Computer Navigated Hip and Knee Replacement Surgery

This is a relatively new technique that uses computer modeling to help facilitate accuracy in joint replacement surgery.

Its use is increasing rapidly throughout hospitals in Australia and now New Zealand.

Alignment in total knee replacement is critical to the function and long term durability of total knee replacement. Traditional techniques have relied on a combination of surgical "eyeballing" and indirect methods to guide the cuts in the bone which determine the position/alignment of the prosthesis.

Computer navigation reduces the number of prosthesis that is inserted in less than ideal alignment. Mal alignment can result in an "unbalanced" knee, or early wear of the prosthesis.

The technique is simple, adds little time to the procedure and has other benefits in that it facilitates less invasive surgery and eliminates the need for intramedullary guides, the insertion of which cause an embolic shower of fat and marrow upon the cardiovascular system.

Whilst the vast majority of knee replacements performed using conventional techniques perform very well. It is hoped that this technology will reduce the small number that may perform poorly because of mal alignment.

I have trained in this surgery in Perth, Western Australia, which is considered one of the pioneering centers of computer navigation.

I have performed this surgery in Kenepuru hospital and with the help of Smith and Nephew, we will have the facility to perform the surgery in Bowen in the New Year.

The equipment used is the latest Brain Lab computer system which should have increased applications to other parts of orthopaedic surgery.

At the moment we can use the computer navigation for total knee replacement and we will also use it to increase accuracy in hip resurfacing.

Future applications include osteotomies and trauma.

References

J Arthroplasty. 2005 Oct;20(7 Suppl 3):132-8.
Computer assisted navigation in total knee arthroplasty: comparison with conventional methods. Anderson, Buehler KC, Markel DC. Department of Orthopaedic Surgery, Wayne State University/Detroit Medical Center, Providence Hospital, Detroit, Michigan, USA.

Clin Orthop Relat Res. 2005 Apr;(433):152-9.
Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Department of Orthopaedic Surgery, St. Vincenz-Hospital, Danziger Strasse 17, D-33034 Brakel, Germany.