Comparison of operative time and accuracy using conventional fixed navigation cutting blocks and adjustable Pivotal™ cutting blocks

Computer-assisted navigation in total knee arthroplasty has been shown to improve implant positioning and may lead to improved patient outcomes. The purpose of this study was to assess differences in time and accuracy using a navigation system with either a conventional (20 knees) or specially designed (20 knees) system of cutting blocks. The time needed for fixing and positioning the specially designed blocks averaged 2.9 minutes, compared to 6.4 minutes for the conventional blocks (p < 0.001). In the coronal plane, the mean angular difference between the instrument slot and the resected bone was smaller for the specially designed blocks than for the conventional blocks. This difference was significant for both the femoral (p = 0.007) and tibial (p = 0.028) cuts. These encouraging results show the need for further study of navigation in total knee arthroplasty.

[1]  P Cinquin,et al.  [Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study]. , 2001, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur.

[2]  Markus Tingart,et al.  Intraoperative cutting errors in total knee arthroplasty , 2005, Archives of Orthopaedic and Trauma Surgery.

[3]  R. Morris,et al.  Coronal alignment after total knee replacement. , 1991, The Journal of bone and joint surgery. British volume.

[4]  U Holz,et al.  [CT analysis of leg alignment after conventional vs. navigated knee prosthesis implantation. Initial results of a controlled, prospective and randomized study]. , 2003, Der Unfallchirurg.

[5]  J. Rand,et al.  Ten-year evaluation of geometric total knee arthroplasty. , 1988, Clinical orthopaedics and related research.

[6]  R. K. Mielke,et al.  [Navigation in knee endoprosthesis implantation--preliminary experiences and prospective comparative study with conventional implantation technique]. , 2001, Zeitschrift fur Orthopadie und ihre Grenzgebiete.

[7]  D. Banzer,et al.  Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. , 2003, The Journal of bone and joint surgery. British volume.

[8]  M. Tingart,et al.  Navigation in total-knee arthroplastyCT-based implantation compared with the conventional technique , 2004, Acta orthopaedica Scandinavica.

[9]  J. Jenny,et al.  [Computer-assisted implantation of a total knee arthroplasty: a case-controlled study in comparison with classical instrumentation]. , 2001, Revue de chirurgie orthopedique et reparatrice de l'appareil moteur.

[10]  M. Ritter,et al.  Postoperative alignment of total knee replacement. Its effect on survival. , 1994, Clinical orthopaedics and related research.