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J Arthroplasty. 2011 Jan;26(1):82-7. doi: 10.1016/j.arth.2009.11.023. Epub 2010 Feb 19.

Margin of error in alignment: a study undertaken when converting from conventional to computer-assisted total knee arthroplasty.

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Department of Orthopaedic Surgery, Lilavati Hospital & Research Centre, Mumbai, India.


We analyzed alignment of 300 knees, divided equally into groups according to total knee arthroplasty technique: Conventional, CAS-Early (computer-assisted surgery during the surgeon's learning curve), and CAS-Late (after experience with CAS). With the margin of error for alignment of the mechanical axis and femoral and tibial components each within ±3°, the Conventional group's success rate was only 66%; but the rate for the CAS-Early group was 94%. The CAS-Late group's rate was 100%, with no outliers; moreover, the margin of error was reduced to within ±2° in 92% of patients and within ±1° in 52%. For the Conventional group's success rate to be 100%, the margin of error would have to be statistically relaxed to an unacceptable ±8°. Computed-assisted surgery improves alignment even early in the learning curve.

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