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Extra-Medullary Computer-Assisted Total Knee Replacement: Towards Lesser Invasive Surgery

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Navigation and Robotics in Total Joint and Spine Surgery

Abstract

Modern total knee replacement has emerged as one of the most successful and reproducible surgical procedures performed today [26,41]. Much of this success has been due to the advances made with improved instrumentation with an understanding of the importance of restoring normal alignment of the mechanical axis of the knee [1,12,13,15, 22, 29, 36, 46]. However, even with modern intra-medullary alignment systems there is still variability in the overall results achieved. There is further continued concern about fat embolization with intra-medullary techniques. Computer-assisted extra-medullary techniques offer the opportunity for improved accuracy and reproducibility while avoiding instrumenting the intramedullary canal. As total knee replacement continues to evolve with minimally invasive surgery, the incorporation of computer-assisted techniques has the potential to allow the surgeon to continue to place the knee components accurately with less trauma to the patient.

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References

  1. Bargren JH, Blaha JD, Freeman MAR (1983) Alignment in total knee arthroplasty: Correlated biomechanical and clinical observations. Clin Orthop 173:178–183.

    PubMed  Google Scholar 

  2. Berman AT, Parmet JL, Harding SF et al. (1998) Emboli observed with the use of transesophageal echocardiography immediately after tourniquet release during total knee arthroplasty with cement. J Bone Joint Surg 88A:389.

    Google Scholar 

  3. Caillouette JT, Anzel SH (1990) Fat embolism syndrome following the intramedullary alignment guide in total knee arthroplasty. Clin Orthop 251:198–199

    PubMed  Google Scholar 

  4. Clark RE, Brillman J, Davis DA et al. (1995) Microemboli during coronary artery bypass grafting: Genesis and effect on outcome. J Thorac Cardiovasc Surg 109:249–258.

    Article  PubMed  CAS  Google Scholar 

  5. Colonna DM, Stump DA, Kilgus DJ etal. (1999) Total hip arthroplasty produces intraoperative brain embolization and neuropsychologic dysfunction up to 6 weeks postoperatively. Anesthesiology A79:91.

    Google Scholar 

  6. Dorr LD, Merkel C, Mellman MF etal. (1989) Fat emboli in bilateral total knee arthroplasty. Clin Orthop 248:112–118; discussion 118–119

    PubMed  Google Scholar 

  7. Dorr LD, Boiardo RA (1997) Technical considerations in total knee arthroplasty. Clin Orthop 205:5–11.

    Google Scholar 

  8. Ecker ML, Lotke PA, Windsor RE et al. (1987) Long-term results after total condylar knee arthroplasty: Significance of radiolucent lines. Clin Orthop 216:151–158.

    PubMed  Google Scholar 

  9. Fahmy NR, Chandler HP, Danylchuk K et al. (1990) Blood gas and circulatory changes during total knee replacement: The role of the intramedullary alignment rod. J Bone Joint Surg 72A: 19–26.

    Google Scholar 

  10. Giachino AA, Rody K, Turek MA et al. (2001) Systemic fat and thrombus embolization in patients undergoing total knee arthroplasty with regional heparinization. J Arthroplasty 16:288–292.

    Article  PubMed  CAS  Google Scholar 

  11. Gurd AD (1970) Fat embolism:an aid to diagnosis. J Bone Joint Surg 52B: 732–737.

    Google Scholar 

  12. Hood RW, Vanni M, Insall JN (1981) The correction of knee alignment in 225 consecutive total condylar knee replacements. Clin Orthop 160:94–105.

    PubMed  Google Scholar 

  13. Insall JN, Binazzi R, Soudry M et al. (1985) Total knee arthroplasty. Clin Orthop 192:13–22.

    PubMed  Google Scholar 

  14. Jazrawi LM, Birdzell L, Kummer FJ et al. (2000) The accuracy of computed tomography for determining femoral and tibial total knee arthroplasty component rotation. J Arthroplasty 15:761–766.

