Workflow Analysis of a Total Knee Arthroplasty

4. Summary
Although traditional TKA was already a very successful operation, there is still place
forimprovement. Some argue that the results right now are not much better than in the
traditional TKA andthat it increases operation time, yet we still ha
ven’t seen the full potential of computer aided TKA.
Specifically trained surgery teams have shown that they can finish the operation in the same
time as thetraditional surgery. Also the results will improve much more in the future when more
and more data canbe taken into account for the operation without big effort from the doctors.
Thus better results can beachieved as the whole process will be modeled around the specific
patient.Also with new DICOM standards on the way, the CAN TKA will become much more
integratedinto the rest of the hospital system and will be more accepted. In addition there are
emerging workflowplanners for CAN TKA already available like OrthoPilot which help
organize the whole process evenmore.
Minimally invasive TKA’s which ar
e becoming more popular are in dire need of CAN too which willhelp them reach higher safety
and acceptability.After these aspects have been taken into account, a big scale statistic will be
able to show thereal improvements over the traditional surgery.

PreoperativeLaboratorystudiesPreoperativeRadiographsPatientPreperartion.Antibiotics,Anesthe
siaStart of OPQuery ImplantRepositoryApply Tourniquetand sterile drapesOpen knee,cauterize
veinsApply the threecutting jigs.Drill holes andapply trialcomponentsTest alignmentand range
ofmotionApply cement andadd finalcomponentsSuture the woundand deflatetourniquetTest
alignmentand range ofmotionApply referencearrays to femureand tibiaRegister kneeposition
andsurface oncomputerDigitaladaptedbone modelJigorientationproposalCheck ligamenttension
on modelCheck componentpositioning onmodelCheck componentpositioning onmodelCheck
range ofmotion and gapsymmetry onmodelCheck saw cutaccuracy
withmodelImplantTemplateRepositorySupp.131ImplantationPlan SRDocumentSupp.134Choose
optimalimplant and alignwith patient data
Navigation System
Cut bones withsawPlanning PhaseEnd of OP
 References:
[1]http://de.wikipedia.org/wiki/Arthrose [2]
Simon H Palmer, et al.

Total Knee Arthroplasty

http://emedicine.medscape.com/article/1250275-overview [3] Edheads + COSI Virtual Knee

Surgery,http://www.edheads.org/activities/knee/
[4] H. Bäthis, et al
.

Alignment in total knee arthroplasty

http://www.jbjs.org.uk/cgi/reprint/86-B/5/682.pdf
[5]Tim Alexander Walde ,et al.

Process Optimization in Na
vigated Total Knee Arthroplasty”

http://www.orthosupersite.com/view.aspx?rid=4074
[6] “
Computer Assisted Total Knee Replacement

2 part video by http://www.orangeorthopaedics.com

http://www.youtube.com/watch?v=yBdCiwcGiPA
http://www.youtube.com/watch?v=YfvUATneyXs
[7]

“
 Computer Assisted Navigation for Orthopedic Procedures of the Pelvis and
AppendicularSkeleton

http://blue.regence.com/trgmedpol/surgery/sur136.html
[8] OrthoPilot® Navigation Syst
emhttp://www.orthopilot.de/cps/rde/xchg/ae-orthopilot-de/hs.xsl/7245.html
[9] “
Computer-
assisted TKA: Greater Precision, Doubtful Clinical Efficacy: Opposes”
http://www.orthosupersite.com/view.aspx?rid=42846 [10] DICOM Supplement 131[11]
DICOM Supplement 134