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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 5, 601-605.
doi: 10.1302/0301-620X.88B5.17431  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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Accuracy of a computer-assisted navigation system for total knee replacement

R. P. Pitto, MD, PhD, FRACS, Professor Orthopaedic Surgeon1; A. J. Graydon, MBChB, Registrar Junior Lecturer1; L. Bradley, MBChB, Registrar Junior Lecturer1; S. F. Malak, ME, Research Engineer2; C. G. Walker, PhD, Senior Lecturer, Statistician2; and I. A. Anderson, PhD, Senior Lecturer3

1 Department of Orthopaedics, Middlemore Hospital, 93311 Otahuhu, Auckland, New Zealand.
2 Department of Engineering Science
3 Bioengineering Institute, 70 Symonds Street, University of Auckland, New Zealand.

Correspondence should be sent to Dr R. P. Pitto; e-mail: RPitto{at}middlemore.co.nz

The object of this study was to develop a method to assess the accuracy of an image-free total knee replacement navigation system in legs with normal or abnormal mechanical axes. A phantom leg was constructed with simulated hip and knee joints and provided a means to locate the centre of the ankle joint. Additional joints located at the midshaft of the tibia and femur allowed deformation in the flexion/extension, varus/valgus and rotational planes. Using a digital caliper unit to measure the coordinates precisely, a software program was developed to convert these local coordinates into a determination of actual leg alignment. At specific points in the procedure, information was compared between the digital caliper measurements and the image-free navigation system. Repeated serial measurements were undertaken. In the setting of normal alignment the mean error of the system was within 0.5°. In the setting of abnormal plane alignment in both the femur and the tibia, the error was within 1°. This is the first study designed to assess the accuracy of a clinically-validated navigation system. It demonstrates in vitro accuracy of the image-free navigation system in both normal and abnormal leg alignment settings.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General