Abstract
It is widely accepted that navigation system for TKA improves precision in component alignment. Furthermore, some of the system can measure knee kinematics during surgery. On the other hand, the measurements of kinematics during surgery have limitations because of anesthesia and usage of air tourniquet. The purpose of the present study is to compare the knee kinematics during surgery using navigation system and that after surgery using 2D/3D Registration Technique. Our final goal of the study is to improve clinical outcome by performing feedback of good clinical results to operating theater by means of kinematic analysis.
Kinematics of ten TKA knees for female (average age 71 years old) medial compartmental osteoarthritic knees concerning axial rotation and anterior-posterior translation were measured twice, the time during surgery and 4 weeks after surgery. During surgery, measurement was performed using CT based navigation system (Vector Vision 1.6, Brain LAB, Heimstetten, Germany). Four weeks after surgery, knee kinematics was measured again using a 2-dimensional to 3-dimensional registration technique, which used computer-assisted design models to reproduce the position of metallic implants from single-view fluoroscopic images. Surgery was performed by single surgeon using subvastus approach to eliminate the influence of approach to muscle balance. Implant using the present study was P.F.C. Sigma RP-F (DePuy, Warsaw, USA).
Axial rotation in navigation and 2D/3D are 12.3+/−2.3, and 12.6+/−3.8, respectively. Axial rotations in both of the measurement have the same pattern. A-P translations also have the same pattern between measurement in navigation and that in 2D/3D technique. These results suggested that intraoperative kinematic measurement links to postoperative kinematics. Studies of correlations between kinematics and good clinical results are ongoing.
