Accelerometer-Based, Portable Navigation (KneeAlign) vs Conventional Instrumentation for Total Knee Arthroplasty: A Prospective Randomized Comparative Trial

Gharaibeh, Monther; Solayar, Gandhi Nathan; Harris, Ian A.; Chen, Darren B.; MacDessi, Samuel J.

doi:10.1016/j.arth.2016.08.025

Cited by 44 publications

(64 citation statements)

References 21 publications

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“…1). [8][9][10][15][16][17][18][19][20][21][22][23][24] Among the included studies, six were RCTs, 8,10,17,19,21,23 one was a prospective study, 16 and six were retrospective studies. 9,15,18,20,22,24 The present meta-analysis analyzed 1,454 patients with 1,551 TKAs (mean sample size, 119.31 TKAs per study).…”

Section: Search Resultsmentioning

confidence: 99%

“…All six RCTs were claimed as being randomized; five of those provided adequate generation of random sequences and appropriate concealment of allocation. 8,10,17,19,23 None of those studies completely reported blinding of the participant and personnel. Only the studies of Ikawa et al, 17 Kinney et al, 19 and Thiengwittayaporn et al 8 clearly expounded the blinding of outcome assessment.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…9 The operative times of PADs also exhibited incongruity in different studies. 8,10 In addition, the association between alignments and clinical outcomes remains inconclusive. The sample size enrolled in each study was relatively small, which may have influenced the quality of the evidence; hence, we conducted this meta-analysis to provide a relatively more credible and overall assessment of PAD compared with CON in TKA.…”

mentioning

confidence: 99%

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

Sun

Wang

et al. 2019

J Knee Surg

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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.

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Section: Search Resultsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

mentioning

confidence: 99%

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

Sun

Wang

et al. 2019

J Knee Surg

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“…10 Several studies have shown that despite the surgeons' experience, conventional guides can still be unreliable and it has a limited degree of accuracy. [11][12][13] Errors can happen as this technique is dependent on surgeons' judgment, fixation of instruments, knowledge of knee kinematics and hand eye coordination. 13,14 Mahaluxmivala et al analyzed 673 TKA's and found that 25% of cases had Varus and/or Valgus of ±3° regardless of the surgeons' experience.…”

Section: Introductionmentioning

confidence: 99%

“…12,18 Recently navigation systems have been developed using accelerometer and gyroscopes in attempt to combine the accuracy associated with CAS and convenience of conventional systems which does not require the use of large computer systems for registration and alignment results to provide the surgeon intra operatively. 5,6,9,11,19 The iAssist (Zimmer Inc, Warsaw, IN) system uses four pods which are attached to the surgical instruments and intraoperatively using accelerometer and gyroscope provides the precise alignment and position in relation to anatomic landmarks. Within these pods are inertial gyroscopes that exchange information using a secure local wireless channel, and information is displayed to the surgeon intraoperatively.…”

Section: Introductionmentioning

confidence: 99%

iAssist versus conventional total knee arthroplasty in patients with varus and valgus deformities

et al. 2018

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INTRODUCTIONThe frequency in which knee replacements are performed is truly staggering. This reality increases the burden on joint replacement surgeons to get it right on the first time as the demand for total knee arthroplasty (TKA) is expected to increase significantly over the next 20 years. 1 TKA is effective in improving quality of life of those suffering from osteoarthritis. The success of TKA depends on various factors like the restoration of mechanical axis, component positioning, joint line restoration, flexion and extension gaps and soft tissue balance. This is particularly true in cases of valgus and varus knees. Many studies confirm that achieving accurate component implantation and mechanical axis of ±3° to neutral mechanical axis leads to long term prosthesis survival and decreased component loosening. [2][3][4][5][6] Ritter et al noted significant risk of aseptic failures with tibial component orientation of less than 90° relative to tibial axis and femoral component orientation greater than 8° of valgus relative to femoral axis. 7 Berend et al in a review of 3152 TKA's confirmed the chance of implant failure escalated by roughly 17 times due to a tibial varus alignment of greater than 3°.8 Jeffry et al analyzed the outcome of TKA in 115 patients and found cases of implant loosening at 24% when the Valgus and or Varus exceeded ±3° whereas it was only 3% in other cases. In every TKA performed, the surgeon aims to achieve a neutral mechanical axis and a number of technologies are available to aid and guide the surgeon intra operatively like intra-medullary (IM) and extra medullary (EM) jigs, patient specific instrumentation (PSI) large console CAS, ABSTRACTBackground: Accelerometer and gyroscope based iAssist system's accuracy in restoring the hip knee angle (HKA) in valgus and varus deformity patients is compared to that of conventional system. Methods: In this retrospective study we compared the HKA of 26 patients in iAssist group with that of 26 patients in conventional group. The knee joints were evaluated with full leg length radiographs. Results: The iAssist group patients' post-operative hip knee angle was much near to our target angle when compared to that of patients in conventional technique group. Conclusions: iAssist brings the high accuracy associated with large console CAS systems with lower costs and helps surgeons in low volume hospitals achieve specific intra operative goals with the familiarity of conventional guides.

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A review of computer‐assisted orthopaedic surgery systems

Wang

Shang

et al. 2020

Robotics Computer Surgery

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Background: Computer-assisted orthopaedic surgery systems have great potential, but no review has focused on computer-assisted surgery systems for the spine, hip, and knee. Methods: A systematic search was performed in Web of Science and PubMed. We searched the literature on computer-assisted orthopaedic surgery systems from 2008 to the present and focused on three aspects of systems: training, planning, and intraoperative navigation. Results and discussion: In this review study, we reviewed 34 surgical training systems, 31 surgical planning systems, and 41 surgical navigation systems. The functions and characteristics of the surgical systems were compared and analysed, and the current concerns about and the impact of the surgical systems on doctors and surgery were clarified. Conclusion: Computer-assisted orthopaedic surgery systems are still in the development stage. Future surgical training systems should include synthetic models with patient anatomy. Surgical planning systems with automatic planning should be developed, and surgical navigation systems with multimodal fusion, robotic assistance and imaging should be developed.

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Accelerometer-Based, Portable Navigation (KneeAlign) vs Conventional Instrumentation for Total Knee Arthroplasty: A Prospective Randomized Comparative Trial

Cited by 44 publications

References 21 publications

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

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

iAssist versus conventional total knee arthroplasty in patients with varus and valgus deformities

A review of computer‐assisted orthopaedic surgery systems

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