LIVRE JDG 2010

CONCLUSIONS

As Lord Kelvin stated in the XIX century

“If

it can be measured, it can be improved”.

This

philosophy fully adapts to the concept of navi-

gation. With the help of less invasive and

image free systems in the last 15 years the

knowledge about anatomy and kinematics of

the knee has improved dramatically, first in

vitro and now

in vivo

Our studies showed that navigation system

might be used to analyse kinematic patterns

throughout the range of motion of TKA. The

use of navigation systems to evaluate knee

kinematics intraoperatively provided quantita-

tive and extensive information on reconstruc-

ted and osteoarthritic knee behaviour and data

comparable to postoperative studies.

These data begin to establish requisite transla-

tional values for various types of TKA tech-

niques. With this information available to the

surgeon during surgery, it is now possible to

think at the “on demand” individualized surge-

ry, where quantitative kinematic data can help

refine implant positioning, maintaining

patients’ physiological movement and re-defi-

ne the implant design.

At present generation one of system allows a

complete intra-operative evaluation of the inter-

vention, but with the evolution of technology,

with non invasive CAS systems, we will be able

to increase knowledge about knee kinematics

also outside the operating room. That will allow

researcher to compare kinematic data also with

contralateral limb, or in post-operative rehabili-

tation without the use of radiological tech-

niques. Further improvement will be the possi-

bility of standardize kinematic tests and there-

fore to start the collection of a global dataset

that may be used on navigation systems, where

a real time feedback, together with a intra-ope-

rative decision making software, will provide

an effective help to the surgeon.

JOURNÉES LYONNAISES DE CHIRURGIE DU GENOU

142

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