{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T05:03:14Z","timestamp":1787979794170,"version":"build-2784847793"},"reference-count":35,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,7,29]],"date-time":"2011-07-29T00:00:00Z","timestamp":1311897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Extra\u2010articular post\u2010traumatic deformity may make difficult the implantation of total knee arthroplasty (TKA). Staged surgical procedures, including femoral or tibial osteotomy, can be required to restore proper alignment. These procedures may be inappropriate because of high rate of complications. Intra\u2010articular resection is an alternative procedure, but it is limited by the potential compromise of collateral knee ligaments. Conventional instrumentation cannot be used in patients with previous trauma and residual bone deformity. We want to assess whether computer\u2010assisted surgery may be a good alternative to traditional techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty consecutive TKAs were performed in 20 patients (12\u00a0men and 8 women) with knee arthritis due to extra\u2010articular deformity. The mean age was 52 years. According to Moreland method, the mean (\u00b1 standard deviation) of the pre\u2010operative hip\u2013knee\u2013ankle angle was 10.4\u00b0 \u00b1 8.3\u00b0 in varus. In all cases, an image\u2010free knee navigation system was used because of the severe deformity or the presence of retained hardware that prevented the use of the intramedullary rod. The average follow\u2010up was 3.1 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One month after surgery, the mean hip\u2013knee\u2013ankle angle was 0.8\u00b0 \u00b1 1.2\u00b0 in varus. At follow\u2010up, the Knee Society Score increased from an average of 48 pre\u2010operatively to 91 (<jats:italic>P<\/jats:italic> &lt; 0.05) post\u2010operatively, with over 90% of excellent and good results. Mean range of motion improved from a 7\u00b0\u201374\u00b0 mean range pre\u2010operatively to 0\u00b0\u201394\u00b0 post\u2010operatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The general value of navigation systems in achieving accurate bone cuts and restoring the mechanical axis has been established in the literature for standard TKA but not yet for extra\u2010articular deformity. Our findings at mid\u2010term follow\u2010up on a large cohort of these patients showed that these systems used for intra\u2010articular resection are a very effective alternative to previous techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Prospective study, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-011-1602-1","type":"journal-article","created":{"date-parts":[[2011,7,28]],"date-time":"2011-07-28T07:54:11Z","timestamp":1311839651000},"page":"546-551","source":"Crossref","is-referenced-by-count":38,"title":["Navigation\u2010assisted total knee arthroplasty in knees with osteoarthritis due to extra\u2010articular deformity"],"prefix":"10.1002","volume":"20","author":[{"given":"Fabio","family":"Catani","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Orthopaedic Department University of Bologna, Istituto Ortopedico Rizzoli Via G.C. 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