Preliminary experience with electromagnetic navigation system in TKA

Abstract

Accuracy of implant positioning and precise reconstruction of leg alignment offers the best way to achieve good long-term results in total knee arthroplasty. Computer instrumentation was developed to improve the final position of the component and restore the mechanical axis. Current navigation systems use either optical or electromagnetic tracking. The advantage of the Electromagnetic (EM) navigation system is that no line-of-sight issues are present. However, special iron-free instruments are required. This report analyzes the postoperative radiological results of 32 knees treated using an EM system. All the measurements were recorded using software able to subtend angles automatically by five physicians, three radiologist and two orthopedic residents not involved with the surgery. Each radiograph was measured three times, in random order, and at delayed intervals. We found an ideal alignment for the mechanical axis (180 ± 3°) in 30 out of 32 cases, whereas all the patients achieved a value of 90° ± 3° for both femoral and tibial frontal component angles. An apparently over-corrected implant position for the sagittal femoral component was reported, with a mean value of 11.2° ± 3.6. The mean position of the tibial component was 90.6° ± 2.8; just four measurements were outside of the ± 3° of the desired value. EM is safe and there were no complications related to this system. An almost perfect correlation was found between the mechanical axis value of the EM navigation system (179.8° ± 1.8) and the median value of the all reviewers (180.3° ± 1.9) with a difference of 0.5°.