Cirugía asistida por ordenador. Su utilidad en distintos grados de deformidades preoperatorias / Computer assisted surgery. Its usefulness in different levels of pre-operative deformities

Objetivo. Conocer los resultados obtenidos con cirugía asistida por ordenador en nuestro medio en comparación con las técnicas convencionales y analizar la influencia de la navegación ante distintos grados de deformidad preoperatoria. Material y método. Estudio retrospectivo con 100 pacientes intervenidos de artroplastia total de rodilla mediante técnica convencional y cirugía asistida por ordenador. Se comparó el eje mecánico postoperatorio del miembro inferior en carga entre ambos grupos y en función de la deformidad preoperatoria de cada caso. Resultados. Se obtiene una alineación óptima con mayor frecuencia al utilizar el sistema de navegación (62%) que mediante una técnica convencional (36%). Los pacientes con deformidades menores de 10° de varo presentaron una media de alineación postoperatoria dentro del intervalo óptimo (0 ± 3° de desviación del eje mecánico neutro) mientras que aquellos con más de 15° de varo muestran una alineación fuera de rango, independientemente de la técnica empleada (p = 0,002). En aquellos con una deformidad de entre 10 y 15° de varo preoperatoria los valores de alineación se encontraron más próximos al eje neutro en el grupo de la navegación (178,7°) que en el de técnica convencional (175,5°), aunque estas diferencias no son estadísticamente significativas (p = 0,127). Conclusión. La alineación postoperatoria obtenida con la navegación es mejor que con la técnica convencional, con un menor porcentaje de casos fuera de rango y una mayor precisión en la colocación de los implantes. Se observa un potencial beneficio de la navegación para aquellos casos con deformidades de entre 10 y 15° de varo (AU)

Objective. To compare the results obtained with computer assisted surgery with conventional techniques and evaluate the influence of navigation at different levels of preoperative deformity. Material al method. A retrospective study was conducted on 100 cases with primary total knee arthroplasty performed with conventional or computer assisted surgery. A comparison was made of the post-operative mechanical axis of the lower limb between both groups and in terms of pre-operative deformity. Results. Optimal alignment is most often obtained by using the navigation system (62%) than by a conventional technique (36%). Patients with deformities under 10° varus showed a mean post-operative alignment within the optimal range (0 ± 3° deviation from the neutral mechanical axis), while those with more than 15° of varus show an alignment out of range, regardless of the technique used (p = .002). In those with a deformity of between 10 and 15° of pre-operative varus alignment, values were found closer to the neutral axis in the navigation group (178.7°) than in the conventional technique (175.5°), although these differences are not statistically significant (p = .127). Conclusion. Post-operative alignment obtained with navigation is better than with the conventional technique, with a smaller percentage of cases out of range, and greater accuracy in placing implants. A potential benefit was observed in navigation for cases with deformities of between 10 and 15° of varus (AU)

Computer assisted surgery. Its usefulness in different levels of pre-operative deformities.

OBJECTIVE: To compare the results obtained with computer assisted surgery with conventional techniques and evaluate the influence of navigation at different levels of preoperative deformity. MATERIAL AL METHOD: A retrospective study was conducted on 100 cases with primary total knee arthroplasty performed with conventional or computer assisted surgery. A comparison was made of the post-operative mechanical axis of the lower limb between both groups and in terms of pre-operative deformity. RESULTS: Optimal alignment is most often obtained by using the navigation system (62%) than by a conventional technique (36%). Patients with deformities under 10° varus showed a mean post-operative alignment within the optimal range (0±3° deviation from the neutral mechanical axis), while those with more than 15° of varus show an alignment out of range, regardless of the technique used (p=.002). In those with a deformity of between 10 and 15° of pre-operative varus alignment, values were found closer to the neutral axis in the navigation group (178.7°) than in the conventional technique (175.5°), although these differences are not statistically significant (p=.127). CONCLUSION: Post-operative alignment obtained with navigation is better than with the conventional technique, with a smaller percentage of cases out of range, and greater accuracy in placing implants. A potential benefit was observed in navigation for cases with deformities of between 10 and 15° of varus.