PMID: 20100412Jan 27, 2010Paper

Computer-assisted navigation for the assessment of fixed flexion in knee arthroplasty.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
Price A M GallieEmil H Schemitsch

Abstract

Correction of a fixed flexion deformity is an important goal when performing total knee arthroplasty. The purpose of this study was to assess the accuracy of clinical assessment compared with imageless computer navigation in determining the degree of fixed flexion. We performed navigation anatomy registration using 14 cadaver knees.The knees were held in various degrees of flexion with 2 crossed pins. The degree of flexion was first recorded on the computer and then on lateral radiographs. The cadaver knees were draped as they would be for a total knee arthroplasty, and 9 examiners were asked to clinically assess by visual observation the amount of fixed flexion.Three examiners repeated the process 1 week later. The mean error from the radiographs in the navigation group was 2.18 degrees (95% confidence interval [CI] 1.23 degrees -3.01 degrees) compared with 5.57 degrees (95% CI 4.86 degrees -6.29 degrees) in the observer group. The navigation was more consistent, with a range of error of -5 degrees to +5.5 degrees compared with -18.5 degrees to +17.5 degrees in the observer group. The observers tended to underestimate the amount of knee flexion (median error -4 degrees), whereas the navigation group was more evenly distributed...Continue Reading

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