd. Brno: Neptun, 2003. 76 str. ISBN 80-902896-5-7.
9. HART, R., JANEČEK, M., ČIŽMÁŘ, I. et al. Minimal-invasive und navigierte Implantation von Knietotalendoprothesen. Orthopäde. 2006, 35, 552-557. ISSN 1433-0431.
10. HART, R., JANEČEK, M., CHAKER, A. et al. Total knee arthroplasty implanted with and without kinematic navigation. Int Orthop. 2003, 27, 366-369. ISSN 1432-5195.
11. HAUSCHILD, O., KONSTANTINIDIS, L., BAUMANN, T. et al. Correlation of radiographic and navigated measurements of TKA limb alignment: a matter of time? Knee Surg Sports Traumatol Arthrosc. 2011, 18, 1317–1322. ISSN 1433-7347.
12. KENDOFF, D., BOARD, T.N., CITAK, M. et al. Navigated lower limb axis measurements: influence of mechanical weight-bearing simulation. J Orthop Res. 2008, 26, 553–561. ISSN 1554-527X.
13. KOMZÁK, M., OKÁL, F., SAFI, A., HART, R. Total knee replacement with using of the kinematic navigation system. In: BERHARDT, V.L. (ed.). Advances in medicine and biology. Volume 48. New York: Nova science publishers, 2012. 320 p. ISBN 978-1-61942-300-8.
14. OKÁL, F., SAFI, A., KOMZÁK, M., HART, R. Possibilities of computer application in primary knee replacement. In: FOKTER, S.K.(ed.) Recent advances in hip and knee arthroplasty. 1st. edition. Rijeka: InTech, 2012. 452p. ISBN 978-953-307-841-0.
15. SIU, D., COOKE, T.D., BROEKHOVEN, L.D., LAM, M. et al. A standardized technique for lower limb radiography. Practice, applications, and error analysis. Invest Radiol. 1991, 26, 71–77. ISSN 1536-0210.
16. SOSNA, A., VAVŘÍK, P., KRBEC, M., POKORNÝ, D. a kol. Základy ortopedie. 1. vyd. Praha: Triton, 2001. 169 str. ISBN 80-7254-202-8.
17. SPARMANN, M., WOLKE, B., CZUPALLA, H. et al. Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br. 2003, 85, 830–835. ISSN 2044-5377.
18. SPECOGNA, A.V., BIRMINGHAM, T.B. et al. Reliability of lower limb frontal plane alignment measurements using plain radiographs and digitized images. J Knee Surg. 2004, 17, 203–210. ISSN 1538-8506.
19. YAFFE, A.M., KOO, S.S., STULBERG, S.D. Radiographic and navigation measurements of TKA limb alingnment do not correlate. Clin Orthop Relat Res. 2008, 466, 2736–2744. ISSN 1528-1132.
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Surgery Traumatology Trauma surgeryČlánok vyšiel v časopise
Trauma Surgery
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