Imageless Navigation System Does Not Improve Component Rotational Alignment in Total Knee Arthroplasty

Cheng, Tao; Zhang, Guoyou; Zhang, Xianlong

doi:10.1016/j.jss.2010.05.006

Cited by 56 publications

(42 citation statements)

References 100 publications

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“…As demonstrated in previous meta-analyses, [50][51][52][53] neutral component alignment is improved with navigation in TKA. We examined various component alignment measures (mechanical axis deviation from neutral, coronal plane alignment, component slope, and femoral component rotation; and outliers of anatomic axis, mechanical axis, coronal plane alignment, and component slope) and verified that navigation is superior to CONV methods.…”

Section: Discussionsupporting

confidence: 60%

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Navigated versus Conventional Total Knee Arthroplasty

et al. 2013

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Computer-aided navigation in total knee arthroplasty (TKA) promises improved alignment, performance, and survivorship. Previous meta-analyses demonstrated that navigation yields better component alignment; however, they did not discuss other indicators of performance. This meta-analysis compares navigated (NAV) and conventional (CONV) TKAs and includes clinical outcomes and adverse events. Forty-seven studies (22 randomized trials) of varying methodological quality involving 7,151 TKAs created the sample population. Statistical analyses included analysis of variance of weighted means and random effects modeling. As seen in previous meta-analyses, NAV is favored over CONV TKA. Analysis of surgical characteristics found that length of surgery and tourniquet times were lower for CONV, but not significant. Meta-analysis found that tourniquet times favored CONV but not a strong relationship for length of surgery. Analysis of individual adverse events did not reveal any significant differences. However, when examining adverse events in their totality, the NAV experienced significantly fewer complications. TKA performed with imageless navigation improves component alignment, provides for lower blood loss, improves clinical outcomes as measured by Knee Society and WOMAC scores, and has fewer total adverse events. Published data are insufficient to determine any correlations between component alignment and outcomes.

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Section: Discussionsupporting

confidence: 60%

“…Our meta-analyses of alignment outcomes are in agreement with previous meta-analyses. [50][51][52][53] Four of the deviations from neutral meta-analyses demonstrated that NAV was significantly favored: tibial component coronal plane alignment deviation from neutral (p < 0.0005) (►Fig. 8), .…”

Section: Resultsmentioning

confidence: 99%

Navigated versus Conventional Total Knee Arthroplasty

et al. 2013

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“…In addition, a navigation system allows high reproducibility of intraoperative measurement of the mechanical axes of the lower limb [21]. Although imageless navigation system was reported not to obtain accurate rotational alignment after TKA [35], a number of studies have used a navigation system to assess intraoperative knee kinematics [25,36]. In the present study, we used the navigation system to assess the influence of surgical procedures on the intraoperative knee kinematics to clarify the relationship at the same time point.…”

Section: Discussionmentioning

confidence: 99%

Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty

Matsumoto

Takayama

Muratsu³

et al. 2015

The Journal of Arthroplasty

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“…When looking at the results more in detail, it is obvious that the coronal single component alignment showed very good results, whereas the HKA showed minor results to comparable studies concerning success rates in CAS-series. A literature review of 29 quasirandomized/randomized controlled trials and 11 prospective comparative studies (CAS versus conventional) revealed the proportion of HKA with a margin of error of 3° of 88.9% in the CAS-series as well as proportions for DFA and PTA of 94.1% and 95.5%, respectively [26]. …”

Section: Discussionmentioning

confidence: 99%

Accuracy of Patient Specific Cutting Blocks in Total Knee Arthroplasty

Helmy

Trong

Kühnel

2014

BioMed Research International

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Background. Long-term survival of total knee arthroplasty (TKA) is mainly determined by optimal positioning of the components and prosthesis alignment. Implant positioning can be optimized by computer assisted surgery (CAS). Patient specific cutting blocks (PSCB) seem to have the potential to improve component alignment compared to the conventional technique and to be comparable to CAS. Methods. 113 knees were selected for PSI and included in this study. Pre- and postoperative mechanical axis, represented by the hip-knee-angle (HKA), the proximal tibial angle (PTA), the distal femoral angle (DFA), and the tibial slope (TS) were measured and the deviation from expected ideal values was calculated. Results. With a margin of error of ±3°, success rates were 81.4% for HKA, 92.0% for TPA, and 94.7% for DFA. With the margin of error for alignments extended to ±4°, we obtained a success rate of 92.9% for the HKA, 98.2% for the PTA, and 99.1% for the DFA. The TS showed postoperative results of 2.86 ± 2.02° (mean change 1.76 ± 2.85°). Conclusion. PSCBs for TKA seem to restore the overall leg alignment. Our data suggest that each individual component can be implanted accurately and the results are comparable to the ones in CAS.

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Imageless Navigation System Does Not Improve Component Rotational Alignment in Total Knee Arthroplasty

Cited by 56 publications

References 100 publications

Navigated versus Conventional Total Knee Arthroplasty

Navigated versus Conventional Total Knee Arthroplasty

Semimembranosus Release Reduces Tibial Internal Rotation and Flexion Angle in Cruciate-Retaining Total Knee Arthroplasty

Accuracy of Patient Specific Cutting Blocks in Total Knee Arthroplasty

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