The aim of study is to evaluate the accuracy of a navigation system during curved peri-acetabular osteotomy (CPO).
Forty-seven patients (53 hips) with hip dysplasia were enrolled and underwent CPO with or without navigation during surgery. Clinical and radiographical evaluations were performed and compared between the navigation group and non-navigation group, post-operatively.
The clinical outcomes were not significantly different between the navigation and non-navigation groups. Furthermore, post-operative reorientation of the acetabular fragment was similar between the navigation and non-navigation groups. However, the discrepancy between the pre-operative planning line and post-operative osteotomy line was significantly improved in the navigation group compared with that in the non-navigation group (p < 0.05). Further, the complication rate was significantly improved in the navigation group (p < 0.001).
The accuracy of the osteotomy’s position was significantly improved by using the navigation. Therefore, the use of navigation during peri-acetabular osteotomy can avoid complications.
Since the early 1970s, total knee arthroplasties have undergone many changes in both their design and their surgical instrumentation. It soon became apparent that to improve prosthesis durability, it was essential to have instruments which allowed them to be fitted reliably and consistently. Despite increasingly sophisticated surgical techniques, preoperative objectives were only met in 75% of cases, which led to the development, in the early 1990s, in Grenoble (France), of computer-assisted orthopaedic surgery for knee prosthesis implantation. In the early 2000s, many navigation systems emerged, some including pre-operative imagery (“CT-based”), others using intra-operative imagery (“fluoroscopy-based”), and yet others with no imagery at all (“imageless”), which soon became the navigation “gold standard”. They use an optoelectronic tracker, markers which are fixed solidly to the bones and instruments, and a navigation workstation (computer), with a control system (e.g. pedal). Despite numerous studies demonstrating the benefit of computer navigation in meeting preoperative objectives, such systems have not yet achieved the success they warrant, for various reasons we will be covering in this article. If the latest navigation systems prove to be as effective as the older systems, they should give this type of technology a well-deserved boost.
Robotic-assisted knee arthroplasty has been clinically available for the past 2 decades, but is still in the early stages of adoption for use in total knee arthroplasty (TKA). The purpose of this technology is to improve the precision, accuracy, and reproducibility of TKA. Robotic-assisted systems may be passive, semiactive, or active. Although robotic-assisted systems have been used extensively in unicondylar knee arthroplasty, there are relatively few studies of using this technology in TKA. These early studies have shown that robot-assisted technology may lead to improvements in both mechanical axis and component alignment. No studies have demonstrated that these radiographic improvements have translated into any clinical benefit, however. The purpose of this review is to introduce robotic-assisted systems for use in knee arthroplasty, describe the potential advantages and limitations associated with this technology, and review several of the systems that are currently available.