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The definitive treatment to relieve the pain, disability, and loss of motion associated with late-stage osteoarthritis is total knee arthroplasty (TKA) (also known as a total knee replacement). While long-term implant survival of TKA is approximately 90-95% for elderly patients after 10 to 15 years, the clinical outcomes are worse for younger, active patients. For most patients, TKA successfully relieves the pain associated with osteoarthritis of the knee, but improvements are needed to allow patients to perform more physically demanding activities such as stair negotiation, squatting, kneeling, gardening, and recreational sports. There exists a wide range of clinical outcomes that makes it difficult for the surgeon to give an individual patient an accurate estimation of post-operative outcome.

We are developing a transformational and computer-assisted approach to total knee arthroplasty. Through our comprehensive and rigorous approach, we seek to answer the question of whether it is possible to predict post-operative functional outcomes based on objective intra-operative measurements of surgical technique, specifically component alignment and initial soft tissue balance. This approach is innovative because it represents the first effort to parameterize key aspects of surgical technique and objectively relate intra-operative measurements to post-operative outcomes. Such an integrated approach will allow us to determine to what degree actions taken by the surgeon during surgery affect the post-operative functional course for a given patient. With that knowledge, surgeons will be able to make patient-specific intra-operative decisions and better predict post-operative function. Physical therapists can customize a patient’s rehabilitation program. Implant manufacturers can customize the design of an implant to match a certain type of patient and can ensure high post-operative function despite a given amount of variability in surgical technique.

This approach to total knee arthroplasty has both experimental and computational approaches and is sponsored by the National Institutes of Health and industry. We currently have the following active projects
• Using Intra-operative Measurements to Predict the Post-operative Outcomes of TKA
• Subject-Specific Modeling of TKA
• Parametric Analysis of Component Alignment Using a Simulated Oxford Rig

Computer-Assisted Total Knee Arthroplasty