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J Knee Surg 2021; 34(08): 870-876
DOI: 10.1055/s-0039-3402481
Original Article

Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty

Masanori Tsubosaka
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Tomoyuki Kamenaga
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Yuichi Kuroda
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Koji Takayama
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Shingo Hashimoto
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Kazunati Ishida
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Shinya Hayashi
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Ryosuke Kuroda
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
,
Tomoyuki Matsumoto
1   Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
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Abstract

Several studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.

Keywords

kinematically aligned total knee arthroplasty - accelerometer-based portable navigation - iASSIST - accuracy of tibial bone cutting - 2011 KSS


Publikationsverlauf

Eingereicht: 30. Mai 2019

Angenommen: 10. November 2019

Artikel online veröffentlicht:
31. Dezember 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Dorr LD, Boiardo RA. Technical considerations in total knee arthroplasty. Clin Orthop Relat Res 1986; (205) 5-11
    PubMedSuche in Google Scholar
  • 2 Insall J, Tria AJ, Scott WN. The total condylar knee prosthesis: the first 5 years. Clin Orthop Relat Res 1979; (145) 68-77
    PubMedSuche in Google Scholar
  • 3 Insall JN, Binazzi R, Soudry M, Mestriner LA. Total knee arthroplasty. Clin Orthop Relat Res 1985; (192) 13-22
    PubMedSuche in Google Scholar
  • 4 Ritter MA, Faris PM, Keating EM, Meding JB. Postoperative alignment of total knee replacement. Its effect on survival. Clin Orthop Relat Res 1994; (299) 153-156
    PubMedSuche in Google Scholar
  • 5 Wasielewski RC, Galante JO, Leighty RM, Natarajan RN, Rosenberg AG. Wear patterns on retrieved polyethylene tibial inserts and their relationship to technical considerations during total knee arthroplasty. Clin Orthop Relat Res 1994; (299) 31-43
    PubMedSuche in Google Scholar
  • 6 Bäthis H, Perlick L, Tingart M, Lüring C, Perlick C, Grifka J. Radiological results of image-based and non-image-based computer-assisted total knee arthroplasty. Int Orthop 2004; 28 (02) 87-90
    CrossrefPubMedSuche in Google Scholar
  • 7 Mahaluxmivala J, Bankes MJ, Nicolai P, Aldam CH, Allen PW. The effect of surgeon experience on component positioning in 673 Press Fit Condylar posterior cruciate-sacrificing total knee arthroplasties. J Arthroplasty 2001; 16 (05) 635-640
    CrossrefPubMedSuche in Google Scholar
  • 8 Sparmann M, Wolke B, Czupalla H, Banzer D, Zink A. Positioning of total knee arthroplasty with and without navigation support. A prospective, randomised study. J Bone Joint Surg Br 2003; 85 (06) 830-835
    CrossrefPubMedSuche in Google Scholar
  • 9 Bäthis H, Perlick L, Tingart M, Lüring C, Zurakowski D, Grifka J. Alignment in total knee arthroplasty. A comparison of computer-assisted surgery with the conventional technique. J Bone Joint Surg Br 2004; 86 (05) 682-687
    CrossrefPubMedSuche in Google Scholar
  • 10 Bauwens K, Matthes G, Wich M. et al. Navigated total knee replacement. A meta-analysis. J Bone Joint Surg Am 2007; 89 (02) 261-269
    CrossrefPubMedSuche in Google Scholar
  • 11 Delp SL, Stulberg SD, Davies B, Picard F, Leitner F. Computer assisted knee replacement. Clin Orthop Relat Res 1998; (354) 49-56
    CrossrefPubMedSuche in Google Scholar
  • 12 Jenny JY, Boeri C. Computer-assisted implantation of total knee prostheses: a case-control comparative study with classical instrumentation. Comput Aided Surg 2001; 6 (04) 217-220
    CrossrefPubMedSuche in Google Scholar
  • 13 Laskin RS. Instrumentation pitfalls: you just can't go on autopilot!. J Arthroplasty 2003; 18 (03, Suppl 1): 18-22
    CrossrefPubMedSuche in Google Scholar
  • 14 Haaker RG, Stockheim M, Kamp M, Proff G, Breitenfelder J, Ottersbach A. Computer-assisted navigation increases precision of component placement in total knee arthroplasty. Clin Orthop Relat Res 2005; (433) 152-159
    CrossrefPubMedSuche in Google Scholar
  • 15 Jenny JY, Clemens U, Kohler S, Kiefer H, Konermann W, Miehlke RK. Consistency of implantation of a total knee arthroplasty with a non-image-based navigation system: a case-control study of 235 cases compared with 235 conventionally implanted prostheses. J Arthroplasty 2005; 20 (07) 832-839
    CrossrefPubMedSuche in Google Scholar
