Computer-Assisted Total Knee Arthroplasty for Significant Tibial Deformities

Computer-assisted total knee arthroplasty has been demonstrated to provide reproducible limb mechanical alignment within 3° from the neutral mechanical axis. However, restoring proper implant and extremity alignment remains a significant challenge with proximal tibial deficiencies. In this prospective study, we describe the use of computer navigation to quantify the amount of bone loss on the medial or lateral tibial plateau and the use of these data to assess the need for augmentation with metallic tibial wedges. In this study, we demonstrate that computer-assisted total knee arthroplasty in patients with significant tibial deformities can accurately measure severe tibial deformities, predict tibial augment thickness, and provide excellent mechanical alignment and restore the joint line without excessive bony resection, repeated osteotomies, and repeated augment trialing.