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Correct alignment of the component and soft tissue balancing have been cited as two of the most important aspects of successful knee replacement (arthroplasty). They are the most important predictors of longevity of knee replacement. Minor misalignment can lead to early loosening, early polyethylene wear and poor function.

 

Knees have traditionally been aligned using jigs either loosely clamped on to the outside of the leg or referenced from rods placed in the middle of the bones. The majority of knee replacements (prosthesis) can be implanted in a satisfactory position using this older technology. However, a proportion of components may be mal-aligned, potentially leading to poorer function and earlier failure.

 

Computer navigation in total knee replacement attempts to correct some of the problems faced in traditional total knee replacement. Dr. Naveen Talwar and his team are among a very exclusive group of surgeons who have advanced training in computer navigation surgery and utilise this technique in the operating room.

 

The objective of computer-assisted surgery is to combine the precision and accuracy of computer technology with the surgeons’ skill and expertise. As a result, Dr. Talwar and his team are able to achieve alignment of implants with a degree of accuracy not possible with the naked eye. This surgical procedure affords their patients enhanced results and recovery along with a quick return to normal life.

 

COMPUTER ASSISTED TOTAL KNEE REPLACEMENT

A computer-assisted knee replacement procedure begins with the Dr. Talwar placing several small arrays on the patient’s leg. An infrared camera is used to track the movement of the arrays via a computer that analyzes the positions and creates an anatomical three dimensional drawing of the knee. Using this real-time graphic display, Dr. Talwar makes cuts in the bone to ensure proper alignment on the mechanical axis for the implant. The implant is then secured with bone cement, tested to ensure proper alignment, and the incision is closed with stitches.

 

At the completion of total knee replacement surgery balancing the ligaments surrounding the knee has always been the most difficult and "subjective" part of knee replacement surgery. In conventional surgery the knee ligaments are balanced chiefly by the surgeons "feel" to determine if the ligaments are appropriately taut. Though experienced surgeons can achieve excellent ligament balance in most cases, reproducibility is difficult and results are subjective. With computer navigation, ligament balancing can potentially be quantified to the nearest millimeter of ligament laxity or tautness.

BENEFITS OF COMPUTER ASSISTED KNEE REPLACEMENT SURGERY

  • Better balance and positioning of prosthesis

  • More accurate placement and alignment of prosthesis

  • Better functioning knee

  • Early return to active lifestyle for the patient

Dr. Talwar has been using use this exciting technology for his knee replacements for the last several years. He has now accumulated a wealth of experience using this technique and has been involved in training other surgeons wishing to use the technology.

 

For a brief demo of the procedure, visit Computer Assisted Knee Replacement

 

COMPUTER NAVIGATED PAINLESS KNEE REPLACEMENT

Computer-guided (navigated) knee replacement surgery is an established and proven method to improve accuracy reproducibility, and enhance the overall clinical outcome. This procedure is a constantly evolving science.

 

In earlier generation of computer navigation models, the array (transmitter) were attached to knee by drilling extra holes in thigh bone and leg bones outside the knee. These extra holes created by surgeon to attach array sometimes led to complications like fracture of thigh or leg bones, infection or damage to nerves and arteries/veins.

 

The latest generation of computer navigation (Pinless Navigation System) guides the surgeon directly from the joint surface without the need for extra wounds and thus less pain and no risk of fracture through the pin holes.

 

The Pinless Navigation System) used by Dr. Naveen Talwar does not require drilling extra holes in thigh and leg bones outside the knee. The transmitter arrays are attached through jig system in the knee itself without drilling extra holes in the thigh or leg bones. This avoids many complications of previous models of Computer Navigation systems.

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