Improving outcomes in total knee arthroplasty—do navigation or customized implants have a role?
Identifieur interne : 004253 ( Ncbi/Checkpoint ); précédent : 004252; suivant : 004254Improving outcomes in total knee arthroplasty—do navigation or customized implants have a role?
Auteurs : Matthew D. Beal [États-Unis] ; Dimitri Delagramaticas [États-Unis] ; David Fitz [États-Unis]Source :
- Journal of Orthopaedic Surgery and Research [ 1749-799X ] ; 2016.
Abstract
Modern total knee arthroplasty is effective at treating the pain and disability associated with osteoarthritis. The number of total knee replacements done in the USA continues to increase. Despite the great care taken during all of these procedures, some patients remain dissatisfied with their outcome. While this dissatisfaction is likely multifactorial, malalignment of the prosthetic components is a major cause of postoperative complications. A neutral mechanical axis plus or minus 3° is felt to have a positive impact on the survivorship of the prosthesis. Conventional instrumentation has been shown to have a significant number of total knee replacements that lie well outside a neutral coronal alignment. With that in mind, significant effort has been placed into the development of technology to improve the overall alignment of the prosthesis. In order to reduce the number of outliers, several companies have developed cost-effective systems to aid the surgeon in achieving a more predictably aligned prosthesis in all three planes. We will review the literature that is available regarding several of these tools to examine if navigation or custom guides improve outcomes in total knee arthroplasty. Our review supports that while both navigation and custom implants guides seem to be a cost effective way to achieve a predictable mechanical alignment of a total knee prosthesis therefore reducing the number of outliers, the cost may be increased operative times with no perceived difference in patient satisfaction with navigation custom guides.
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DOI: 10.1186/s13018-016-0396-8
PubMed: 27216272
PubMed Central: 4877731
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Improving outcomes in total knee arthroplasty—do navigation or customized implants have a role?</title><author><name sortKey="Beal, Matthew D" sort="Beal, Matthew D" uniqKey="Beal M" first="Matthew D." last="Beal">Matthew D. Beal</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Delagramaticas, Dimitri" sort="Delagramaticas, Dimitri" uniqKey="Delagramaticas D" first="Dimitri" last="Delagramaticas">Dimitri Delagramaticas</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Fitz, David" sort="Fitz, David" uniqKey="Fitz D" first="David" last="Fitz">David Fitz</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">27216272</idno><idno type="pmc">4877731</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877731</idno><idno type="RBID">PMC:4877731</idno><idno type="doi">10.1186/s13018-016-0396-8</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000923</idno><idno type="wicri:Area/Pmc/Curation">000923</idno><idno type="wicri:Area/Pmc/Checkpoint">000096</idno><idno type="wicri:Area/Ncbi/Merge">004253</idno><idno type="wicri:Area/Ncbi/Curation">004253</idno><idno type="wicri:Area/Ncbi/Checkpoint">004253</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Improving outcomes in total knee arthroplasty—do navigation or customized implants have a role?</title><author><name sortKey="Beal, Matthew D" sort="Beal, Matthew D" uniqKey="Beal M" first="Matthew D." last="Beal">Matthew D. Beal</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Delagramaticas, Dimitri" sort="Delagramaticas, Dimitri" uniqKey="Delagramaticas D" first="Dimitri" last="Delagramaticas">Dimitri Delagramaticas</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Fitz, David" sort="Fitz, David" uniqKey="Fitz D" first="David" last="Fitz">David Fitz</name><affiliation wicri:level="3"><nlm:aff id="Aff1">Northwestern University Feinberg School of Medicine, Chicago, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Northwestern University Feinberg School of Medicine, Chicago</wicri:regionArea><placeName><settlement type="city">Chicago</settlement><region type="state">Illinois</region></placeName></affiliation></author></analytic><series><title level="j">Journal of Orthopaedic Surgery and Research</title><idno type="eISSN">1749-799X</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Modern total knee arthroplasty is effective at treating the pain and disability associated with osteoarthritis. The number of total knee replacements done in the USA continues to increase. Despite the great care taken during all of these procedures, some patients remain dissatisfied with their outcome. While this dissatisfaction is likely multifactorial, malalignment of the prosthetic components is a major cause of postoperative complications. A neutral mechanical axis plus or minus 3° is felt to have a positive impact on the survivorship of the prosthesis. Conventional instrumentation has been shown to have a significant number of total knee replacements that lie well outside a neutral coronal alignment. With that in mind, significant effort has been placed into the development of technology to improve the overall alignment of the prosthesis. In order to reduce the number of outliers, several companies have developed cost-effective systems to aid the surgeon in achieving a more predictably aligned prosthesis in all three planes. We will review the literature that is available regarding several of these tools to examine if navigation or custom guides improve outcomes in total knee arthroplasty. Our review supports that while both navigation and custom implants guides seem to be a cost effective way to achieve a predictable mechanical alignment of a total knee prosthesis therefore reducing the number of outliers, the cost may be increased operative times with no perceived difference in patient satisfaction with navigation custom guides.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Felson, Dt" uniqKey="Felson D">DT Felson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Cross, M" uniqKey="Cross M">M Cross</name></author><author><name sortKey="Smith, E" uniqKey="Smith E">E Smith</name></author><author><name sortKey="Hoy, D" uniqKey="Hoy D">D Hoy</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kurtz, S" uniqKey="Kurtz S">S Kurtz</name></author><author><name sortKey="Ong, K" uniqKey="Ong K">K Ong</name></author><author><name sortKey="Lau, E" 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Becker</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Illinois</li></region><settlement><li>Chicago</li></settlement></list><tree><country name="États-Unis"><region name="Illinois"><name sortKey="Beal, Matthew D" sort="Beal, Matthew D" uniqKey="Beal M" first="Matthew D." last="Beal">Matthew D. Beal</name></region><name sortKey="Delagramaticas, Dimitri" sort="Delagramaticas, Dimitri" uniqKey="Delagramaticas D" first="Dimitri" last="Delagramaticas">Dimitri Delagramaticas</name><name sortKey="Fitz, David" sort="Fitz, David" uniqKey="Fitz D" first="David" last="Fitz">David Fitz</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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