TKA navigation linked with increased survivorship, reduced systemic embolization risk
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WAILEA, Hawaii — For patients with malaligned knees or in whom systemic embolization is a concern, total knee arthroplasty performed with navigation can be invaluable, a speaker at Orthopedics Today Hawaii said.
In addition, Douglas A. Dennis, MD, said during his presentation that his main indication for navigation during TKA is patients with conditions that affect his ability to pass the diaphyseal rod intraoperatively.
“We know that malalignment is associated with decreased survivorship. Navigation can improve alignment. You don’t have to cannulate the medullary canal, which is shown to be problematic in creating systemic embolization. You can’t pass the rod in anatomic deformity,” he said.
A study by David M. Fang, MD, Merrill A. Ritter, MD, and colleagues, that Dennis discussed, emphasized the importance of proper alignment in TKA, with which navigation helps. Survivorship data for 6,070 TKAs in the study showed failure rates of 0.5% for knees aligned in neutral. However, failure rates were three times higher for knees aligned in valgus or varus, results showed.
Furthermore, in support of using navigation, Dennis, who is an Orthopedics Today Editorial Board Member, said, “Blood loss is less.”
Developments underway will not only make navigation easier, but will impact the usability of robotics, an area of technology related to navigation and computer-assisted arthroplasty, according to Dennis.
“We’re going to see patellar registration, instrumented saw blades, pressure-sensitive balancing, accelerometer-based [applications] and also, I think, the computer will enhance total knee robotics,” he said.
Reference:
Fang DM, et al. J Arthroplasty. 2009;doi:10.1016/j.arth.2009.04.034.
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Dennis DA. Life is better with navigation. Presented at: Orthopedics Today Hawaii 2021; May 30-June 3, 2021; Wailea, Hawaii.
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