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Comparing alignment of proximal tibia first cut between narrow and wide saw blade in CAS TKA.

OBJECTIVE
The primary aim of the present study is to comparison between using narrow and wide saw blade of proximal tibial bone cut in close slot cutting block guide verified by computer navigation system.


MATERIAL AND METHOD
The authors evaluated 80 knees in 80 patients. After cutting the proximal tibia, the cutting surface was validated using the navigated cutting block adapter, and the angular difference between the cutting surface and that preoperatively planned in the sagittal and coronal planes was recorded.


RESULTS
The average cutting error of all knees was 1.8 degrees +/- 2.7 degrees in use narrow blade and 1.2 degrees +/- 2.2 degrees in use wide blade. The authors did not find statistically significant difference between the first 40 patients and the next 40 patients. The average cutting error of sclerotic bone was 2.3 degrees +/- 2.7 degrees in use narrow blade and 1.1 degrees +/- 2.1 degrees in use wide blade. The authors find statistically significant. The average error in the coronal plane was 1.5 degrees +/- 1.1 degrees in valgus and 2 (2.5%) in varus of the 80 knees had a malalignment of more than 1 degrees with respect to the targeted cutting plan.


DISCUSSION
Alignment of cutting surface should be checked after cut proximal tibia and recut to reach target alignment and should be cut with wide saw blade especially in sclerotic bone.