The Accuracy of Initial Bone Cutting in Total Knee Arthroplasty

Takaaki Ohmori; Toru Maeda; Tamon Kabata; Yoshitomo Kajino; Shintaro Iwai; Hiroyuki Tsuchiya

doi:10.4236/ojo.2015.510040

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OJO> Vol.5 No.10, October 2015

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The Accuracy of Initial Bone Cutting in Total Knee Arthroplasty ()

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DOI: 10.4236/ojo.2015.510040 3,327 Downloads 3,876 Views Citations

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Takaaki Ohmori¹, Toru Maeda^1,2, Tamon Kabata^1*, Yoshitomo Kajino¹, Shintaro Iwai¹, Hiroyuki Tsuchiya¹

Affiliation(s)

¹Department of Orthopedic Surgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
²Department of Orthopedic Surgery, Kanazawa Red Cross Hospital, Kanazawa, Japan.

ABSTRACT

Background: The aim of this study was to evaluate the accuracy of initial bone cutting of the distal femur and the proximal tibia in TKA using an image-free navigation system. Methods: From February 2006 to March 2013, we evaluated 60 knees in 50 patients using an image-free navigation system (Navigation: Stryker Navigation Cart System; Software: Stryker Knee Navigation; Ver2.0: Stryker Orthopaedics US NJ Mahwah). First, we measured the angle shown by the navigation system before cutting, at the time we set the jig. Second, we measured the angles shown by navigation after the bone was cut using the jig. Then, we compared these two angles for each patient to determine the bone cutting error. Results: In the distal femur, 37 of 60 knees were cut in an extended position in the sagittal plane, and 26 of 60 knees were cut in a varus in the coronal plane. In the proximal tibia, 29 of 60 knees were cut with decreased posterior slope in the sagittal plane, and 26 of 60 knees were cut in a valgus. Conclusions: In this study, the distal femur tended to be cut in an extended and a varus position and the proximal tibia did with decreased posterior slope and in a valgus position after initial bone cutting. It is necessary to note the initial cutting error in TKA. Since cutting errors affect postoperative outcome, we should cut bones several times. And as the reasons of the cause of the error, we propose new reason that cutting bone is not parallel with accuracy to AP axis.

KEYWORDS

Total Knee Arthroplasty, Bone Cutting Errors, Distal Femur, Proximal Tibia, Navigation

Cite this paper

Ohmori, T. , Maeda, T. , Kabata, T. , Kajino, Y. , Iwai, S. and Tsuchiya, H. (2015) The Accuracy of Initial Bone Cutting in Total Knee Arthroplasty. Open Journal of Orthopedics, 5, 297-304. doi: 10.4236/ojo.2015.510040.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Matsumoto, T., Tsumura, N. and Kurosaka, M. (2004) Prosthetic Alignment and Sizing in Computer-Assisted Total Knee Arthroplasty. International Orthopaedics, 28, 282. http://dx.doi.org/10.1007/s00264-004-0562-1

[2]	Sungkhun, P., Larbpaiboonpong, V. and Turajane, T. (2012) Comparing Alignment of Proximaltibia First Cut between Narrow and Wide Saw Blade in CAS TKA. Journal of the Medical Association of Thailand, 95, S87-S91.

[3]	Elloy, M.A., Manning, M.P. and Johnson, R. (1992) Accuracy of Intramedullary Alignment in Total Knee Replacement. Journal of Biomedical Engineering, 14, 363-370. http://dx.doi.org/10.1016/0141-5425(92)90080-5

[4]	Jeffery, R.S., Morris, R.W. and Denham, R.A. (1991) Coronal Alignment after Total Knee Replacement. Journal of Bone and Joint Surgery (British Volume), 73, 709-714.

[5]	Ritter, M.A., Faris, P.M. and Keating, E.M. (1994) Postoperative Alignment of Total Knee Replacement. Its Effect on Survival. Clinical Orthopaedics, 299, 153-156.

