Stryker computer navigation system has been used for total knee arthroplasty (TKA) procedures since October 2008 at the Russian Ilizarov Scientific Centre for Restorative Traumatology and Orthopaedics. There have been 126 computer assisted TKA that accounted for 11.5 % of primary TKA within this period (1096 procedures). Arthritis of the knee joints with evident pain syndrome was an indication to TKA surgery. Arthritis of the knee joint of 27 patients (21.4 %) was accompanied by femoral deformity of various etiology with debris found in the medullary canal in several cases. The rest 99 patients (78.6 %) were regular cases of primary TKA.Introduction
Material and methods
We report a prospective study of 106 consecutive patients younger than 60 years old who suffered an intertrochanteric fracture of the proximal femur and were treated with an “Ilizarov” external fixator. All surviving patients were assessed with the assistance of the “CITO” evaluation system for fracture outcomes at three months post-injury and 73 patients were either clinically reviewed or contacted by a letter to establish the long-term results. Complications included one intraoperative death, one case of post-traumatic ankylosis of the hip, two cases that were discharged in varus and one case in valgus of the femoral neck. Other complications included pin-track infections and stiffness at the level of the knee that required a year to resolve. Overall long-term satisfaction was high (76% in reviewed patients and 91% in patients contacted by letter). The advantages of the “Ilizarov” external fixator include minimal disruption of the tissues and blood loss, capability of closed reduction of the fractures as well as post-operative manipulation of the fracture by gradual adjustments of the frame. This method, however, is time consuming, requires expertise and intense follow-up during the immediate post-operative period.
