Non-invasive navigation in total knee arthroplasty :A validation study

The purpose of this study was to evaluate intraoperative alignment during total knee arthroplasty using a handheld navigation system, iAssist, in comparison with conventional optical surgical navigation. Sixty-two consecutive patients were enrolled in this prospective study. iAssist was used to determine implant component positioning. Orientation of the cuts were verified using a conventional optical surgical navigation system. We compared the iAssist system with the conventional system in terms of accuracy, percentage of outliers, bias, and precision. The occurrence of component malalignment was low. Taking standard radiography as the reference, there were no relevant differences between the handheld device and optical navigation in terms of measurement of accuracy or in outlier occurrence. Bias was small for both technologies, and precision was comparable. The study provides preliminary evidence that the use of iAssist leads to satisfactory implant alignment. The results from this study imply that iAssist could be a viable alternative to conventional optical navigation.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Non-invasive navigation in total knee arthroplasty: a validation study

The purpose of this study was to evaluate intraoperative alignment during total knee arthroplasty using a handheldnavigation system, iAssist, in comparison with conventional optical surgical navigation. Sixty-two consecutive patients were enrolled in this prospective study. iAssist was used to determine implantcomponent positioning. Orientation of the cuts were verified using a conventional optical surgical navigation system. We compared the iAssist system with the conventional system in terms of accuracy, percentage of outliers, bias, and precision.The occurrence of component malalignment was low. Taking standard radiography as the reference, there were no relevantdifferences between the handheld device and optical navigation in terms of measurement of accuracy or in outlier occurrence. Bias was small for both technologies, and precision was comparable. The study provides preliminary evidence that the use of iAssist leads to satisfactory implant alignment. The results from this study imply that iAssist could be a viable alternative to conventional optical navigation

L'arthroplastie totale de hanche: histoire et perspectives d'une intervention chirurgicale emblématique

With nearly 2 million implants placed annually, total hip arthroplasty is one of the most frequently performed surgerical procedure. A historical review of this intervention reminds us of the times when surgery was done by barber, before the f irst attempts of interposit ion arthroplasty. It is only in 1970 that Sir John Charnley lay the foundations of modern arthroplasty. The pharmaceutical industry, by sharing this lucrative market of $ 5 billion annual revenue, is now playing a major role in the development of the next generation of implants.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Intérêt de la navigation non invasive dans l'arthroplastie totale de genou

During surgery of total knee arthroplasty, we use a computerized non invasive navigation (Brainlab Victor Vision CT-free) to assess the accuracy of the bone cuts (navigation expresse). The purpose of this study is to evaluate non invasive navigation when a total knee arthroplasty is achieved by conventional instrumentation. The study is based on forty total knee arthroplasties. The accuracy of the tibial and distal femoral bone cuts, checked by non invasive navigation, is evaluated prospectively. In our clinical series, we have obtained, with the conventional instrumentation, a correction of the mechanical axis only in 90 % of cases (N = 36). With non invasive navigation, we improved the positioning of implants and obtained in all cases the desired axiometry in the frontal plane. Although operative time is increased by about 15 minutes, the non invasive navigation does not induce intraoperative or immediate postoperative complications. Despite the cost of this technology, we believe that the reliability of the procedure is enhanced by a simple and reproducible technique.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Luxation acromio-claviculaire complexe chez un patient de 74 ans

Acromioclavicular dislocation is a frequent pathology commonly encountered in traumato-logy. Therefore, its management is generally standardized, guided by clinical and radiological evaluation. This can range from conservative treatment by limb immobilization and functional rehabilitation, to surgical treatment by using minimally invasive techniques. We present the particular case of a 74-year-old patient with an acromioclavicular dislocation associated with a non-displaced fracture of the coracoid process as well as of the spine of the scapula. This article aims to describe the diagnostic traps as well as discuss the treatment options for this complex presentation.SCOPUS: ed.jinfo:eu-repo/semantics/publishe

Evaluation des patients opérés d'une fracture fémorale proximale dans le cadre du programme Fragility Fracture durant la période de confinement belge

