Orthopedics & Orthopedic Surgery
Area of Focus: Hip, Knee & Lower Extremity and Resident Information
Computer assisted surgery has emerged as an important technology for improving the surgical technique of total knee arthroplasty, particularly for mechanical axis alignment and ligament balancing. The literature reveals that multiple randomized control trials show a high statistical improvement in obtaining the desired postoperative limb axis alignment with computer assistance. Known pitfalls of computer navigation have included inadequate stability of the reference arrays, lack of knowledge of the prescribed anatomical reference points, femoral stress fracture from large pins placed in the distal femoral or tibial shaft, and possible neurovascular injury if pins are directed into the popliteal space posteriorly. In this video, Dr. Stiehl reviews the basic considerations of computer setup, placement of the dynamic reference base arrays, kinematic hip referencing, and anatomical point matching to perform a typical procedure. The total knee arthroplasty shown here demonstrates the method of computer assisted navigation and shows a typical work flow during the procedure.