Total knee arthroplasty using computer assisted navigation in patients with severe valgus deformity of the knee

Background Severe valgus deformity often has bone defect and laxity of the medial ligamentous,and total kneearthroplasty in severe valgus knee is,in most cases,more challenging for surgeons.The usefulness of a computerassisted navigation system in reestablishing the mechanical axis has been well established.Hence,the interest forsurgeons is how the navigation system makes the procedure of total knee arthroplasty with severe valgus knee easier.Methods From June 2006 to March 2008 in Department of Joint Surgery,Shanghai Sixth People’s Hospital,6 patients(7 knees) with severe valgus knee underwent total knee arthroplasty using the Stryker Navigation system,which is anactive wireless and imageless system.All the patients were followed up for 12 to 18 months after surgery.The X-rayradiographs for whole limbs were obtained on all patients to determine preoperative and postoperative alignments.Results A primary,posterior stabilized prosthesis was utilized in all cases.The average preoperative overallmechanical axis of the seven knees was 19.6°±4.6° of valgus (range 16° to 29°),and the average postoperativemechanical axis was 0.4°±0.7° (range 0.8° varus to 1.4° valgus).Conclusions The navigation system is a very effective and useful tool for accurate intraoperative restoration ofalignment in the face of significant deformity with valgus knee.To prevent component malposition,we did not reduce theknee before solidification of bone cement but controlled alignment using the navigation system up to implantation of thefinal component.