Technical Considerations and Accuracy Improvement of Accelerometer-Based Portable Computer Navigation for Performing Distal Femoral Resection in Total Knee Arthroplasty

Fujimoto, Eisaku; Sasashige, Yoshiaki; Nakata, Kyouhei; Yokota, Gen; Omoto, Takenori; Ochi, Mitsuo

doi:10.1016/j.arth.2016.05.067

Cited by 19 publications

(26 citation statements)

References 19 publications

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“…[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). None of the included studies contained revision or failure cases.…”

Section: Search Resultsmentioning

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%

“…2C). [8][9][10]15,[22][23][24] Two studies reported the tibial component posterior slope out of AE2 degrees. 10,21 After pooling the results, the two techniques were found to be comparable (OR, 0.95; 95% CI, 0.39-2.32; p ¼ 0.91; outlier percentage: PAD/ CON ¼ 7.94%/8.33%) (►Fig.…”

Section: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

confidence: 99%

“…Nonrandomized studies The results of femoral coronal angles were also analyzed. Ten studies with 11 groups reported a femoral coronal angle out of AE3 degrees, [8][9][10][15][16][17][18][19]22,24 and the result of the analysis revealed that the PAD group was much more accurate than the CON group (OR, 0.30; 95% CI, 0.14-0.64; p ¼ 0.002; hetero-geneity was found and random-effects model was used; outlier percentage: PAD/CON ¼ 5.32%/15.98%) (►Fig. 3A).…”

Section: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

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: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

confidence: 99%

Section: Alignment Outliers Out Of Ae2 or Ae3 Degreesmentioning

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

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“…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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Navigation in Total Knee Arthroplasty

Runner

Scudday

Nassif

2022

Essentials of Cemented Knee Arthroplasty

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Technical Considerations and Accuracy Improvement of Accelerometer-Based Portable Computer Navigation for Performing Distal Femoral Resection in Total Knee Arthroplasty

Cited by 19 publications

References 19 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

Navigation in Total Knee Arthroplasty

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