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Intraoperative Assessment of Bone Cuts to Guide Surgical Technique During Total Knee Arthroplasty
W. Andrew Hodge, MD; Sabine Schmitt, MD; Melinda Harman, PhD; Kim Mitchell, BS; Scott Banks, PhD
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from a commercial entity (Encore Medical). Also, commercial entities (Encore Medical and ORTHOsoft) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.
Note: The authors acknowledge David S. Rondon, MD, for contributing two patients to this study.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(suppl 3):137-143. doi: 10.2106/JBJS.G.00585
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Extract

Correction of deformity with bone resection matched to the thickness of the prosthesis is a required surgical placement (Fig. 1). Current instrumentation used during total Cstrategy to achieve a well-functioning total knee re-knee arthroplasty consists of external jigs that surgeons manually align to achieve proper bone cuts and implant position. However, alignment errors of 3° to 5° can occur, contributing to improper component and limb alignment. Verification of templating and instrument alignment can be approached intraoperatively with a low-tech method (i.e., measuring the removed bone with calipers and recording the measurement on a pathway grid) or a high-tech method (i.e., computer-assisted surgical navigation). Such intraoperative measurement of bone resection during total knee arthroplasty creates a pathway for identifying surgical errors early in the decision-making process, when it is easy to make compensatory adjustments with the remaining cuts. This aids the identification of the location and timing of compounding errors.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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