An analysis of intra-operative variation in femorotibial alignment in the coronal plane during computer navigated total knee replacement

Published online: Apr 27 2010

Paraskumar Mohanlal, Sunil Jain

From Medway Maritime Hospital, Gillingham, Kent, UK


A prospective study was performed to assess the intra-operative variation in femoral and tibial axis alignment during navigated total knee replacement. The intra-operative initial, trial and final mechanical axis alignments were recorded from the navigation system. The mean variation and correlation coefficient were calculated and analysed. There were 40 patients (24 females, 16 males), with ages ranging from 37 to 89 years. The average initial alignment was 0.03° valgus, trial 0.64º varus and final 0.25° varus. Average deviation from initial to trial angle was 0.97º, from trial to final angle 0.74º and from initial to final angle 1.08º. The correlation co efficient between the initial and trial alignment was 0.25, between trial and final alignment 0.43 and between initial and final alignment 0.09. This study highlights a significant variation in femorotibial alignment in the coronal plane between the different stages of navigated total knee replacement. Constant vigilance is necessary to monitor the parameters during surgery to achieve a desired final alignment.