    Article  PubMed  CAS  Google Scholar 

  15. Jeffery RS, Morris RW, Denham RA (1991) Coronal alignment after total knee replacement. J Bone Joint Surg 73B: 709–714.

    Google Scholar 

  16. Jenny JY, Boeri C (2001) Computer-assisted implantation of a total knee arthroplasty: a case-controlled study in comparison with classical instrumentation. Revue de Chirurgie Orthopedique et Reparatrice del Appareil Moteur 87:645–652.

    CAS  Google Scholar 

  17. Kilo J, Czerny M, Gorlitzer M et al. (2001) Cardiopulmonary bypass affects cognitive brain function after coronary artery bypass grafting. Ann Thoracic Surg 72:1926–1932.

    Article  CAS  Google Scholar 

  18. Klein AL, Stewart WC, Delos M et al. (1990) Visualization of acute pulmonary emboli by transesophageal echocardiography. J Am Soc Echocardiogr 3:412.

    PubMed  CAS  Google Scholar 

  19. Koessler MJ, Pitto RP (2002) Fat embolism and cerebral function in total hip arthroplasty. Intern Orthop 26:259–262.

    Article  CAS  Google Scholar 

  20. Laskin RS (1990) Total condylar knee replacement in patients who have rheumatoid arthritis: A ten-year follow-up study. J Bone Joint Surg 72A: 529–535.

    Google Scholar 

  21. Lonner JH, Laird MT, Stuchin SA (1996) Effect of rotation and knee flexion on radiographic alignment in total knee arthroplasties.Clin Orthop 331:102–106

    Article  PubMed  Google Scholar 

  22. Lotke PA, Ecker ML (1977) Influence of positioning of prosthesis in total knee replacement. J Bone Joint Surg 59A: 77–79.

    Google Scholar 

  23. Mahaluxmivala J, Bankes MJK, Nicolai P et al. (2001) The effect of surgeon experience on component positioning in 673 press fit condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplasty 16:635–640.

    Article  PubMed  CAS  Google Scholar 

  24. McGrory JE, Trousdale RT, Pagnano MW et al. (2002) Preoperative hip to ankle radiographs in total knee arthroplasty. Clin Orthop 404:196–202.

    Article  PubMed  Google Scholar 

  25. Miehlke RK, Clemens U, Jens JH et al. (2001) Navigation in knee endoprosthesis implantation: preliminary clinical experiences and prospective comparative study with conventional implantation technique. Z Orthop Ihre Grenzgeb 139:109–116.

    Article  Google Scholar 

  26. Mont MA, Booth RE Jr, Laskin RS etal.(2003) The spectrum of prosthesis design for primary total knee arthroplasty.Instructional Course Lectures 52:397–407

    PubMed  Google Scholar 

  27. Monto RR, Garcia J, Callaghan JJ (1990) Fatal fat embolism following total condylar knee arthroplasty. J Arthroplasty 5:291–299.

    Article  PubMed  CAS  Google Scholar 

  28. Morawa LG, Manley MT, Edidin AA et al. (1991) Transesophageal echocardiography monitored events during total knee arthroplasty. Clin Orthop 331:192.

    Google Scholar 

  29. Moreland JR (1988) Mechanics of failure of total knee arthroplasty.Clin Orthop 226:49–64

    PubMed  Google Scholar 

  30. Nizard R (2002) Computer assisted surgery for total knee arthroplasty. Acta Orthop Belg 68:215–230.

    PubMed  CAS  Google Scholar 

  31. Oswald MH, Jakob RP, Schneider E et al. (1993) Radiological analysis of normal axial alignment of femur and tibia in view of total knee arthroplasty. J Arthroplasty 8:419–426.

    Article  PubMed  CAS  Google Scholar 

  32. Parmet JL, Berman AT, Horrow JC et al. (1993) Thromboembolism coincident with tourniquet deflation during total knee arthroplasty. Lancet 341:1057–1058.

    Article  PubMed  CAS  Google Scholar 

  33. Parmet JL, Horrow JC, Singer R et al. (1994) Echogenic emboli upon tourniquet release during total knee arthroplasty: pulmonary hemodynamic changes and embolic composition. Anesth Analg 9:940–945.

