Abstract
Navigated Total Knee Arthroplasty (TKA) is a new technique in our hospital. Any new procedure can be associated with both technical difficulties and difficulties due to patient and theatre staff expectations. The aim of this study was to demonstrate our learning curve and assess patient and staff acceptance. We highlight common technical problems unique to navigation and offer our solutions.
A prospective study of 231 consecutive Emotion TKA were implanted over a 30 month period with Orthopilot version 4.2 Navigation system using soft tissue management (BBraun Aesculap, Tutlingen). They were done by a single knee surgeon previously experienced only in non-navigated TKA. Patient height and weight were measured preoperatively and the BMI calculated. Tourniquet times were recorded digitally with fixed timing criteria. Informed consent was obtained.
Our results showed a significant decrease of tourniquet time with experience (p=< 0.0001) with other possible factors being preoperative deformity and BMI. There was full patient acceptance with the exception of the first patient. The surgical team had to modify patient positioning on the operating table, setup of the theatre and navigation equipment, placement of the scrub staff and delegation of tasks.
Navigated Emotion TKA with Orthopilot software provided a comfortable learning curve. It was readily acceptable to patients and staff and has been adopted as our standard practice. The discussion of problems and the introduction of solutions had a positive effect on building our team. Further investigation is needed to elucidate other variables that affect the tourniquet time.
Correspondence should be addressed to Mr K Deep, General Secretary CAOS UK, Dept of Orthopaedics, Golden Jubilee National Hospital, Glasgow G81 4HX, Scotland. Email: caosuk@gmail.com
