Classically, a surgeon depends onspecially designed jigs to aid inthe osteotomy and the placemento the implants. Combining X-raytemplating and the surgeon’sexperience, airly consistent resultshave been achieved. However, thereare still a signicant number opatients who are outliers to the norm,in which the knee implant is notaccurately implanted, oten becausethe mechanical axis has not beenaccurately restored.
COMPUTER NAVIGATION AND PATIENT - SPECIFICINSTRUMENTATION
Despite excellent results in kneereplacement, we know romexperience that i a prosthesis is notaccurately implanted, early revisionis oten the consequence. Total kneearthroplasty in varus alignment ailbecause o medial tibial collapsewhile those in valgus alignment doso rom ligamentous instability.
Theintramedullary design o jigs may alsoresult in at embolism and bleedingrom the bone canal.Computer navigation was introducedabout a decade ago to addresssome o these issues. The aim wasto extend longevity and prolongunction o a replaced knee, intandem with improved implantdesign. Computer navigation alsominimised the variability to producea more consistent knee surgeryoutcome every time. However,computer-navigated surgery neverbecame very popular as there isa airly steep learning curve andthey take longer time to perorm.Economically there is also a capitaloutlay or the purchase o expensivecomputer navigation system. Advances in medical imaging,computer modelling, and materialscience have advanced to allowsurgeons to more accurately implanta replaced knee. Patient-specicinstrumentation (PSI) is such arecent development. An MRI image
Customised knee replacement?
Improved prosthesis design and better material science over the last three decades have improved not only theunction but also the longevity o contemporary knee replacement. However, even the most advanced and welldesigned knee implant needs to be implanted accurately so that it will unction the way it is designed to. Moreimportantly, the limb’s mechanical axis must be restored accurately.