Joint line changes after primary total knee arthroplasty: navigated versus non-navigated
Identifieur interne : 000349 ( Main/Exploration ); précédent : 000348; suivant : 000350Joint line changes after primary total knee arthroplasty: navigated versus non-navigated
Auteurs : A. Jawhar [Allemagne] ; V. Shah [Inde] ; S. Sohoni [Inde] ; H. P. Scharf [Allemagne]Source :
- Knee Surgery, Sports Traumatology, Arthroscopy [ 0942-2056 ] ; 2013.
English descriptors
- Teeft :
- Alignment, Alignment change, Arthroplasty, Arthrosc, Bone joint surg, Clin orthop relat, Clinical outcome, Conventional technique, Femoral, Fibula, Fibula head, Flexion, Implant, Joint line, Joint line change, Joint line height, Joint line level, Joint line position, Joint line reconstruction, Joint line shift, Knee surg sport traumatol arthrosc, Limb alignment, Magnification factor, Median, Median joint line shift, More accurate, Natural joint line, Navigation, Navigation system, Orthop, Outlier, Postoperative, Postoperative joint line shift, Preoperative, Present study, Primary total knee arthroplasty, Radiograph, Randomized, Resection, Significant difference, Surg, Tibial, Tkas, Total knee arthroplasty, Total knee replacement, Traumatol, View radiograph.
Abstract
Abstract: Purpose: Navigation has been introduced to achieve more accurate positioning of the implants after TKA. The scientific attention was mainly paid on limb alignment rather than restoration of the natural joint line. The aim of our study was to compare the accuracy of the joint line restoration in primary TKA with and without navigation. We hypothesized that joint line reconstruction in navigated TKA is more accurate. Methods: A total of 493 primary TKAs operated in a single medical centre were consecutively selected and divided into two groups. 206 cases were performed computer assisted (BrainLab CI-System), whereas 287 knees were implanted conventionally. For both groups, the joint line position of the knee was determined on standardized calibrated standing pre- and postoperative digital radiographs in ap view by a modified method of Kawamura et al. A joint line shift of more than 8 mm was defined as outlier. Results: In the conventional group, the joint line shift averaged 0.7 mm (±4.4 mm), whereas the findings in the computer-assisted cases were in average 0.6 mm (±4.5 mm). The joint line was located above 8 mm in 6 % of non-navigated versus 6.8 % of navigated primary TKAs. There were no statistically significant differences of joint line shift between the different component types. A statistically significant relation was not found between joint line shift and leg alignment changes. Conclusions: Conventional surgical technique allows a precise joint line reconstruction in primary TKA. Navigation did not improve the joint line reconstruction. Level of evidence: Diagnostic study, Level III.
Url:
DOI: 10.1007/s00167-013-2580-2
Affiliations:
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Jawhar</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopaedic and Trauma Surgery Center, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Mannheim</settlement></placeName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Allemagne</country></affiliation></author><author><name sortKey="Shah, V" sort="Shah, V" uniqKey="Shah V" first="V." last="Shah">V. Shah</name><affiliation wicri:level="1"><country xml:lang="fr">Inde</country><wicri:regionArea>Navrang Hospital, Vadodara, Gujarat</wicri:regionArea><wicri:noRegion>Gujarat</wicri:noRegion></affiliation></author><author><name sortKey="Sohoni, S" sort="Sohoni, S" uniqKey="Sohoni S" first="S." last="Sohoni">S. Sohoni</name><affiliation wicri:level="1"><country xml:lang="fr">Inde</country><wicri:regionArea>Kaushalya Medical Foundation Trust Hospital, Thane, Maharashtra</wicri:regionArea><wicri:noRegion>Maharashtra</wicri:noRegion></affiliation></author><author><name sortKey="Scharf, H P" sort="Scharf, H P" uniqKey="Scharf H" first="H. P." last="Scharf">H. P. Scharf</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Orthopaedic and Trauma Surgery Center, University Medical Center Mannheim of University Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim</wicri:regionArea><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Karlsruhe</region><settlement type="city">Mannheim</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Knee Surgery, Sports Traumatology, Arthroscopy</title><title level="j" type="abbrev">Knee Surg Sports Traumatol Arthrosc</title><idno type="ISSN">0942-2056</idno><idno