IS THE PRESSURE IN THE AXIS OF THE LOWER LIMB DURING TOTAL KNEE ARTHROPLASTY SUFFICIENT TO IMITATE WEIGHT-BEARING?
Authors:
Michal Baňas 1; Radek Hart 1,2; Pavel Šváb 1; Adel Safi 1
Authors‘ workplace:
Departement of Orthopaedics and Traumatology, General Hospital Znojmo
1; Ortopedicko-traumatologické oddělení, Nemocnice Znojmo
1; Departement of Traumatology, Trauma Hospital Brno
2; Klinika traumatologie LF MU, Úrazová nemocnice Brno
2
Published in:
Úraz chir. 22., 2014, č.1
Overview
INTRODUCTION:
Gonarthrosis is non-inflammatory degenerative disease affecting the cartilage of the knee, often associated with mechanical axis deviation of the limbs. The definitive restoration of the mechanical axis of the limb during total knee arthroplasty using navigation system occurs during surgery and in the final phase of the operation during the solidification of bone cement, when the weight-bearing is imitated by pressure to heel in the axis of the limb. The goal of the study was to clarify whether this imitation of weight-bearing of the limb is sufficient in determining the mechanical axis of the limb.
MATERIAL AND METHODS:
We investigated the mechanical axis of the limb before and after total knee arthroplasty from measurements from weight-bearing X-ray and from the navigation system. We enrolled 113 patients.
RESULTS:
Complete agreement between the data from X-ray and navigation system before total knee arthroplasty was found in 14 patients (12 %), 1–2 degrees difference was found in 36 patients (32 %), 3–4 degrees difference was found in 23 patients (20 %) and in 40 patients (35 %) difference was greater than 4 degrees. The average difference between the mechanical axes obtained from X-ray and navigation system before total knee arthroplasty was 4 degrees (maximum 17 degrees). The correspondence between the data from X-ray and navigation system after total knee arthroplasty was found in 35 patients (31 %), 1–2 degrees difference was found in 51 patients (45 %), 3–4 degrees difference was found in 22 patients (19 %) and in 5 patients (4 %) this difference was greater than 4 degrees. The average difference between the mechanical axis obtained from X-ray and navigation system after total knee arthroplasty was 2 degrees (maximum 11 degrees). T-test for post-operative X-ray data and post-operative navigation system data showed statistically significant difference (p = 0.02).
CONCLUSION:
The pressure in the axis of the limb to imitate weight-bearing during total knee arthroplasty is not sufficient.
KEY WORDS:
Total knee arthroplasty, navigation system, mechanical axis of the limb.
Sources
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