{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T00:32:57Z","timestamp":1760920377040,"version":"build-2065373602"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"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":[[2014,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Many studies have demonstrated higher precision and better radiological results in Total knee arthroplasty (TKA) with computer\u2010assisted surgery (CAS). On the other hand, studies revealed a lengthening of operation time up to 20\u00a0min for this technique and demonstrated rare additional complications as fractures and neurovascular injuries caused by the array pins and any intraoperative array dislocation leads to abortion of CAS. To combine the advantages and eliminate the disadvantages of standard CAS, we evaluated the accuracy of a so\u2010called pinless CT\u2010free version of knee navigation (pinless CAS) abandoning the reference pins and reducing the necessary workflow to a minimum.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The present study compares the accuracy of the reference methods of two different CT\u2010free knee navigation software versions (Brainlab Knee 2.1 and Brainlab Knee Express 2.5). Thirty patients received TKA assisted by standard CAS. Intraoperatively, the proposed bony resections of standard CAS were matched with the new pinless CAS. Postoperatively, the results were checked by evaluating the radiographs concerning leg axis, femoral flexion and tibial slope.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All results concerning precise cuts (femoral as well as tibial coronal\/varus\u2013valgus alignment, femoral flexion alignment and tibial slope, resection height) were comparable between both groups (n.s.). In femoral, we found a mean deviation of coronal alignment of 0.3\u00b0 (SD 0.7) and flexion of 0.2\u00b0 (SD 0.8). In tibial, we found a mean deviation of coronal alignment of 0.2\u00b0 (SD 0.5) and slope of 0.2\u00b0 (SD 0.6). The mean additional operation time for the pinless CAS was below 2\u00a0min. The postoperative mechanical leg axis was within the threshold of 3\u00b0 in all patients, tibial slope and femoral flexion matched with CAS values.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In clinical routine, pinless CAS can comprise the advantages of CAS leaving the disadvantages aside. It reduces surgical time and avoids complications associated with the tracking pins of conventional CAS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>I.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-013-2430-2","type":"journal-article","created":{"date-parts":[[2013,1,31]],"date-time":"2013-01-31T05:59:01Z","timestamp":1359611941000},"page":"1819-1826","source":"Crossref","is-referenced-by-count":20,"title":["No difference in accuracy between pinless and conventional computer\u2010assisted surgery in total knee arthroplasty"],"prefix":"10.1002","volume":"22","author":[{"given":"C.","family":"Baier","sequence":"first","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Maderbacher","sequence":"additional","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H. R.","family":"Springorum","sequence":"additional","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Zeman","sequence":"additional","affiliation":[{"name":"Center for Clinical Studies University Hospital Regensburg Regensburg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W.","family":"Fitz","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital Harvard Medical School Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Schaumburger","sequence":"additional","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Grifka","sequence":"additional","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Orthopaedic Department University of Regensburg Kaiser\u2010Karl V.\u2010Allee 3 93077 Bad Abbach Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,2]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402\u2010012\u20101536\u20101"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00601"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2009.12.005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010008\u20100150\u20106"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101588\u20108"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100990\u2010y"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2009.04.034"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010011\u20102121\u20106"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/48\/14\/314"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00222"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100983\u2010x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2009.11.008"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.90B8.20553"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.88B5.17431"},{"key":"e_1_2_7_16_1","first-page":"412","article-title":"Total condylar knee arthroplasty for valgus and combined valgus\u2010flexion deformity of the knee","volume":"33","author":"Ranawat CS","year":"1984","journal-title":"Instr Course Lect"},{"key":"e_1_2_7_17_1","doi-asserted-by":"crossref","unstructured":"ShroutP FleissJ(1979)Intraclass correlations: uses in assessing rater reliability","DOI":"10.1037\/\/0033-2909.86.2.420"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447\u201020120426\u201017"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.10.010"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.01778"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-013-2430-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-013-2430-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-013-2430-2","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T11:24:37Z","timestamp":1760873077000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-013-2430-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2]]},"references-count":19,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1007\/s00167-013-2430-2"],"URL":"https:\/\/doi.org\/10.1007\/s00167-013-2430-2","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"type":"print","value":"0942-2056"},{"type":"electronic","value":"1433-7347"}],"subject":[],"published":{"date-parts":[[2013,2]]}}}