Lack of agreement between computer navigation and post-operative 2-dimensional computed tomography (CT) measurements for component and limb alignment in total knee arthroplasty (TKA)

• Published in: The knee Vol. 23; no. 1; pp. 137 - 143
• Main Authors: Dahabreh, Ziad, Scholes, Corey J, Giuffre, Bruno, Coolican, Myles R.J, Parker, David A
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2016; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Alignment; Arthroplasty, Replacement, Knee - methods; Bone Malalignment - diagnosis; Bone Malalignment - surgery; Computed tomography; Computer-assisted surgery; Conflicts of interest; Female; Follow-Up Studies; Humans; Joint surgery; Knee Joint - diagnostic imaging; Knee Joint - surgery; Knee Prosthesis; Male; Measurement techniques; Middle Aged; Mismatch; Navigation systems; Orthopedics; Osteoarthritis, Knee - diagnosis; Osteoarthritis, Knee - surgery; Prostheses; Radiography; Reproducibility of Results; Retrospective Studies; Statistical analysis; Surgery, Computer-Assisted - methods; TKA; Tomography, X-Ray Computed; Transplants & implants; Alignment; TKA; Computed tomography; Mismatch; Computer-assisted surgery
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2015.07.009

Abstract Background The purpose of this study was to assess the degree of mismatch between intraoperative navigation data using imageless computer navigation and post-operative CT scan measurements with respect to bone cuts, component and limb alignment during TKA. Methods Intraoperative navigation data including bone cut verification and overall limb alignment during TKA was compared to postoperative CT measurements of component and limb alignment according to the Perth protocol. The proportion of cases with mismatch between navigation and CT measurements at two and three degree thresholds was identified. Results In a total sample of 50 primary TKAs, 20% of cases showed a mismatch of more than two degrees between navigation and CT obtained measurements for coronal femoral alignment, 42% for femoral rotation, 16% for tibial component coronal alignment and 32% for overall limb alignment. Conclusion Mismatch between intraoperative navigation data and postoperative CT measurements suggests that postoperative CT scan alignment data should be interpreted with caution. A surgeon should consider a multitude of factors when analysing component and limb alignment postoperatively.