type="eISSN">1433-7347</idno><title level="j" type="issue">Patient specific surgery in total knee arthroplasty</title><imprint><publisher ref="https://scientific-publisher.data.istex.fr/ark:/67375/H02-SWLMH5L1-1">Springer Berlin Heidelberg</publisher><pubPlace>Berlin/Heidelberg</pubPlace><date type="published" when="2013">2013</date><biblScope unit="vol" from="21" to="21">21</biblScope><biblScope unit="issue" from="10" to="10">10</biblScope><biblScope unit="page" from="2355">2355</biblScope><biblScope unit="page" to="2362">2362</biblScope></imprint><idno type="ISSN">0942-2056</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0942-2056</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Alignment</term><term>Alignment change</term><term>Arthroplasty</term><term>Arthrosc</term><term>Bone joint surg</term><term>Clin orthop relat</term><term>Clinical outcome</term><term>Conventional technique</term><term>Femoral</term><term>Fibula</term><term>Fibula head</term><term>Flexion</term><term>Implant</term><term>Joint line</term><term>Joint line change</term><term>Joint line height</term><term>Joint line level</term><term>Joint line position</term><term>Joint line reconstruction</term><term>Joint line shift</term><term>Knee surg sport traumatol arthrosc</term><term>Limb alignment</term><term>Magnification factor</term><term>Median</term><term>Median joint line shift</term><term>More accurate</term><term>Natural joint line</term><term>Navigation</term><term>Navigation system</term><term>Orthop</term><term>Outlier</term><term>Postoperative</term><term>Postoperative joint line shift</term><term>Preoperative</term><term>Present study</term><term>Primary total knee arthroplasty</term><term>Radiograph</term><term>Randomized</term><term>Resection</term><term>Significant difference</term><term>Surg</term><term>Tibial</term><term>Tkas</term><term>Total knee arthroplasty</term><term>Total knee replacement</term><term>Traumatol</term><term>View radiograph</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose: Navigation has been introduced to achieve more accurate positioning of the implants after TKA. The scientific attention was mainly paid on limb alignment rather than restoration of the natural joint line. The aim of our study was to compare the accuracy of the joint line restoration in primary TKA with and without navigation. We hypothesized that joint line reconstruction in navigated TKA is more accurate. Methods: A total of 493 primary TKAs operated in a single medical centre were consecutively selected and divided into two groups. 206 cases were performed computer assisted (BrainLab CI-System), whereas 287 knees were implanted conventionally. For both groups, the joint line position of the knee was determined on standardized calibrated standing pre- and postoperative digital radiographs in ap view by a modified method of Kawamura et al. A joint line shift of more than 8 mm was defined as outlier. Results: In the conventional group, the joint line shift averaged 0.7 mm (±4.4 mm), whereas the findings in the computer-assisted cases were in average 0.6 mm (±4.5 mm). The joint line was located above 8 mm in 6 % of non-navigated versus 6.8 % of navigated primary TKAs. There were no statistically significant differences of joint line shift between the different component types. A statistically significant relation was not found between joint line shift and leg alignment changes. Conclusions: Conventional surgical technique allows a precise joint line reconstruction in primary TKA. Navigation did not improve the joint line reconstruction. Level of evidence: Diagnostic study, Level III.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Inde</li></country><region><li>Bade-Wurtemberg</li><li>District de Karlsruhe</li></region><settlement><li>Mannheim</li></settlement></list><tree><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Jawhar, A" sort="Jawhar, A" uniqKey="Jawhar A" first="A." last="Jawhar">A. Jawhar</name></region><name sortKey="Jawhar, A" sort="Jawhar, A" uniqKey="Jawhar A" first="A." last="Jawhar">A. Jawhar</name><name sortKey="Scharf, H P" sort="Scharf, H P" uniqKey="Scharf H" first="H. P." last="Scharf">H. P. Scharf</name></country><country name="Inde"><noRegion><name sortKey="Shah, V" sort="Shah, V" uniqKey="Shah V" first="V." last="Shah">V. Shah</name></noRegion><name sortKey="Sohoni, S" sort="Sohoni, S" uniqKey="Sohoni S" first="S." last="Sohoni">S. Sohoni</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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