Abstract
Total knee arthroplasty (TKA) for osteoarthritis (OA) patients with extra-articular deformity is still challenging because angular deformity, canal sclerosis, or the retained hardware that precludes the use of the traditional intramedullary guide. In addition, atypical bone cut for intra-articular correction leads to imbalanced soft tissue gap. Furthermore, corrective osteotomy should be considered for severe deformity or para-articular deformity cases. Recently, navigation-assisted TKA has been reported to increase the accuracy of prosthetic positioning and limb alignment. This system can calculate mechanical axis regardless of extra-articular deformity, canal sclerosis, or retained hardware. Accordingly, navigation surgery has been considered to be a powerful option especially in TKAs with extra-articular deformity cases. Here, we report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular deformities and/or retained hardware. Navigation-assisted TKA is an effective and reliable alternative for patients with extra-articular deformities.
Highlights
The long-term success of total knee arthroplasty (TKA) is dependent on the accurate positioning of the prosthesis and proper soft tissue balancing
In most TKAs for arthritic knees, proper alignment and ligament balancing can be achieved by the techniques of appropriate bone resection and soft tissue release
(1) Altered mechanical axis due to angular deformity, canal sclerosis, or retained hardware which cannot be removed prevents the use of traditional intramedullary guide which is a useful tool for conventional TKAs. (2) Atypical intra-articular bone resection to perform intraarticular correction makes the soft tissue balancing complex
Summary
The long-term success of total knee arthroplasty (TKA) is dependent on the accurate positioning of the prosthesis and proper soft tissue balancing. In most TKAs for arthritic knees, proper alignment and ligament balancing can be achieved by the techniques of appropriate bone resection and soft tissue release. A couple of studies have demonstrated that computer-assisted TKA provides more accurate, reliable, and reproducible component positioning [1, 2]. This procedure can make accurate bone resection regardless of angular deformity, canal stenosis, or retained hardware. We report 3 successful navigation-assisted TKAs for osteoarthritis with extra-articular femoral deformities and/or retained hardware
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