Article
First experiences with computer navigation assisted minimally invasive total knee replacement
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Authors
Published: | June 13, 2005 |
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Outline
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Introduction
Studies suggest improved recovery using minimally invasive techniques and accurate implant alignment using computer navigation in total knee replacement. The combination of a minimally invasive technique with computer navigation was evaluated.
Patients and methods
15 patients underwent a navigation assisted total knee replacement using a minimally invasive midvastus approach with fixation of the navigation system by two separate skin incisions. Postoperative course and radiographic alignment was analyzed. Functional outcomes were compared preoperatively and 6 weeks postoperatively.
Results
Average incision length was 11.4 ± 1,1 cm. At 6 weeks passive range of motion was 106,3 ± 9,0 degrees, Knee Society Score changed from 84 ± 14 to 153 ± 18 and Oxford Knee Score from 44 ± 7 to 27 ± 7. Straight leg raise was obtained at day 2,8 ± 1,0. Bloodloss amounted to 696 ± 172 ml. Radiographic alignment of implants showed ± 3 degrees position in femoral and tibial coronal and axial plains in all patients. Postoperative recovery did not show an impaired or painful course.
Discussion
The results suggest the practical combination of a navigation system with a minimally invasive technique.
If limited disruption of the extensor mechanism led to a rapid restoration of the quadriceps function but has a limited exposure of the knee, the navigation system represents a helpful tool for the positioning of implants.
Further evaluation with greater patient collectives, longer followup and optimal instrument design are required before this combination may become a reasonable alternative for the eligible patient.