| Computer assisted surgery (CAS) systems for total knee arthroplasty have been shown to help surgeons improve the alignment of the femoral and tibial replacement components. However, no computer assistance is currently available for resecting (i.e. cutting) the patella. With conventional patellar resection techniques, studies have established a direct link between asymmetrically resectioned patellae and postoperative anterior knee pain. Asymmetric resections occur when the four quadrants of the resected patella differ in thickness. Given the accuracy of computer assistance, the development of computer-assisted techniques for resecting the patella offers the potential to decrease the incidence of resection asymmetry. Therefore, anterior knee pain would also decrease.;This thesis describes a novel computer-assisted patellar resurfacing system and its validation on both artificial and cadaveric knee specimens. On the artificial knees, the use of computer assistance led to more accurate and repeatable results compared to conventional techniques, particularly in the superoinferior plane of the patella. However, the use of computer assistance increased the time required for the procedure. For the cadaveric specimens, the computer-assisted technique matched its conventional counterpart, despite several advantages given to the conventional resection, including allowing multiple cuts (versus one for CAS), using normal patellar geometry and having the focused educational training of CAS, which resulted in better conventional results than reported clinically. Repeatability was better for the CAS system, in the mediolateral plane. With improvements to the current system, computer-assisted patellar resurfacing could be a valuable tool in the operating room. |
