PINLESS Computer Navigation- The Google Maps of Total Knee Replacement
“Any sufficiently advanced technology is indistinguishable from magic”
-Arthur C Clarke
Knee and Hip replacement surgery practices are continuously undergoing improvements and innovations, this helps in improving the results and reliability of Total Knee Replacement Surgery. One of the most important developments in this area is PINLESS Computer Navigation. The way google maps have revolutionized our way of traveling, similarly, this technology has revolutionized Knee Replacement Surgery.
With Google maps, we are no more dependent on the static map or memory, but we have a live system in front of us navigating us to our destination, providing real-time inputs on traffic and diversions. Similarly, PINLESS Computer Navigation helps the surgeon in providing a precise approximation of the mechanical Axis and almost Zero error surgery.
Although Computer Navigation for Knee Replacement was introduced in the surgical practice way back in August 1997, it never became popular amongst Knee and Hip surgeons because the older version of Computer Navigation was clumsy & required to place pins in the thigh bones(Femur) & leg bone(tibia) to put the sensors (arrays) to feed the computer.
Let’s first talk about what is computer navigation for Knee Replacement? Computer Navigation helps in creating a 3D model of the patient’s knee on the computer in the operating room. On this recreated knee model, the computer guides us about the various degrees of cuts & balancing, and we can control even 0.5 degrees of deviation here and there which a naked eye cannot see. The other traditional method of doing this cutting and balancing is by using mechanical Jigs. It has been seen that in about 10% of the knees, even an experienced surgeon can make a deviation of more than 3 degrees of the desired axis (mechanical axis), using mechanical jigs.
Here comes the role of Computer Navigation, which helps in reducing this error and providing precision. This earlier version of computer navigation required drilling pins in the thigh bone & leg bone away from the knee which was highly undesirable. Drilling these two 4.5 mm pins in the thigh bone(Femur) & leg bone (Tibia) with an older(pinned) version of Computers, could lead to infection, fractures, damage to the bone, damage to the vessels, or damage to the ligaments and other complications.
Then came the so-called PINLESS Computer Navigation, where one does not require drilling pins outside the knee joint (Thighbone (femur), Leg Bone (tibia)). This obviates going away from the surgical field (Knee ) and reduces the chances of complications like infection, pathological fractures, damage to the vessels, Neurovascular deficit, or damage to the ligaments. PINLESS computer Navigation is the latest in the field of joint replacement and is a very precise & safe technique to take advantage of computer navigation without any chances of complications.
Computer navigation is basically one additional check when a surgeon is performing a Total Knee Replacement to assess the accuracy of the cuts. A perfectly aligned Knee not only lasts longer but also allows the patient an early recovery. The patient can start walking as early as 4 hours. Another big advantage is that as the surgeon is guided by computer Navigation, he can perform this surgery by making small incisions thereby expediting recovery. It Confirms the accuracy of the cuts thus allowing the surgeon to accurately place the implants and align the legs.
By using this technique, errors in alignment if any can be easily identified and corrected. That’s how it earned the name of the Zero Error technique. It is a big boon for patients with deformities around the knee joints and needing Knee Replacement. A properly aligned knee implant will last much longer. It is like having a navigation system in the operation theatre.
Just as a word of caution, that this term Computer Navigation is very loosely used. If you visit the internet every surgeon is advertising that he/she is using computer navigation surgery. Is it true? You need to be sure about it. Those who are claiming computer navigation, are actually performing computer navigation? You can ask your surgeon to give you a computer navigation report if they are performing computer navigation surgery.
The only disadvantage with the use of technology is that it adds to the cost of surgery. Such techniques also need to use more consumables thus adding to the overall cost of surgery. Also, it requires expertise to perform, so ensure that the surgeon has enough volume and experience to use this technology appropriately and optimally.
But its advantage like near anatomical alignment and better results makes its use worthwhile. PINLESS Computer Navigation is the latest in the field of joint replacement and is a very precise & safe technique to take advantage of computer navigation without any chances of complications. Just like Google maps are the highly efficient and precise modality of traveling.