Introduction :The management of SARS-CoV-2 infection has completely reformed the medical sector. Between March 14 and May 17 2020, only urgent surgical operations remained, including the management of proximal femoral fractures. The aim of our study is to best qualify this population of surgical patients by evaluating some clinical and epidemiological characteristics and assessing the infection rate. Material and Methods :This is a retrospective, descriptive and mono-centric cohort study, which identifies all Fragility Fracture program patients who had surgery for a proximal femoral fracture between March 14, 2020 and May 17, 2020 in the CHU Tivoli. Overall we defined the population and analyzed clinical and biological characteristics of patients suspected of or suffering from COVID-19, but also patients who developed the infection during hospitalization, compared to patients considered healthy. Finally, we described our deceased cases. Results :We treated 18 proximal femoral fractures during this period. Eight patients were operated following the COVID-19 precautions. Six patients tested positive, 3 on admission and 3 who become infected during their time in hospital. There were no physiological or biological differences between patients on admission. The mortality rate for positive patients was 33%. Conclusion :Unlike other studies, our incidence of proximal femoral fractures did not decrease during this time. These fractures occur in patients with early stage COVID-19, however the mortality rate remains high.SCOPUS: ar.jDecretOANoAutActifinfo:eu-repo/semantics/publishe

Computer-assisted total knee arthroplasty: Comparative results in a preliminary series of 72 cases

The aim of this study was to assess the value of navigation in achieving correct positioning of the implants and soft-tissue balance in total knee arthroplasty. We compared the axis alignment achieved in 72 LCS TKA's performed with navigation assistance to a historical cohort of 62 LCS TKA's implanted with the conventional instrumentation. The position of the tibial and femoral implants and the post-operative mechanical axes of the lower limbs were compared in the two series: there was a highly significant improvement in the alignment accuracy in the navigated series (p < 0.0001). There were no outliers in the computer-assisted series whereas 47% of the cases in the conventional series showed deviations of the mechanical axis of the lower limb of more than 2° from neutral alignment. However, the position of the femoral implants in rotation was not improved, suggesting that there may be a need for a more refined technique for rotational alignment of the femur, which was based essentially in the present series on ligament balance in flexion. The height of the joint line was preserved in 89% of the cases, validating the empirical use of the spreader tool prototype used during the study. Navigation eases optimal ligament balancing, by providing information that is used for appropriate release of soft tissue to achieve the proper mechanical axis. No major complication related to the use of navigation was observed. Operation time was lengthened on average by 30 minutes. Long-term studies are necessary to show whether better accuracy in ligament balancing and higher precision in restoration of mechanical axes will improve the functional results and the survival rate of knee arthroplasty. © 2005, Acta Orthopædica Belgica.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Osteopoikilosis: Report of a patient with associated complex knee injuries and literature review

ABSTRACTIOsteopoikilosis (OPK) is a rare autosomal dominant hereditary disease with a prevalence estimated at 1/50000. Most of the time asymptomatic and benign, it can be misdiagnosed as other osteoblastic bone diseases (such as bone metastases) and lead to unnecessary stress and costly investigation. We report a 15-year-old boy with a complicated knee injury and associated OPK as well as a literature review.KEYWORDS Osteopoikilosis, Multiple sclerotic lesions, sclerosing bone dysplasiainfo:eu-repo/semantics/publishe

Reliability of patient specific instrumentation in total knee arthroplasty

The aim of this study was to compare the precision between Patient Specific Instrumentation (PSI) and Conventional Instrumentation (CI) as determined intra-operatively by a pinless navigation system. Eighty patients were included in this prospective comparative study and they were divided into two homogeneous groups. We defined an original score from 6 to 30 points to evaluate the accuracy of the position of the cutting guides. This score is based on 6 objective criteria. The analysis indicated that PSI was not superior to conventional instrumentation in the overall score (p = 0.949). Moreover, no statistically significant difference was observed for any individual criteria of our score.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Reliability of Patient Specific Instrumentation in Total Knee Arthroplasty

The aim of this study is to evaluate the precision of a patient specific instrumentation (PSI) system as determined by pinless navigation system. Eighty patients were included in our prospective comparative study and they were divided into two homogeneous groups. The first group consisted of the patients that were operated by the PSI and the second group with the usual instrumentation. We defined an original score (maximum 30 points) to evaluate the accuracy of the cuts. This score is based on 6 objective criteria. The analysis indicated that the PSI was not superior to the conventional (p=0.434). However, we observed that the reliability of the femoral cuts was undermined in the PSI group compared to the UT group and a statistically significant difference for the mechanical axis (p=0.035) and for the thickness cut (p=0.025).