ABSTRACT
Background@#The aim of this study was to evaluate the difference between the planned and verified actual values in total knee arthroplasty (TKA) performed using a navigation system. @*Methods@#Sixty patients who underwent primary TKA for knee pain from March 2018 to July 2018 were included in this study.All patients underwent TKA using the latest version of a computer navigation system (Kick ver. 2.6). All TKA procedures were performed by the same surgeon. The appropriateness of the use of navigation system in each of the several steps during the operation was investigated. Implant size was assessed using a preoperative template and after registration of landmarks with the navigation system. Intraoperative measurement was conducted using a femoral sizing implant apparatus. The difference between the planned value based on the navigation system and the actual cutting value was investigated. Intraoperatively confirmed hip-knee-ankle angle was also compared to the angle measured at postoperative 3 months. @*Results@#The average time spent on the registration process was 242 seconds (range, 205–345 seconds). Intraoperative femoral component size tended to be smaller than the size recommended by the navigation system. A significant difference between the planned distal femoral cutting level (9.08 ± 0.40 mm) and the verified actual cutting level (9.87 ± 1.39 mm) was identified (p < 0.05).The difference between the planned lateral and medial tibial resection levels (10.12 ± 0.34 mm and 4.47 ± 2.17 mm, respectively) and the verified actual lateral and medial tibial resection levels (9.07 ± 1.45 mm and 3.48 ± 2.00 mm, respectively) was statistically significant. Distal femoral cutting angle in sagittal plane was significantly different but femoral and tibial cutting angles showed no significant difference between the planned and verified values. At full extension, the average coronal alignment of the implant recorded after insertion of the actual implant using the navigation system was 0.23° ± 0.51° varus and showed no significant difference from the alignment measured at postoperative 3 months (0.45° ± 0.58°). @*Conclusions@#When performing navigation-assisted TKA, surgeons should aware that frequent errors can occur on the femoral cutting level, tibial cutting level, and implant sizing despite its reported advantage in defining the mechanical limb axis.
ABSTRACT
PURPOSE: This study was performed to evaluate the effectiveness of self-home dressing with nanocrystalline silver dressing method on the treatment of chronic ulcer wounds of the foot. MATERIAL AND METHODS: One hundred-nine patients with chronic foot ulcer due to various causes were treated with nanocrystalline silver dressing material. Dressing was done by themselves in their home. Dressing changes were performed every 2 to 3 days until complete reepithelization. RESULTS: One hundred two cases of all cases had a complete reepithelization. It took 49 days to have a complete reepithelization on average. Seven cases failed to complete reepithelization because of infection. There was no silver intoxication in any cases. CONCLUSION: Using nanocrystalline silver is a useful dressing method for various superficial chronic ulcer and it can be done by themselves at their home. Thus it is considered to be more comfortable to both patients and doctors.