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J Knee Surg 2020; 33(07): 691-703
DOI: 10.1055/s-0039-1685145
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Efficacy of Portable Accelerometer-Based Navigation Devices versus Conventional Guides in Total Knee Arthroplasty: A Meta-analysis

Han Sun   *
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
,
Shuxiang Li   *
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
,
Kun Wang
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
,
Guofeng Wu
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
,
Jian Zhou
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
,
Xiaoliang Sun
1   Department of Articular Orthopaedics, The Third Affiliated Hospital of Soochow University, Changzhou, P.R. China
› Author Affiliations
Funding None.
Further Information

Publication History

06 December 2018

18 February 2019

Publication Date:
08 April 2019 (online)

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Abstract

Various studies have provided different conclusions regarding which component's alignment can be actually improved by a novel portable accelerometer-based navigation device (PAD) compared with the conventional guide (CON); the operative times and clinical outcomes reported by these studies also exhibited incongruity. Thus, this meta-analysis was conducted to evaluate the efficacy of PADs in total knee arthroplasty (TKA). The Web of Science, EMBASE, PubMed, MEDLINE, and Cochrane Library databases were systematically searched. Studies published till July 2018 and comparing PAD with CON in treatment with TKA were identified. Sixteen studies in which 1,551 TKAs were reported were included. Results showed that PAD was significantly superior to CON in reducing tibial component alignment out of ±3 degrees, femoral coronal angle out of ±3 degrees, and overall mechanical alignment out of ±3 degrees. PAD can also help obtain a more accurate result of femoral coronal angle (degree); however, it requires a longer operative time than the CON group. The two groups were comparable in tibial component alignment out of ±2 degrees, tibial component posterior slope out of ±3 degrees, tibial component posterior slope out of ±2 degrees, femoral coronal angle out of ±2 degrees, femoral sagittal angle out of ±3 degrees, femoral sagittal angle out of ±2 degrees, tibial component alignment (degree), tibial component posterior slope (degree), femoral sagittal angle (degree), overall mechanical alignment (degree), blood loss, Knee Society knee score, Knee Society function score, Oxford Knee Score, Short Form-36 physical component score, Short Form-36 mental component score, and range of motion. In conclusion, compared with CON, PAD can help improve the femoral coronal angle as well as decrease the outliers out of ±3 degrees in femoral/tibial coronal angles and overall mechanical alignment. However, PAD did not show significant advantages in tibial and femoral component sagittal angles out of ±3 degrees, various outliers of ±2 degrees, most mean values of component alignments, operative time, and various functional or satisfactory scores.

Keywords

knee arthroplasty - conventional guides - computer-assisted navigation systems - accelerometers - hand-held navigation - meta-analysis

Ethical Approval

Meta-analysis collects relevant data from published articles, and thus, no ethics committee approval was needed for this meta-analysis.


* These authors contributed equally to this work.