Is technological-assisted leg axis alignment reliable in total knee arthroplasty with varus–valgus deformities?

Purpose: Computer-assisted systems improve conventional instrumentation in normalizing the axis of the limb in frontal deformities. The performance of a postoperative X-ray has been questioned to verify this axis, assuming that it can be replaced by the final image that appears on the system monitor...

Descripción completa

Detalles Bibliográficos
Autores: Hernández-Vaquero Panizo, Daniel|||0000-0003-3518-6629, Noriega Fernández, Alfonso, Roncero González, Sergio
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Universidad de Oviedo (UNIOVI)
Repositorio:RUO. Repositorio Institucional de la Universidad de Oviedo
Idioma:inglés
OAI Identifier:oai:dnet:ruo_________::68dc876225a91b5e9f4464735c45c082
Acceso en línea:https://hdl.handle.net/10651/83319
https://dx.doi.org/10.1007/S00590-025-04551-7
Access Level:acceso abierto
Palabra clave:Alignment
Computer-assisted system
Digital x-ray
Technology-assisted TKA
Total knee arthroplasty
Varus-valgus deformities
Descripción
Sumario:Purpose: Computer-assisted systems improve conventional instrumentation in normalizing the axis of the limb in frontal deformities. The performance of a postoperative X-ray has been questioned to verify this axis, assuming that it can be replaced by the final image that appears on the system monitor. The objective of this work is to verify whether both axes are similar. Methods: In 123 patients with varus–valgus frontal deformity, a total knee arthroplasty was implanted with the aid of the same navigation system without previous images. On the one hand, the final femorotibial angulation that appeared on the monitor screen, and on the other hand, the one observed in a long postoperative digitalized radiograph were recorded. Results: A discrepancy and poor correlation were observed between the femorotibial alignment verified radiographically and that shown on the system monitor at the end of the surgical procedure. Differences were significant in the valgus deformity group (p = 0.04) and especially in the varus cases (p < 0.001). The median postoperative axis as measured by computer-assisted was very close to neutral, but a deviation toward varus was observed on the X-ray. Conclusion: The axis of the limb observed with a computer-assisted system is closer to neutral alignment than that shown on the digitalized X-ray image after total arthroplasty in patients with frontal deformities. A postoperative X-ray is recommended as certification of the result, being more reliable than the final image from the system monitor.