DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20201727

A study on radiological outcomes of accelerometer based hand held navigation system in total knee arthroplasty

Hiranyakumar S., Shivaraj Nadagouda, Vishnu Harikrishnan

Abstract


Background: The goal of obtaining more accurate component alignment in total knee arthroplasty (TKA) has led to the development of techniques like portable accelerometer-based handheld navigation system, computer assisted system, patient specific instrumentation. Among which hand held navigation has showed promising results for achieving accurate resection and alignment and only few studies were done to assess radiological outcome or the effective component alignment using portable accelerometer-based hand held navigation system in TKA.

Methods: TKA using portable accelerometer-based hand held navigation system (Smith and Nephew- knee align) was done on 25 knees with primary osteoarthritis. Preoperative and post-operative mechanical axis and component alignments were measured using hip-to-ankle radiographs.

Results: Among the femoral components, 92.0% were placed within 90°±2° to the femoral mechanical axis in the coronal and   96.0% of the tibial components were placed within 90°±2° to the mechanical axis in the coronal plane, 94.3% of the TKAs had an overall lower extremity alignment within 3° of neutral to the mechanical axis, based on postoperative hip-to-ankle radiographs.

Conclusions: The degree of accuracy in positioning the femoral and tibial component in TKA using portable accelerometer-based hand held navigation system (knee align) is very much promising and is an effective intraoperative tool for reducing the proportion of outliers for component placement and thus decreasing the chances of instability and early wear and tear of the components in TKA.


Keywords


Knee, Arthroplasty, Femoral component alignment, Tibial component alignment, Hand held navigation

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References


Orthopaedics. 13th ed. Tennessee: Elsevier; 2016; 413-458.

Berend M, Ritter M, Keating E, Faris P, Meding J. Tibial component failure mechanisms in total knee replacement. J Arthroplasty. 2004;19(2):262.

Hafez M, Moholkar K. Patient-specific instruments: advantages and pitfalls. SICOT-J. 2017;3:66.

Shen C, Tang Z, Hu J, Zou G, Xiao R, Yan D. Patient-Specific Instrumentation Does Not Improve Accuracy in Total Knee Arthroplasty. Orthopedics. 2015;38(3):178-88.

Xie C, Liu K, Xiao L, Tang R. Clinical Outcomes After Computer-assisted Versus Conventional Total Knee Arthroplasty. Orthopedics. 2012;35(5):647-53.

Dennis D, Channer M, Susman M, Stringer E. Intramedullary versus extramedullary tibial alignment systems in total knee arthroplasty. J Arthroplasty. 1993;8(1):43-7.

Sharkey P, Hozack W, Rothman R, Shastri S, Jacoby S. Why Are Total Knee Arthroplasties Failing Today. Clinical Orthop Related Res. 2002;404:7-13.

Parratte S, Pagnano M, Trousdale R, Berry D. Effect of Postoperative Mechanical Axis Alignment on the Fifteen-Year Survival of Modern, Cemented Total Knee Replacements. J Bone Joint Surgery-American Vol. 2010;92(12):2143-9.

Iorio R, Mazza D, Drogo P, Bolle G, Conteduca F, Redler A, et al. Clinical and radiographic outcomes of an accelerometer-based system for the tibial resection in total knee arthroplasty. Int Orthop. (2014);39(3):461-6.

Bugbee W, Kermanshahi A, Munro M, Cauley J Copp S. Accuracy of a hand-held surgical navigation system for tibial resection in total knee arthroplasty. Knee. 2014;21(6):1225-8.

Nam D, Cody E, Nguyen J, Figgie M, Mayman D. Extramedullary Guides Versus Portable, Accelerometer-Based Navigation for Tibial Alignment in Total Knee Arthroplasty: A Randomized, Controlled Trial: Winner of the 2013 HAP PAUL Award; 2014.

Nam D, Nawabi D, Cross M, Heyse T, Mayman D. Accelerometer-Based Computer Navigation for Performing the Distal Femoral Resection in Total Knee Arthroplasty. J Arthroplasty. 2012;27(9):1717-22.