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.