Adjustable cutting blocks improve alignment and surgical time in computer-assisted total knee replacement.
Academic Article
Overview
abstract
PURPOSE: Computer navigation increases accuracy and precision of component alignment in total knee arthroplasty (TKA) compared to the manual technique, but is often associated with increases in surgical time. In a previous cadaver study, we demonstrated a significant improvement in guide positioning precision, final bone cut precision, and procedure length when using adjustable cutting blocks (ACB) compared to conventional cutting blocks (CCB) in computer-navigated TKA. The aim of this study was to evaluate the use of ACB in vivo. METHODS: We radiographically compared component alignment and mechanical leg alignment, as well as tourniquet time, in 94 patients who underwent TKA using either ACB (N = 30) or CCB (N = 64). RESULTS: Postoperative mechanical alignment variability was significantly less in the ACB group (SD = 1.7°) than in the CCB group (SD = 2.7°). Tourniquet time was significantly reduced by 14.8 min in the ACB group compared to the CCB. Differences in component alignment were not significant. CONCLUSION: ACB for TKA significantly reduced postoperative mechanical alignment variability and tourniquet time compared to conventional navigated instrumentation, while providing equal or better component alignment. LEVEL OF EVIDENCE: III.
