Bone and Joint Institute

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Computer Aided Surgery





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© 2015 The Authors. Optimal component alignment in total knee arthroplasty has been associated with better functional outcome as well as improved implant longevity. The ability to align components optimally during minimally invasive (MIS) total knee replacement (TKR) has been a cause of concern. Computer navigation is a useful aid in achieving the desired alignment although it is limited by the error during the manual registration of landmarks. Our study aims to compare the registration process error between a standard and a MIS surgical approach. We hypothesized that performing the registration error via an MIS approach would increase the registration process error. Five fresh frozen lower limbs were routinely prepared and draped. The registration process was performed through an MIS approach. This was then extended to the standard approach and the registration was performed again. Two surgeons performed the registration process five times with each approach. Performing the registration process through the MIS approach was not associated with higher error compared to the standard approach in the alignment parameters of interest. This rejects our hypothesis. Image-free navigated MIS TKR does not appear to carry higher risk of component malalignment due to the registration process error. Navigation can be used during MIS TKR to improve alignment without reduced accuracy due to the approach


Published by Taylor & Francis. This is an Open Access article distributed under the terms of the Creative Commons Attribution License(, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The original article can be found at:

Edward T. Davis, Joseph Pagkalos, Price A. M. Gallie, Kelly Macgroarty,James P. Waddell & Emil H. Schemitsch (2015) A comparison of registration errors withimageless computer navigation during MIS total knee arthroplasty versus standard incisiontotal knee arthroplasty: a cadaveric study, Computer Aided Surgery, 20:1, 7-13. DOI:10.3109/10929088.2015.1076037

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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