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Ahead of Print Issue - March 2021, Volume 15, Issue No. 1

Official Journal of Malaysian Orthopaedic Association and ASEAN Orthopaedic Association

Reliability of Imageless Computer-Assisted Navigation for Femoral Rotational Alignment in Total Knee Arthroplasty


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).

Materials and Methods: 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.

Abstract   |   Reference

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The Malaysian Orthopaedic Journal is a peer-reviewed journal that is published three times a year in both print and electronic online version. The purpose of this journal is to publish original research studies, evaluation of current practices and case reports in various subspecialties of orthopaedics and traumatology, as well as associated fields like basic science, biomedical engineering, rehabilitation medicine and nursing.

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