Comparison of the iAssist Handheld Guidance System to Conventional Instruments for Mechanical Axis Restoration in Total Knee Arthroplasty

Kinney, Matthew C.; Cidambi, Krishna R.; Severns, Dustyn; Gonzales, Francis B.

doi:10.1016/j.arth.2017.06.004

Cited by 40 publications

(42 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%

“…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. On the contrary, all seven nonrandomized cohort studies had a clearly stated aim, end points appropriate to the aim of the study, an adequate control group, baseline equivalence of groups, and adequate statistical analyses; however, the follow-up period of those studies was relatively unsatisfactory, except for the study by Goh et al 16 There were variable reports of inclusion of consecutive patients, prospective collection of data, unbiased assessment of the study end point, <5% loss to follow-up, prospective calculation of the study size, and contemporary groups.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Eight studies with nine groups reported a tibial component alignment out of AE3 degrees [8][9][10]15,16,19,22,24 ; the pooled result indicated that PAD was better than CON with significant differences (OR, 0.56; 95% CI, 0.33-0.93; p ¼ 0.02; outlier percentage, PAD/CON ¼ 5.36%/10.00%) (►Fig. 2A).…”

Section: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

confidence: 99%

See 3 more Smart Citations

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%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

confidence: 99%

See 2 more Smart Citations

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

View full text Add to dashboard Cite

show abstract

“…However, there are many concerns such as the learning curve required, expensive procedure, requirement of preoperative imaging (computed tomography [CT] scans or magnetic resonance imaging [MRI], longer operative time, extra pin sites, and difficulties with sensitive optical instrumentations regarding the use of this technology Recently, some smart, easy, and cheap new navigation systems have been introduced in TKA using accelerometer portable components designed to improve component position and alignment. One of these systems is the i-ASSIST Knee Surgical Assistance for Total Knee Arthroplasty (Zimmer Inc, Warsaw, IN) [24,25]. This device provides intraoperative matching of bone cuts and overall alignment at each surgical step using an internal position-sensing technology integrated into microelectronic pods that attach to the standard cutting blocks.…”

mentioning

confidence: 99%

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

Matassi

Lepri

Innocenti

et al. 2019

The Journal of Arthroplasty

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New technology‐based assistive techniques in total knee arthroplasty: A Bayesian network meta‐analysis and systematic review

Gao

Dong

et al. 2020

Robotics Computer Surgery

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Background The radiological and clinical efficiency among robot‐assisted surgery (RAS), computer‐assisted navigation system (CAS) and conventional (CON) total knee arthroplasty (TKA) remains controversial. Methods Bayesian network meta‐analysis (NMA) and systematic review were performed to investigate radiological and clinical efficiency, respectively. The certainty of the evidence was evaluated using Grading of Recommendations, Assessment, Development and Evaluation and Confidence in the Evidence from Reviews of Qualitative tools. Results Thirty‐four RCTs (7289 patients and 7424 knees) were included. The NMA showed that RAS‐TKA had the highest probability for mechanical axis restoration (odds ratio for RAS vs. CAS 3.79, credible interval [CrI] 1.14–20.54, very low certainty), followed by CAS‐TKA (odds ratio for CAS vs. CON 2.55, CrI 1.67–4.01, very low certainty) and then CON‐TKA, without significant differences in other radiological parameters. No differences were found in clinical outcomes after qualitative systematic review (overall low certainty). Conclusions Technology‐based assistive techniques (CAS and RAS) may surpass the CON‐TKA, when considering higher radiological accuracy and comparable clinical outcomes.

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Comparison of the iAssist Handheld Guidance System to Conventional Instruments for Mechanical Axis Restoration in Total Knee Arthroplasty

Cited by 40 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

Total Knee Arthroplasty in Patients With Extra-Articular Deformity: Restoration of Mechanical Alignment Using Accelerometer-Based Navigation System

New technology‐based assistive techniques in total knee arthroplasty: A Bayesian network meta‐analysis and systematic review

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