[6]	Nakahara, H., Matsuda, S. and Morooka, T. (2012) Cutting Error of the Distal Femur in Total Knee Arthroplasty by Use of a Navigation System. Journal of Arthroplasty, 27, 1119-1122. http://dx.doi.org/10.1016/j.arth.2011.09.018

[7]	Tanzer, M., Smith, K. and Burnett, S. (2002) Posterior-Stabilized versus Cruciate-Retaining Total Knee Arthroplasty: Balancing the Gap. Journal of Arthroplasty, 17, 813. http://dx.doi.org/10.1054/arth.2002.34814

[8]	Plaskos, C., Hodgson, A.J. and Inkpen, K. (2002) Bone Cutting Errors in Total Knee Arthroplasty. Journal of Arthroplasty, 6, 698-705. http://dx.doi.org/10.1054/arth.2002.33564

[9]	Otani, T., Whiteside, L.A. and White, L.A. (1993) Cutting Errors in Preparation of Femoral Components in Total Knee Arthroplasty. Journal of Arthroplasty, 8, 503-510. http://dx.doi.org/10.1016/S0883-5403(06)80215-9

[10]	Catani, F., Biasca, N. and Ensini, A. (2008) Alignment Deviation between Bone Resection and Final Implant Positioning in Computer-Navigated Total Knee Arthroplasty. Journal of Bone and Joint Surgery (American Volume), 90, 765. http://dx.doi.org/10.2106/JBJS.G.00293

[11]	Reed, S.C. and Gollish, J. (1997) The Accuracy of Femoral Intramedullary Guides in Total Knee Arthroplasty. Journal of Arthroplasty, 12, 677. http://dx.doi.org/10.1016/S0883-5403(97)90141-8

[12]	Daniilidis, K. and Tibesku, C.O. (2013) Frontal Plane Alignment after Total Knee Arthroplasty Using Patient-Specific Instruments. International Orthopaedics, 37, 45-50. http://dx.doi.org/10.1007/s00264-012-1732-1

[13]	Hasegawa, M., Yoshida, K. and Wakabayashi, H. (2013) Cutting and Implanting Errors in Minimally Invasive Total Knee Arthroplasty Using a Navigation System. International Orthopaedics, 37, 27-30. http://dx.doi.org/10.1007/s00264-012-1688-1

[14]	Insall, J.N., Dorr, L.D. and Scott, R.D. (1998) Rationale of the Knee Society Clinical Rating System. Clinical Orthopaedics and Related Research, 13, 248.

[15]	Imamura, R., Matsuda, S. and Okazaki, K. (2011) Influence on Femoral Antero-Posterior Sizing of the Error in Sagittal Angle of Femoral Distal Cut in Total Knee Arthroplasty. Journal of Orthopaedic Trauma, 60, 714-717. http://dx.doi.org/10.5035/nishiseisai.60.714

[16]	Tsukeoka, T. and Lee, T.H. (2012) Sagittal Flexion of the Femoral Component Affects Flexion Gap and Sizing in Total Knee Arthroplasty. Journal of Arthroplasty, 27, 1094. http://dx.doi.org/10.1016/j.arth.2011.10.015

[17]	Tsukeoka, T., Tsuneizumi, Y. and Lee, T.H. (2013) The Effect of a Sagittal Cutting Error of the Distal Femur on the Flexion-Extension Gap Difference in Total Knee Arthroplasty. Journal of Arthroplasty, 28, 1099-1102. http://dx.doi.org/10.1016/j.arth.2012.12.017

[18]	Daluga, D., Lombardi Jr., A.V. and Mallory, T.H. (1991) Knee Manipulation Following Total Knee Arthroplasty: Analysis of Prognostic Variables. Journal of Arthroplasty, 6, 119. http://dx.doi.org/10.1016/S0883-5403(11)80006-9

[19]	Mahaluxmivala, J., Bankes, M.J. and Nicolai, P. (2001) The Effect of Surgeon Experience on Component Positioning in 673 Press Fit Condylar Posterior Cruciate-Sacrificing Total Knee Arthroplasties. Journal of Arthroplasty, 16, 635-640. http://dx.doi.org/10.1054/arth.2001.23569