Frederic Picard

Computer-assisted total knee replacement arthroplasty

The reliability of techniques to position a total knee replacement (TKR) is still limited by the relative inaccuracy of the instrumentation. The main obstacle encountered by mechanical instrumentation systems is the inconsistency of the reference points. These reference points are the centers of joint articulation that will allow the establishment of the mechanical axis for the lower limb. These references guide the placement of the bone-cutting guides. At present, it is impossible to accurately locate these articular centers preoperatively. This handicaps the accuracy of the mechanical instruments and limits their accuracy. The goal of the total knee instrumentation procedure is to achieve cuts that are perpendicular to the mechanical axes of the femur and the tibia. The longevity of total knee arthroplasty is closely related to its intraoperative positioning. The computer-assisted procedure offers an effective and novel positioning method that improves the accuracy of the surgical technique of the TKR. We have chosen to present the steps of the computer-assisted TKR technique next to the corresponding steps of a currently available, mechanically based technique that is representative of many that are presently in use.