alexa Saw Cut Accuracy in Knee Arthroplasty–An Experimental Case-Control Study
ISSN: 2167-7921

Journal of Arthritis
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Research Article

Saw Cut Accuracy in Knee Arthroplasty–An Experimental Case-Control Study

Adil Ajuied*, Christian Smith, Adrian Carlos, Diane Back, Peter Earnshaw, Paul Gibb and Andrew Davies
Guy’s & St. Thomas Hospitals, Guys Hospital, St Thomas’s St, London SE1 9RT, UK
Corresponding Author : Dr. Adil Ajuied
BSc(Hons) MSc FRCS (Tr & Orth)Consultant Orthopaedic Surgeon
Senior Honorary Clinical lecturer, Guy’s & St. Thomas Hospitals
Guys Hospital, St Thomas’s St, London SE1 9RT, UK
Tel: +44 7713 399944
E-mail: [email protected]
Received November 26, 2014; Accepted January 26, 2015; Published February 03, 2015
Citation: Ajuied A, Smith C, Carlos A, Back D, Earnshaw P, et al. (2015) Saw Cut Accuracy in Knee Arthroplasty–An Experimental Case-Control Study. J Arthritis 4:144. doi:10.4172/2167-7921.1000144
Copyright: © 2015 Ajuied A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Introduction: Navigated TKA (Total Knee Arthroplasty) has heightened awareness of mal-alignment in conventional TKA, as well as providing an accurate means of measuring alignment intra-operatively. Debate as to the importance and significance of alignment versus knee balance continues. Aim: To assess cutting error, and examine the hypothesises: • ‘Slotted osteotomies are more accurate than non-slotted’ • ‘Second pass of the saw blade improves the accuracy of osteotomies’ Method: Three pairs of fresh frozen human knees were prepared, exposed, and positioned as for primary TKA. Standard cutting guides were used in conjunction with a clinical navigation system, and the error (difference between the achieved resection, and the planned resection) in each osteotomy was measured. A second, tidying, pass of the saw blade was made and the error re-measured. Cutting guides were used with a slotted and un-slotted technique in left and right knees respectively. A single experienced surgeon performed all 96 osteotomies. Results: Slotted tibial osteotomies are significantly more accurate in the sagittal (p=0.01) and coronal (p=0.04) planes. Second pass osteotomies reduce variability in femoral (p=0.07) and tibial (p=0.17) osteotomies. Discussion: The bone cutting process is prone to high levels of random error that can result in implant malalignment, and thus predispose to aseptic loosening. Navigated TKA gives the operating surgeon the opportunity to check each osteotomy, and correct any error where necessary. In conventional TKA the use of dual pass, slotted osteotomies should provide improved accuracy.

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