Bone preservation is desired for future revision in any knee arthroplasty. There is no study comparing the difference in the amount of bone resection when soft tissue balance is performed with or without computer navigation. To determine the effect on bony cuts when soft tissue balance is performed with or without use of computer software by standard manual technique in total knee arthroplasty. One hundred patients aged 50 to 88 years underwent navigated TKR for primary osteoarthritis. In group A, 50 patients had both soft tissue release and bone cuts done using computer-assisted navigation. In group B, 50 patients had soft tissue release by standard manual technique first and then bone cuts were guided by computer-assisted navigation. In group A the mean medial tibial resection was 5 ± 2.3 mm and lateral was 8 ± 1 mm compared to 5 ± 2 mm ( Our results show that performing soft tissue release and bone cuts using computer- assisted navigation is more bone conserving as compared to manual soft tissue release and bone cuts using computer navigation for TKR, thus preserving bone for possible future revision surgery.Background
Identification of the exact make and model of an orthopaedic implant prior to a revision surgery can be challenging depending upon the surgeon's experience and available knowledge base about the available implants. The current identification procedure is manual and time consuming as the surgeon may have to do a comprehensive search within an online database of radiographs of an implant to make a visual match. There is further time lapse in contacting that particular implant manufacturer to confirm the make and model of the implant and then order the whole inventory for the revision surgery. This leads to delay in treatment thus requiring extra hospital bed occupancy. We have analysed image recognition techniques currently in use for image recognition to understand the underlying technologies based on an interface commonly known as Application Programming interface (API). These API's specifies how the software components of the proposed application interact with each other. The objective of this study is to leverage one or a combination of API's to design a fully functional application in the initial phase and that can help recognize the implant accurately from a large database of radiographs and then develop a specialized and advanced API/Technology in the implant identification application.Background of Study
Materials and Methods
Increased accuracy of pre-operative imaging in patient-specific instrumentation (PSI) can result in longer-term savings, and reduced accumulated dose of radiation by eliminating the need for post-operative imaging or revision surgery. The benefits and drawbacks of CT vs MRI for use in PSI is a source of ongoing debate. This study reviews all currently available evidence regarding accuracy of CT vs MRI for pre-operative imaging in PSI. The MEDLINE and EMBASE databases were searched between 1990 and 2013 to identify relevant studies. As most studies available focus on validation of a single technique rather than a direct comparison, the data from several clinical studies was assimilated to allow comparison of accuracy. Overall accuracy of each modality was calculated as proportion of outliers >3 % in the coronal plane.Introduction
Methods
We reviewed the outcome of 69 uncemented, custom-made,
distal femoral endoprosthetic replacements performed in 69 patients
between 1994 and 2006. There were 31 women and 38 men with a mean
age at implantation of 16.5 years (5 to 37). All procedures were
performed for primary malignant bone tumours of the distal femur.
At a mean follow-up of 124.2 months (4 to 212), 53 patients were
alive, with one patient lost to follow-up. All nine implants (13.0%)
were revised due to aseptic loosening at a mean of 52 months (8
to 91); three implants (4.3%) were revised due to fracture of the
shaft of the prosthesis and three patients (4.3%) had a peri-prosthetic
fracture. Bone remodelling associated with periosteal cortical thinning
adjacent to the uncemented intramedullary stem was seen in 24 patients
but this did not predispose to failure. All aseptically loose implants
in this series were diagnosed to be loose within the first five
years. The results from this study suggest that custom-made uncemented
distal femur replacements have a higher rate of aseptic loosening
compared to published results for this design when used with cemented
fixation. Loosening of uncemented replacements occurs early indicating
that initial fixation of the implant is crucial. Cite this article:
Establishing a full-thickness cartilage in the lateral compartment and functionally intact ACL is vital before proceeding with unicompartmental knee replacement (UKR). The aim of this study is to assess whether MRI is a useful adjunct in predicting suitability for UKR, as compared to standard and stress radiographs. We identified 50 patients with a knee found suitable for UKR based on their standard and stress radiographs (full-thickness cartilage on lateral side). These patients underwent an additional cartilage-specific MRI scan to identify the status of ACL and the lateral compartment. The final decision regarding the suitability for UKR was based on the intra-operative observation.INTRODUCTION
METHODS