Intraoperative Navigation of Patient-Specific Instrumentation Does Not Predict Final Implant Position

• Published in: The Journal of arthroplasty Vol. 30; no. 4; pp. 564 - 566
• Main Authors: Abdel, Matthew P., MD, von Roth, Philipp, MD, Hommel, Hagen, MD, Perka, Carsten, MD, Pfitzner, Tilman, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-04-2015
• Subjects: Aged; Arthroplasty, Replacement, Knee - instrumentation; Arthroplasty, Replacement, Knee - methods; Female; femoral rotation; Femur - surgery; Humans; intraoperative navigation; Intraoperative Period; Knee Prosthesis; Male; mechanical axis; Middle Aged; Orthopedics; patient-specific instrumentation (PSI); Retrospective Studies; Rotation; Surgery, Computer-Assisted - instrumentation; Tibia - surgery; Tomography, X-Ray Computed; total knee arthroplasty (TKA); total knee arthroplasty (TKA); mechanical axis; intraoperative navigation; femoral rotation; patient-specific instrumentation (PSI)
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2014.11.005

Abstract The purpose of this study was to determine if intraoperative navigation predicted final implant position of total knee arthroplasties (TKAs) performed with patient-specific instrumentation (PSI). We retrospectively reviewed 60 TKAs performed with PSI and imageless navigation. These values were compared to postoperative coronal alignment based on long-leg radiographs, as well as rotation and tibial slope based on CT scans. The intraoperative coronal position of the tibia as measured by the intraoperative navigation indicated a significantly higher deviation from the neutral mechanical axis than the actual final position ( P = 0.03). Similarly, tibial slope and femoral component rotation measured by intraoperative navigation significantly deviated from the final slope and femoral component rotation ( P < 0.0001). In conclusion, intraoperative navigation of PSI position showed a significantly high deviation from the true final implant position. Level of Evidence: Level III, therapeutic. See Instructions to Authors for a complete description of levels of evidence.