Adult Reconstruction

Giles R. Scuderi, MD, Editor

In the last decade, instrumentation for total knee arthroplasty has improved the accuracy, reproducibility, and reliability of the procedure. The introduction of computer navigation moved surgeons into the arena of advanced technology and leads us into the development of improved medical imaging, sensor technology, and interactive enabling instrumentation, which further optimize the accuracy of surgery. The successful use of these intelligent technologies requires that it supports the surgeon with enhanced feedback, integrates the intraoperative information into the surgical workflow, and provides visual dexterity while performing the procedure. Soft tissue balancing is important in the outcome of total knee arthroplasty, and force sensor technology allows for intra-operative dynamic balancing of the supporting ligaments with fine-tuning and real-time feedback.This has the potential to translate the intraoperative qualitative feel of a balanced knee into a quantitative measurement that is accurate and reproducible. The results of total knee arthroplasty also benefit from the accuracy of knee alignment, relying on the bone resection with proper positioning of components. Incorporating intelligence into the resection guides with gyroscopes and accelerometers provides reproducible accuracy without the complexity of image-guided navigation systems. This current issue of Orthopedic Clinics of North America covers some of the most recent technologic advances in total knee arthroplasty and describes some of the smart technologies that help facilitate the procedure.

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