Abstract
BackgroundThe first stage in the implant of a total knee arthroplasty with computer-assisted surgery is to fasten the emitters to the femur and the tibia. These trackers must be hard-fixed to the bone. The objectives of our study are to evaluate the technical problems and complications of these tracker-pins, the necessary time to fix them to the bone and the possible advantages of a new femoral-fixed tracker-pin.MethodsThree hundred and sixty seven tracker-pins were used in one hundred and fifty one computer-assisted total knee replacements. A bicortical screw was used to fix the tracker to the tibia in all cases; in the femur, however, a bicortical tracker was used in 112 cases, while a new device (OrthoLock) with percutaneous fixation pins was employed in the remaining 39.ResultsTechnical problems related to the fixing of the trackers appeared in nine cases (2.5%). The mean surgery time to fix the tracker pin to the tibia was 3 minutes (range 2–7), and 5 minutes in the case of the femoral pin (range: 4–11), although with the new tool it was only three minutes (range 2–4) (p < 0.001). No complications were observed with this new device.ConclusionThe incidence of problems and complications with the fixing systems used in knee navigation is very small. The use of a new device with percutaneous pins facilitates the fixing of femoral trackers and decreases the time needed to place them.
Highlights
The first stage in the implant of a total knee arthroplasty with computer-assisted surgery is to fasten the emitters to the femur and the tibia
Computer-Assisted Surgery (CAS) has shown its usefulness to achieve a better placement of Total Knee Arthroplasty (TKA) in the sagittal and coronal planes
We studied the eventual advantages of a new femoral fixed emitter as to the necessary time for its fixation and as to the technical problems found
Summary
The first stage in the implant of a total knee arthroplasty with computer-assisted surgery is to fasten the emitters to the femur and the tibia. These trackers must be hard-fixed to the bone. The objectives of our study are to evaluate the technical problems and complications of these tracker-pins, the necessary time to fix them to the bone and the possible advantages of a new femoral-fixed tracker-pin. Computer-Assisted Surgery (CAS) has shown its usefulness to achieve a better placement of Total Knee Arthroplasty (TKA) in the sagittal and coronal planes. Comparative studies between surgery with and without navigation assistance have demonstrated the advantages of CAS when it comes to bone cutting following the limb's mechanical axis. Current imageless navigation systems consist of a workstation, an infrared optical camera system, and battery-powered wireless (page number not for citation purposes)
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