Technology helps surgeons get near-perfect knee implant alignment

Technology helps surgeons get near-perfect knee implant alignment

New approach may increase consistency of results and durability of implants

Image-guided technology enables orthopaedic surgeons to align knee implants with near pinpoint accuracy. According to a panel of orthopaedic surgeons who discussed advancements in computer-assisted total knee arthroplasty (TKA) surgery at a media briefing held yesterday, this close-to-perfect alignment should translate into longer durability of joint replacements.

The briefing, “What’s new in computer-assisted total knee surgery,” was moderated by Daniel J. Berry, MD, and included speakers Kenneth Krackow, MD, and Thomas P. Vail, MD.

“Computer-assisted total knee arthroplasty surgery is making rapid progress,” said Dr. Berry. “Contemporary methods of computer-assisted surgery now have been proven to provide a high level of accuracy in experienced hands. Current efforts are focused on making the process simpler, more efficient, and more cost-effective. As these methods evolve, it seems likely some form of computer assistance will eventually become a routine part of TKA,” Dr. Berry said.

Computer-assisted TKA involves extra time and additional difficulty because it still is in its infancy. As the power of the technology and techniques become more established, it will become a more common procedure and an option for more surgeons and patients.

Approximately 300,000 knee replacement surgeries are performed each year in the United States. Standard knee replacements require the use of an intramedullary (IM) rod, which is inserted up the length of the femur to determine proper knee implant alignment. No IM rod is necessary for the computer-assisted approach, reducing the risk of fat embolization, a complication that can cause acute respiratory distress. The quality and accuracy of the image guidance may enable surgeons to use smaller incisions while achieving the same successful outcomes.

For more opinions on the value of computer-assisted navigation in TKA, see the reports from the 2006 American Association of Hip and Knee Surgeons fall meeting in the January/February issue of AAOS Now.

Dr. Krackow has a consulting agreement and receives institutional support from Stryker. Dr. Vail is a consultant and receives research support from Depuy, Zimmer, and Wright Medical; he has also received royalties from Zimmer.

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