Radiographic outcomes in the coronal plane with iASSIST™ versus optical navigation for total knee arthroplasty: A preliminary case-control study

Desseaux, Antoine; Gräf, P.; Dubrana, F.; Marino, R. A.; Clavé, Arnaud

doi:10.1016/j.otsr.2016.01.018

Cited by 27 publications

(25 citation statements)

References 22 publications

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“…5 The combination of the accuracy of CAS with large console and the convenience of CON has been desired in recent years. Subsequently, portable accelerometer-based navigation devices (PADs) were introduced; these novel navigation systems mainly rely on accelerometer electronic components, 6 are superior to CASs in their low volumes and simpler procedures of navigation, and do not need inserting tracking pins, which helps avoid the associated risk of fractures. 7 Several studies have evaluated the efficiency of PAD by comparing it with CON.…”

mentioning

confidence: 99%

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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mentioning

confidence: 99%

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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“…32 Several reports described high accuracy of TCA in MA-TKA using this navigation system. 16,33,34 Desseaux et al reported that the navigation system provided neutral mechanical axis rotation and optimal implant position in the coronal plane in 95% of cases using iASSIST. 33 Regarding tibial component accuracy, Kinney et al reported no outliers of more than 3 degree in postoperative tibial component alignment compared with the tibial mechanical axis using iASSIST.…”

Section: Discussionmentioning

confidence: 99%

“…16,33,34 Desseaux et al reported that the navigation system provided neutral mechanical axis rotation and optimal implant position in the coronal plane in 95% of cases using iASSIST. 33 Regarding tibial component accuracy, Kinney et al reported no outliers of more than 3 degree in postoperative tibial component alignment compared with the tibial mechanical axis using iASSIST. 16 Nam et al also reported that 97.6% of tibial components were implanted with an alignment of 90 AE 2 degree in the coronal plane using KneeAlign (OrthAlign Inc, Aliso Viejo, CA).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2019

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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.

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“…Our results coincide with previously published data that iAssist results are comparable to other navigation systems. 25 Bathis et al compared a Vector Vision CT free knee, Brain Lab, Munich, Germany) with Conventional technique and achieved mechanical axis of ±3° of valgus and/orvarus in 96% of navigational group compared to 78% in conventional group. 14 For a TKA performed in osteoarthritic knees with valgus and/or varus deformity, there are several specific procedures performed by the surgeon to achieve wellbalanced knee and a neutral mechanical axis by achieving slightly oblique bone resection in frontal and sagittal plane; releasing the soft tissues for a well-balanced stable knee and equal flexion and extension gaps.…”

Section: Discussionmentioning

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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Radiographic outcomes in the coronal plane with iASSIST™ versus optical navigation for total knee arthroplasty: A preliminary case-control study

Abstract: III, prospective case-control study.

Cited by 27 publications

References 22 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

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

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

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