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J Knee Surg 2023; 36(02): 195-200
DOI: 10.1055/s-0041-1731458
Original Article

Comparison with Navigation of a Novel Three-Step Technique for Improving Accuracy of the Distal Femoral Resection during Conventional TKA: A Case–Control Study

Arun B. Mullaji 
1   Department of Orthopaedics, Breach Candy Hospital, Mumbai, Maharashtra, India
,
Ahmed A. Khalifa 
2   Department of Orthopaedics, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt
,
Gautam Shetty
3   Mumbai Shoulder and Knee Institute, Brentwood, Powai, Mumbai, Maharashtra, India
,
Harshad Thakur
4   National Institute of Health and Family Welfare, Baba Gang Nath Marg, Munirka, New Delhi, India
› Author Affiliations Funding None.
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Abstract

Correct placement of the femoral component in the coronal plane during primary total knee arthroplasty (TKA) is related to long-term survival. The aim of this radiographic study was to determine the accuracy of a novel three-step technique for improving the accuracy of the distal femoral cut during conventional technique and compare it with computer navigation during TKA. A total of 458 TKAs were retrospectively analyzed (178 conventional TKAs with the novel technique and 280 navigated TKAs) for postoperative femoral component coronal alignment and compared between the two groups. Mean femoral component coronal alignment was not significantly different (p = 0.314) between the two groups. There was no significant difference in the mean femoral component coronal alignment between varus and valgus knees. The number of outliers (90 ± 3 degrees) for femoral component coronal alignment was not significantly different between the two groups when assessed separately for varus and valgus deformities. The mean value of femoral component alignment using the conventional technique in knees with varus deformity <10 degrees was 88.8 degrees, in knees with varus deformity 10 to 20 degrees was 89.4 degrees, and in those with varus deformity >20 degrees was 90.2 degrees. Femoral component alignment in knees with varus <10 degrees was significantly different from those >20 degrees (p = 0.006); there was no significant difference between knees with varus <10 degrees and those with 10 to 20 degrees varus (p = 0.251), nor between 10 and 20 degrees varus knees and those with varus >20 degrees (p = 0.116). Using the novel three-step technique during conventional TKA to perform the distal femoral cut can help achieve femoral component coronal alignment comparable to the navigation technique.

Keywords

total knee arthroplasty - valgus correction angle - distal femur - alignment - computer-assisted TKAs

Ethical Approval

This article does not contain any experimental studies with human participants or animals performed by any of the authors. Ethical approval was obtained from the Breach Candy Research Centre ethical committee (project no.: P11/2016). Informed consent was obtained from all individual participants included in the study.


Authors' Contributions

A.B.M. performed the study conception and design and the critical revision, A.A.K. performed data acquisition and radiographic measurements. G.S., H.T., and A.A.K. performed analysis and interpretation of data, drafted the manuscript, and designed the figures and tables. All authors discussed the results and commented on the manuscript. All authors approved the final manuscript and its appropriateness for submission and publication.




Publication History

Received: 12 March 2021

Accepted: 01 May 2021

Article published online:
08 July 2021

© 2021. Thieme. All rights reserved.

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