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Computer-assisted navigation and surgical guides aid TAA procedures
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HOLLYWOOD, Florida — Computer-assisted navigation and patient-specific surgical guides helped improve the accuracy of total ankle arthroplasty (TAA) implant placement, based on results of a study presented at the American Orthopaedic Foot and Ankle Society Annual Meeting here.
“Preoperative navigation results in reliable and reproducible placement of total ankle arthroplasties,” investigator Steven L. Haddad, MD, incoming president of the American Orthopaedic Foot and Ankle Society (AOFAS), said. “Deviation was less than 2° in all planes of measurement, which was greater accuracy than 3° used in knee studies to determine when implants can cause increasing wear across that interface. This reduces intraoperative fluoroscopy time, which helps us all as surgeons.”
Steven L. Haddad
The researchers loaded CT scans into a computer-aided design (CAD) assembly to establish anatomical landmarks of tibia/talus alignment in cadavers and then performed virtual total ankle arthroplasty (TAA) with the established landmarks.
“The guide in the tibia was accurate [less] than 1 mm and less than 1° in all circumstances amongst these surgeons, on average,” Haddad said. “Looking at the talar guide variation…we have less than 1 mm and less than 1° of improper accuracy placed across this region, ie., this guide is completely accurate. We compared this to the Prophecy advanced knee system [guide], finding in this case it is a validated system.”
Haddad and colleagues found that preoperative and postoperative implant positioning was within 2° and 1.4 mm of each other in all planes, on average. The intra-observer tibia and talus guide variation was 0.25°±0.13° and in flexion/extension the variation among the trials was 0.47°±0.51°. Varus/valgus was measured at 0.50°±0.39° and 0.45°±0.34°, respectively, and internal/external rotation variation was measured at 0.92°±0.74° and 0.98°±0.54°, respectively, according to the abstract.
This was the first study to examine computer navigation in TAA, Haddad said.
Reference:
Haddad S. Paper #79. Presented at: American Orthopaedic Foot and Ankle Society Annual Meeting; July 18-20, 2013; Hollywood, Fla.
Disclosure: Haddad receives royalties from Wright Medical Technology, is on the speaker’s bureau or performs paid presentations for Olympus BioTech, is a paid consultant for Arthrex Inc. and Wright Medical Technology, owns stock in Tornier, receives research support from Biomimetic. He is on the editorial/governing board of Foot & Ankle International, Foot and Ankle Surgery and Elsevier and is a board member of the American Academy of Orthopaedic Surgeons and the AOFAS.