The use of navigation to achieve planned coronal alignment during cemented revision total knee arthroplasty: a technical note and case series.

Although navigation technologies have been widely adopted over the past two decades in primary total knee arthroplasty (TKA), their application in revision total knee arthroplasty (R-TKA) remains scarcely documented. This technical note outlines a surgical protocol designed to achieve targeted coronal alignment using off-label, image-free, optical navigation during R-TKA. This technique is suitable for all image-free optical navigation systems. We report 8 cases utilizing this method. Based on postoperative long-leg radiograph measures, the mean absolute deviation from the surgical plan was 1.5° ± 1.3° (range 0.2°-3.8°) for the femur (lateral distal femoral angle) and 1.3° ± 1.5° (range 0°-4.7°) for the tibia (medial proximal tibial angle). Navigation assistance during R-TKA appears as a useful tool, particularly in cases where conventional instrumentation proves inadequate (shaft deformation, femoral canal obstruction).