Total Knee Arthroplasty Using a Hybrid Navigation Technique

Abstract

The use of computer navigation for primary total knee arthroplasty (TKA) provides the benefits of accurate bone resection, low outlier frequencies, and the restoration of overall mechanical alignment. However, its use also involves the disadvantage of change in technique and workflow that have been associated with steep learning curve and increased surgical time. Furthermore, several investigators have described the potential risks associated with the use of navigation, which include registration errors, notching of the anterior femoral cortex, oversizing of the femoral component, and overresection. [1-4] These risks mean that surgical plans provided by navigation software might require modification intraoperatively, based on the surgeon’s experience and knowledge. On the other hand, conventional TKA has the advantages of familiarity and simplicity. Furthermore, decisions regarding bony resection level are based on measurements taken using a traditional jig and rod, and thus, anterior notching and femoral component oversizing can be avoided. Unfortunately, the conventional technique is more inaccurate and inconsistent in terms of component alignment ability than computer navigation. [5,6] In this article, we describe a hybrid technique that combines the benefits of computer navigation and conventional TKA. This hybrid navigation technique was developed to allow TKA to be performed in-line with accepted conventional TKA practice, but with the accuracy of computer navigation.