1.Reliability of Imageless Computer-Assisted Navigation for Femoral Rotational Alignment in Total Knee Arthroplasty
Leelasestaporn C ; Thuwapitchayanant M ; Sirithanapipat P ; Sa-ngasoongsong P ; Ruengsilsuwit P
Malaysian Orthopaedic Journal 2021;15(No.1):79-84
Introduction: The aim of this study was to evaluate the
reliability of the femoral component rotation on intraoperative data recorded in a computer-assisted navigation
system (CAN-FRA) compared with the post-operative
femoral component rotation observed on computed
tomography (CT-FRA).
Material and method: Computer-assisted total knee
arthroplasty (TKA) or primary osteoarthritis of the knee was
performed in 51 knees in 36 patients with a mean age of
69.51 years. All procedures were performed by a single
surgeon using the same implant design. The intraclass
correlation coefficient (ICC) was used to compare the intraoperative CAN-FRA with the post-operative CT-FRA. The
angle between the anatomical epicondylar axis and the
posterior condylar axis of the implant (CT-FRA) was
measured at two separate timepoints by three observers who
were blinded to the intra-operative CAN-FRA. Internal
rotation was defined as rotation in the negative direction,
while external rotation was defined as positive.
Results: The mean intra-operative CAN-FRA was 0.1° ±
2.8° (range -5.0° to 5.5°). The mean post-operative CT-FRA
was -1.3° ± 2.1° (range -4.6° to 4.4°). The mean difference
between the CAN-FRA and the CT-FRA was -1.3° ± 2.2°
(range -7.9° to 2.4°). The respective ICC values for the three
observers were 0.92, 0.94, and 0.93, while the respective
intra-observer coefficients were 0.91, 0.85, and 0.90. The
ICC for the intra-operative CAN-FRA versus the postoperative CT-FRA was 0.71.
Conclusion: This study shows that using a computerassisted navigation system in TKA achieves reliable results
and helps to achieve optimal positioning of the femoral
component and rotation alignment correction.


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