  • 16 Kinney MC, Cidambi KR, Severns DL, Gonzales FB. Comparison of the iAssist handheld guidance system to conventional instruments for mechanical axis restoration in total knee arthroplasty. J Arthroplasty 2018; 33 (01) 61-66
    CrossrefPubMedSuche in Google Scholar
  • 17 Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S, Kuroda R. Kinematically aligned total knee arthroplasty: alternative standardized technique?. Ann Transl Med 2017; 5 (Suppl. 01) S10
    CrossrefPubMedSuche in Google Scholar
  • 18 Dossett HG, Estrada NA, Swartz GJ, LeFevre GW, Kwasman BG. A randomised controlled trial of kinematically and mechanically aligned total knee replacements: two-year clinical results. Bone Joint J 2014; 96-B (07) 907-913
    CrossrefPubMedSuche in Google Scholar
  • 19 Dossett HG, Swartz GJ, Estrada NA, LeFevre GW, Kwasman BG. Kinematically versus mechanically aligned total knee arthroplasty. Orthopedics 2012; 35 (02) e160-e169
    CrossrefPubMedSuche in Google Scholar
  • 20 Howell SM, Papadopoulos S, Kuznik KT, Hull ML. Accurate alignment and high function after kinematically aligned TKA performed with generic instruments. Knee Surg Sports Traumatol Arthrosc 2013; 21 (10) 2271-2280
    CrossrefPubMedSuche in Google Scholar
  • 21 Matsumoto T, Takayama K, Ishida K, Hayashi S, Hashimoto S, Kuroda R. Radiological and clinical comparison of kinematically versus mechanically aligned total knee arthroplasty. Bone Joint J 2017; 99-B (05) 640-646
    CrossrefPubMedSuche in Google Scholar
  • 22 Matsumoto T, Hashimura M, Takayama K. et al. A radiographic analysis of alignment of the lower extremities--initiation and progression of varus-type knee osteoarthritis. Osteoarthritis Cartilage 2015; 23 (02) 217-223
    CrossrefPubMedSuche in Google Scholar
  • 23 Matsuda S, Miura H, Nagamine R. et al. Posterior tibial slope in the normal and varus knee. Am J Knee Surg 1999; 12 (03) 165-168
    Suche in Google Scholar
  • 24 Gromov K, Korchi M, Thomsen MG, Husted H, Troelsen A. What is the optimal alignment of the tibial and femoral components in knee arthroplasty?. Acta Orthop 2014; 85 (05) 480-487
    CrossrefPubMedSuche in Google Scholar
  • 25 Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009; 41 (04) 1149-1160
    CrossrefPubMedSuche in Google Scholar
  • 26 Baker PN, van der Meulen JH, Lewsey J, Gregg PJ. National Joint Registry for England and Wales; Data from the National Joint Registry for England and Wales. The role of pain and function in determining patient satisfaction after total knee replacement. J Bone Joint Surg Br 2007; 89 (07) 893-900
    CrossrefPubMedSuche in Google Scholar
  • 27 Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: who is satisfied and who is not?. Clin Orthop Relat Res 2010; 468 (01) 57-63
    CrossrefPubMedSuche in Google Scholar
  • 28 Parratte S, Pagnano MW, Trousdale RT, Berry DJ. Effect of postoperative mechanical axis alignment on the fifteen-year survival of modern, cemented total knee replacements. J Bone Joint Surg Am 2010; 92 (12) 2143-2149
    CrossrefPubMedSuche in Google Scholar
  • 29 Bellemans J, Colyn W, Vandenneucker H, Victor J. The Chitranjan Ranawat award: is neutral mechanical alignment normal for all patients? The concept of constitutional varus. Clin Orthop Relat Res 2012; 470 (01) 45-53
    CrossrefPubMedSuche in Google Scholar
  • 30 Eckhoff DG, Bach JM, Spitzer VM. et al. Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality. J Bone Joint Surg Am 2005; 87 (Suppl. 02) 71-80
    PubMedSuche in Google Scholar
  • 31 Vanlommel L, Vanlommel J, Claes S, Bellemans J. Slight undercorrection following total knee arthroplasty results in superior clinical outcomes in varus knees. Knee Surg Sports Traumatol Arthrosc 2013; 21 (10) 2325-2330
    CrossrefPubMedSuche in Google Scholar
  • 32 Nam D, Weeks KD, Reinhardt KR, Nawabi DH, Cross MB, Mayman DJ. Accelerometer-based, portable navigation vs imageless, large-console computer-assisted navigation in total knee arthroplasty: a comparison of radiographic results. J Arthroplasty 2013; 28 (02) 255-261
    CrossrefPubMedSuche in Google Scholar
  • 33 Desseaux A, Graf P, Dubrana F, Marino R, Clavé A. Radiographic outcomes in the coronal plane with iASSIST™ versus optical navigation for total knee arthroplasty: a preliminary case-control study. Orthop Traumatol Surg Res 2016; 102 (03) 363-368
    CrossrefPubMedSuche in Google Scholar
  • 34 Nam D, Jerabek SA, Haughom B, Cross MB, Reinhardt KR, Mayman DJ. Radiographic analysis of a hand-held surgical navigation system for tibial resection in total knee arthroplasty. J Arthroplasty 2011; 26 (08) 1527-1533
    CrossrefPubMedSuche in Google Scholar