    Google Scholar 

  34. Petersen TL, Engh GA (1988) Radiographic assessment of knee alignment after total knee arthroplasty. J Arthroplasty 3:67–72.

    Article  PubMed  CAS  Google Scholar 

  35. Plaskos C, Hodgson AJ, Inkpen K et al. (2002) Bone cutting errors in total knee arthroplasty. J Arthroplasty 17:698–705.

    Article  PubMed  Google Scholar 

  36. Ranawat CS, Boachie-Adjei O (1988) Survivorship analysis and results of total condylar knee arthroplasty. Clin Orthop 226:6–13.

    PubMed  Google Scholar 

  37. Reed SC, Gollish J (1997) The accuracy of femoral intramedullary guides in total knee arthroplasty. J Arthroplasty 12:677–682.

    Article  PubMed  CAS  Google Scholar 

  38. Ritter MA, Faris PM, Keating EM etal. (1994) Postoperative alignment of total knee replacement: Its effect on survival. Clin Orthop 299:153–156

    PubMed  Google Scholar 

  39. Ritter MA, Herbst SA, Keating EM et al. (1994) Radiolucency at the bonecement interface in total knee replacement: The effects of bone-surfacing preparation and cement technique. J Bone Joint Surg 76A:60–65.

    Google Scholar 

  40. Saragaglia D, Picard F, Chaussard C etal. (2001) Computer-assisted knee arthroplasty: comparison with a conventional procedure: Results of 50 cases in a prospective randomized study. Rev Chir Orthop Reparatrice Appar Mot 87:18–28.

    PubMed  CAS  Google Scholar 

  41. Scuderi GR, Scott WN, Tchejeyan GH (2001) The Insall legacy in total knee arthroplasty. Clin Orthop 392:3–14.

    Article  PubMed  Google Scholar 

  42. Sikorski JM, Chauhan S (2003) Computer-assisted orthopaedic surgery: Do we need CAOS? J Bone Joint Surg 85B: 319–323.

    Article  Google Scholar 

  43. Stern SH, Insall JN (1992) Posterior stabilized prosthesis: Results after follow-up of nine to twelve years. J Bone Joint Surg 74A: 980–986.

    Google Scholar 

  44. Stulberg SD. Loan P. Sarin V (2002) Computer-assisted navigation in total knee replacement: results of an initial experience in thirty-five patients. J Bone Joint Surg 84A [Suppl 2]: 90–98.

    Google Scholar 

  45. Teter KE, Bregman D, Colwell CW Jr (1995) Accuracy of intramedullary versus extramedullary tibial alignment cutting systems in total knee arthroplasty. Clin Orthop 321:106–110

    PubMed  Google Scholar 

  46. Tew M, Waugh W (1985) Tibiofemoral alignment and the results of knee replacement. J Bone Joint Surg 67B:551–556.

    Google Scholar 

  47. Wasielewski RC, Galante JO, Leighty R etal. (1994) Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop 299:31–43

    PubMed  Google Scholar 

  48. Williams-Russo P, Sharrock NE, Mattis S et al. (1995) Cognitive effects after epidural vs.general anesthesia in older adults. JAMA 274:44–50.

    Article  PubMed  CAS  Google Scholar 

  49. Yoshino NJakai S, Ohtsuki Yet al. (2001) Computed tomography measurement of the surgical and clinical transepicondylar axis of the distal femur in osteoarthritic knees. J Arthroplasty 16:493–497.

    Article  PubMed  CAS  Google Scholar 

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  1. R. L. Wixson
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© 2004 Springer-Verlag Berlin Heidelberg

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Wixson, R.L. (2004). Extra-Medullary Computer-Assisted Total Knee Replacement: Towards Lesser Invasive Surgery. In: Navigation and Robotics in Total Joint and Spine Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59290-4_44

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  • DOI: https://doi.org/10.1007/978-3-642-59290-4_44

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-63922-7

  • Online ISBN: 978-3-642-59290-4

  • eBook Packages: Springer Book Archive

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