ABSTRACT
Objetivo. Conocer la concordancia entre el ángulo del eje mecánico femorotibial medido en radiografías y en navegación quirúrgica, tanto en el pre como en el postoperatorio al implantar una artroplastia total de rodilla. Material y método. Se analizaron las mediciones pre y postoperatorias en 88 artroplastias totales del mismo modelo y realizadas todas con el mismo sistema de navegación quirúrgica. Se valoró el ángulo frontal mecánico (AMFFT) y anatómico femorotibial pre y posquirúrgico. Para ello se utilizó una telerradiografía en bipedestación, donde se midió el ángulo mediante técnicas digitalizadas. En la navegación se recogió el ángulo femorotibial en reposo y en varo-valgo forzado, hallándose la media de estos 3 valores. Resultados. La media del AMFFT preoperatorio medido en la radiografía fue 4,55°. La media del mismo ángulo medido en la radiografía postoperatoria fue de 1,72°, con diferencias estadísticamente significativas. La media del AMFFT medido con la navegación antes de iniciar la técnica quirúrgica fue de 3,12° y tras el implante con navegación fue de 0,53°, también con diferencias estadísticamente significativas (p=0,013). El coeficiente de concordancia entre el AMFFT preoperatorio en telerradiografía y en navegación fue de 0,869 (p<0,001) y en el postoperatorio de 0,709 (p=0,017). Conclusiones. Hemos encontrado una fuerte concordancia en el AMFFT entre la medición con radiografías y con navegación quirúrgica. Ello puede suponer que no es necesaria la realización de una telerradiografía cuando se utiliza navegación en el implante de una artroplastia total de rodilla (AU)
Objective. To establish the concordance between angulation of the femoro-tibial mechanical axis measured with x-rays and surgical navigation in both the pre and postoperative period after a total knee arthroplasty (TKA) was implanted. Material and method. Pre and postoperative measurements were analyzed in 88 TKA of the same model and all performed with the same surgical navigation system. The mechanical frontal angle (MFA) and femoro-tibial anatomic angle were measured before and after the TKA. The angulation was digitally measured with a teleradiography. In the navigation, the femoro-tibial angle at rest, forced varus and valgus were registered and the average of these three measurements was calculated. Results. The mean preoperative MFA measured on the radiograph was 4.55°. The mean of the same angle measured on the postoperative radiograph was 1.72°, (p=0.05). The mean of the MFA measured with navigation before TKA was 3.12° and after the implant with navigation was 0.53 (P=.013). The concordance coefficient between the MFA in teleradiography and in navigation was 0.869 (P<.001) preoperatively and 0.709 postoperatively (P=.017). Conclusions. We found a strong concordance between radiographic and surgical navigation measurements of the MFA. This may imply that teleradiography is not necessary when using surgical navigation in TKA (AU)
Subject(s)
Humans , Male , Female , Aged , Arthroplasty, Replacement, Knee/methods , Body Mass Index , Knee Prosthesis , Genu Valgum , Genu Valgum/surgery , Prospective Studies , Radiology Department, Hospital/trends , Lower Extremity , Lower Extremity/surgery , Knee/surgery , KneeABSTRACT
OBJECTIVE: To establish the concordance between angulation of the femoro-tibial mechanical axis measured with x-rays and surgical navigation in both the pre and postoperative period after a total knee arthroplasty (TKA) was implanted. MATERIAL AND METHOD: Pre and postoperative measurements were analyzed in 88 TKA of the same model and all performed with the same surgical navigation system. The mechanical frontal angle (MFA) and femoro-tibial anatomic angle were measured before and after the TKA. The angulation was digitally measured with a teleradiography. In the navigation, the femoro-tibial angle at rest, forced varus and valgus were registered and the average of these three measurements was calculated. RESULTS: The mean preoperative MFA measured on the radiograph was 4.55°. The mean of the same angle measured on the postoperative radiograph was 1.72°, (p=0.05). The mean of the MFA measured with navigation before TKA was 3.12° and after the implant with navigation was 0.53 (P=.013). The concordance coefficient between the MFA in teleradiography and in navigation was 0.869 (P<.001) preoperatively and 0.709 postoperatively (P=.017). CONCLUSIONS: We found a strong concordance between radiographic and surgical navigation measurements of the MFA. This may imply that teleradiography is not necessary when using surgical navigation in TKA.
Subject(s)
Arthroplasty, Replacement, Knee/methods , Knee Joint/physiology , Surgery, Computer-Assisted/methods , Aged , Aged, 80 and over , Biomechanical Phenomena , Female , Humans , Knee Joint/diagnostic imaging , Knee Joint/surgery , Male , Postoperative Period , Preoperative Period , Prospective Studies , Radiography , Torsion, MechanicalABSTRACT
Objetivo: Conocer si las referencias anatómicas adquiridas con los sistemas de navegación quirúrgica en las artroplastias de rodilla facilitan una mejor colocación del componente femoral en la rotación adecuada y comprobar si la toma de referencias por parte de los cirujanos es coincidente con el verdadero eje transversal de la metáfisis distal femoral hallado mediante tomografía computada. Material y método: Estudio observacional descriptivo de corte transversal. Se han estudiado 19 artroplastias de rodilla. En 7 casos se utilizó la instrumentación estándar y en 12 un sistema inalámbrico de navegación quirúrgica. A los pacientes se les realizó una tomografía computada en el pre y postoperatorio para hallar la posición rotacional del implante en relación con el eje transepicondileo. Resultados: No se encontraron diferencias estadísticamente significativas en la rotación final atendiendo a la utilización del navegador. Tampoco se encontraron diferencias entre los grupos al estudiar las diferencias en el cambio de rotación entre tomografías pre y postoperatorias. Conclusiones: La localización de los epicóndilos, gesto que forma parte de la técnica de navegación, parece reproduccible y permiten implantar la artroplastia femoral en buena posición. No obstante este sistema no mejora la colocación del componente femoral en el plano transversal en relación con la técnica convencional (AU)
Objetive: To know if the anatomic references acquired with the technique of surgical navigation in knee arthroplasty get a better placement of the femoral component in the adequate rotation and checking if the location of references by the surgeons is coincident with the distal femoral metaphysis transversal axis in computer tomography. Material and method: Observational study cross-section descriptive. We studied 19 knee arthroplasties. In 7 cases was used the mechanical standard instrumentation and in 12 a wireless system of surgical navigation. A tomography computed was accomplished during the preop and postoperative time to find the rotational position of the implant in relation to the transepicondylar axis. Results: No statistically differences were found in the final rotation depending on the navigation use. When differences n the change of angulations were analyzed between pre and postoperative tomography neither differences were found. Conclusions: In navigation the location of femoral epicondyles is necessary and probably easy to reproduce and makes easier the implantation of the prosthesis in a good position. However the navigation does not improve the placement of the femoral component in the transversal axis when is compared with the conventional technique (AU)
