Determining femoral component position using CAS and measured resection.

Clinical Orthopaedics and Related Research
James Benjamin

Abstract

To evaluate the ability of computer-assisted surgery (CAS) to accurately size and determine rotational alignment of the femoral component in TKA, the author reviewed femoral component position after 50 consecutive primary TKAs using a femur-first, measured resection workflow. The computer software used allowed femoral rotation to be selected based on epicondylar axis, posterior condylar axis, or anteroposterior axis. The final femoral component size and position was determined by the surgeon to avoid anterior notching, match the posterior-medial condyle resection, and flexed to match the plane of the anterior femoral cortex. Femoral sizing was confirmed intraoperatively with a standard sizing guide. The femoral component was downsized in 52% of patients from the size recommended by the computer software. The posterior condylar axis matched the implanted rotational position of the femoral component to within 1 degrees in 64% of patients in contrast to the epicondylar axis (32%) and anteroposterior axis (26%). CAS provides information to make surgical decisions but does not replace clinical judgment. Landmark referencing may be compromised by limited surgical exposures leading to variation in implant positioning by computer softw...Continue Reading

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Citations

Mar 8, 2014·Clinics in Orthopedic Surgery·Brian K Daines, Douglas A Dennis
Aug 27, 2014·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Daniel Hernandez-VaqueroJimena Llorens de los Rios
Aug 29, 2014·Journal of Orthopaedic Surgery·Anastasios P NikolaidesGeorge A Kapetanos
Dec 18, 2021·Experimental and Therapeutic Medicine·Bogdan UivaraseanuSimona Bungau

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