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• W2014870319 abstract "Navigation as part of CAS (Computer Assisted Surgery) has been introduced into TKA more than 10 years ago. After the first experiences and its proven superiority in reconstituting mechanical leg axis it has lost its popularity over the last years. This was mainly because CAS adds time and definitely cost to surgery. Furthermore a lot of studies failed to show an improved clinical outcome of navigated knees. In the last years, some gap-balanced studies were able to demonstrate such an improvement when CAS was applied. This demonstrates that information about gap size in different knee flexion angles is of importance to the procedure of CAS.Two different evolutionary directions can be observed in the technique of CAS over the last years. On the one hand, a trend to a simpler and faster technique for those surgeons that are focussed on information about their bone cuts solely. For those CAS can be pin-free or applied with a more modern tool, like the I-Pad.Another direction of CAS is applicable for the surgeons using a tibia-first, gap-balancing technique. For those the more recent software is able to monitor the influence of specific surgical steps on gap-size throughout the entire surgery. With a dynamic analysis under ligament stress a more realistic simulation of the daily loads on soft tissue has been implemented. This information can be used for sequential release and so the effect of every release-step on the gaps can be quantified. It can also be used for specific surgical techniques, such as the sliding osteotomy of lateral or medial epicondyles in fixed valgus or varus deformities.Another field of CAS is revision TKA. Like in primary TKA, it can be used to place the components more precisely than with conventional instruments. The same pin-free, faster techniques of TKA can be applied in revisions, too. This can help to overcome the problem of pin fixation in the presence of long stems.This article wants to give an overview on the different options of computer assisted surgery in TKA and R-TKA. By summarizing the results of the literature, its benefits and its limitations are demonstrated. By showing new applications and improvements of standard CAS techniques, this article wants to show the evolution of this technique. If those newer techniques will help to improve the clinical outcome and increase its daily feasibility and by that help to increase the acceptance of CAS in daily practice cannot be shown today." @default.
• W2014870319 created "2016-06-24" @default.
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• W2014870319 date "2015-03-01" @default.
• W2014870319 modified "2023-09-28" @default.
• W2014870319 title "Navigation in TKA surgery – Evolutionary technique or blind alley?" @default.
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• W2014870319 doi "https://doi.org/10.1016/j.jor.2015.02.006" @default.
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