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KMID : 0361620070420020227
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Journal of the Korean Orthopaedic Association
2007 Volume.42 No. 2 p.227 ~ p.235
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Comparison of Radiologic Measurements of Total Knee Replacement using Computer-assisted Navigation System and Conventional System in Varus Deformity of the Knee
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Bae Dae-Kyung
Yoon Kyoung-Ho
Kim Seon-Goo
Park Jae-Wan
Shin Myeung-Cheol
Roh Jun-Ha
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Abstract
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Purpose: To compare the radiologic measurements of the mechanical axis and the implant position of Total Knee Arthroplasty (TKA) using a computer-assisted navigation system with those using conventional TKA in varus deformity.
Materials and Methods: From January 2004 to January 2005, 49 TKAs using a CT-free navigation system (Vector Visionⓡ, BrainLab, Heirnstetten, Germany) (Group I) and 24 TKAs using the conventional technique (Group II) were performed on patients who had a preoperative varus deformity＞10o. The patients were also subdivided into two groups, patients with a varus deformity＜20o (group A) and patients with varus deformity＞20° (group B). The PFC Sigma implants were used in both groups. The mechanical axis and implant position were measured by 2 observers according to the
reontgenographic eraluation system of the American Knee Society.
Results: There was no significant difference in α, β, δ angle and mechanical axis between group I and II. There was a significant difference in the γ angle between group I and II (p＜0.05). There was a significant difference in the α and β angle and mechanical axis between group IA and IB (p＜0.05). There was a significant difference in the α angle and mechanical axis between group IIA and IIB (p＜0.05). There was a positive correlation between the measured angle by the respective observers in all groups (p＜0.05).
Conclusion: Patients with a preoperative varus deformity＞20o tended to have more postoperative varus mechanical alignment than those with a preoperative varus deformity between 10o and 20o after TKA. More careful attention during the registration of the femoral mechanical axis should be paid in patients with a larger varus deformity in TKA using a computer-assisted navigation system. On the other hand, a reasonable mechanical valgus angle should be considered in femoral bone cutting for a varus deformity of the distal femur in conventional TKA. In addition, inadequate
positioning of intramedullary crod should be recognized in conventional TKA.
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KEYWORD
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Knee, Varus deformity, Arthroplasty, Computer-assisted navigation system, Radiologic measurements
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