Total Knee Replacement (TKR) is a widely performed surgery
nowadays. Over the years, the surgery has evolved quite significantly in
terms of the techniques utilised and the outcome thereof. It has come a
long way from the monoblock technique to the more advanced high flex
TKR. In today’s digital era, computer is an integral part of TKR surgery,
creating milestones of accomplishment with the success rate as high as
99 percent.
Computer was first introduced in Orthopaedics in France, 1980 for
Anterior Cruciate Ligament (ACL) surgery. In the late 90s, computer
technology was introduced for Joint Replacement Surgery. Many
organisations have invented surgical navigation system to assist during
the surgery, some major ones being - BrainLabs, Medtronics, Aesculap,
Zimmer and Stryker. These are all closed systems with limited
popularity as they are error prone and are not considered as userfriendly
technology. The evolution of the technology in this field could be
summarised as follows:
The first generation - Single way communication, closed system, pins
in bones.
The second generation- Two way communication, open system, pins
in bones.
The third generation - Pinless- World’s only 3rd generation surgical
navigation system for Knee: ASM (Articular Surface Mounted),
Stryker, produced in 2010.
BLK Super Speciality Hospital is equipped with third generation
pinless ASM (Articulate Surface Mounted) Nav3 Express software
technology. Previous versions involved wire and lesser sensitive
trackers whereby, the surgeon had to drill a pin in the thigh and leg bone
to fix the tracker, leaving accuracy in doubt and increasing risk of
fracture of shaft because of the pin. If the pin is loose by any chance, not
holding in osteoporotic bone, all the efforts would be wasted.