Abstract:Background
Bilateral one-stage total knee arthroplasty (BTKA) have increased because it provides a number of advantages. Recently, Accelerometer-based navigation (ABN) system which guide the cutting plane without intramedullary disturbance might result in less endothelial and microvascular damage. Therefore, we hypothesized that the ABN may reduce blood loss, reduce postoperative pain, and better restore BTKA alignment compared to conventional instruments.
Methods… Show more
“…A retrospective case-control study by Jhurani, et al, found that patients who underwent SBTKA with computer navigation experienced no blood loss or blood transfusion bene t compared to those who underwent conventional SBTKA [32]. Similarly, a retrospective study by Laoruengthana, et al reported that ABN could not reduce blood loss or postoperative pain compared to conventional SBTKA [33]. A prospective randomized study by Song, et al reported that robotic-assisted TKA had signi cantly less postoperative mean drainage blood loss compared to conventional TKA among patients undergoing SBTKA [26].…”
Background: Total knee arthroplasty (TKA) is associated with significant blood loss and postoperative transfusion. The accelerometer-based navigation (ABN) system guides the bone cutting plane without breaching the intramedullary canal, which may reduce bleeding. This study aimed to investigate blood loss and transfusion compared between the ABN system and the conventional procedure in patients undergoing one-stage sequential bilateral total knee arthroplasty (SBTKA).
Methods: A total of 66 patients scheduled for SBTKA were randomly allocated to either the ABN or conventional group. Postoperative hematocrit (Hct) level, drainage blood loss, transfusion rate, and amount of packed red cell transfusion were collected. Total red blood cell (RBC) loss was then calculated for the primary outcome.
Results: The mean calculated total RBC loss in the ABN and conventional group was 669.7 and 630.0 mL, respectively (p=0.572). There was no significant difference between groups for other evaluated outcome parameter, including postoperative Hct level, drainage blood loss, or packed red cell transfusion volume. All patients in the conventional group required postoperative blood transfusion while 96.8% of patients in ABN group were transfused.
Conclusions: The total RBC loss and volume of packed red cells transfusion were not significant difference between interventions, which suggest no benefit of the ABN system in reducing blood loss and transfusion in patients undergoing SBTKA.
Trial registration: The protocol of this study was registered in the Thai Clinical Trials Registry database no. TCTR20201126002 on 26/11/2020.
“…A retrospective case-control study by Jhurani, et al, found that patients who underwent SBTKA with computer navigation experienced no blood loss or blood transfusion bene t compared to those who underwent conventional SBTKA [32]. Similarly, a retrospective study by Laoruengthana, et al reported that ABN could not reduce blood loss or postoperative pain compared to conventional SBTKA [33]. A prospective randomized study by Song, et al reported that robotic-assisted TKA had signi cantly less postoperative mean drainage blood loss compared to conventional TKA among patients undergoing SBTKA [26].…”
Background: Total knee arthroplasty (TKA) is associated with significant blood loss and postoperative transfusion. The accelerometer-based navigation (ABN) system guides the bone cutting plane without breaching the intramedullary canal, which may reduce bleeding. This study aimed to investigate blood loss and transfusion compared between the ABN system and the conventional procedure in patients undergoing one-stage sequential bilateral total knee arthroplasty (SBTKA).
Methods: A total of 66 patients scheduled for SBTKA were randomly allocated to either the ABN or conventional group. Postoperative hematocrit (Hct) level, drainage blood loss, transfusion rate, and amount of packed red cell transfusion were collected. Total red blood cell (RBC) loss was then calculated for the primary outcome.
Results: The mean calculated total RBC loss in the ABN and conventional group was 669.7 and 630.0 mL, respectively (p=0.572). There was no significant difference between groups for other evaluated outcome parameter, including postoperative Hct level, drainage blood loss, or packed red cell transfusion volume. All patients in the conventional group required postoperative blood transfusion while 96.8% of patients in ABN group were transfused.
Conclusions: The total RBC loss and volume of packed red cells transfusion were not significant difference between interventions, which suggest no benefit of the ABN system in reducing blood loss and transfusion in patients undergoing SBTKA.
Trial registration: The protocol of this study was registered in the Thai Clinical Trials Registry database no. TCTR20201126002 on 26/11/2020.
“…A retrospective case-control study by Jhurani et al found that patients who underwent SBTKA with computer navigation experienced no blood loss or blood transfusion benefit compared to those who underwent conventional SBTKA [ 35 ]. Similarly, a retrospective study by Laoruengthana et al reported that ABN could not reduce blood loss or postoperative pain compared to conventional SBTKA [ 36 ]. A prospective randomized study by Song et al reported that robotic-assisted TKA had significantly less postoperative mean drainage blood loss compared to conventional TKA among patients undergoing SBTKA [ 26 ].…”
Background
Total knee arthroplasty (TKA) is associated with significant blood loss and postoperative transfusion. The accelerometer-based navigation (ABN) system guides the bone cutting plane without breaching the intramedullary canal, which may reduce bleeding. This study aimed to investigate blood loss and transfusion compared between the ABN system and the conventional procedure in patients undergoing one-stage sequential bilateral TKA (SBTKA).
Methods
A total of 66 patients scheduled for SBTKA were randomly allocated to either the ABN or conventional group. Postoperative hematocrit (Hct) level, drainage blood loss, transfusion rate, and amount of packed red cell transfusion were collected. Total red blood cell (RBC) loss was then calculated for the primary outcome.
Results
The mean calculated total RBC loss in the ABN and conventional group was 669.7 and 630.0 mL, respectively (p = 0.572). There was no significant difference between groups for other evaluated outcome parameters, including postoperative Hct level, drainage blood loss, or packed red cell transfusion volume. All patients in the conventional group required postoperative blood transfusion while 96.8% of patients in the ABN group were transfused.
Conclusions
The total RBC loss and volume of packed red cells transfusion were not significant difference between interventions, which suggest no benefit of the ABN system in reducing blood loss and transfusion in patients undergoing SBTKA.
Trial registration
The protocol of this study was registered in the Thai Clinical Trials Registry database no. TCTR20201126002 on 26/11/2020.
“…After a few simple registration steps, this device determines the lower limb alignment and suggests the resection plane in both the coronal and sagittal views with the capability of verifying or adjusting the resected surface as necessary. 11 12) Therefore, the ABN avoids the need for costly preoperative planning, does not require a bulky computer console and an infrared camera, precludes line-of-sight issues, and eliminates risks associated with the tracking pins. In addition, evidence demonstrated that the ABN is as accurate as the CAS, 13) and the learning curve for the ABN (5–7 cases required) is shorter than that for the CAS (20–30 cases required).…”
Background
Posttraumatic osteoarthritis (PTOA) frequently comprises femoral or tibial deformity, which makes it difficult to perform total knee arthroplasty (TKA). Accelerometer-based navigation (ABN) could be effective in restoring a neutral mechanical axis (MA) in TKA, but a limited number of studies have been reported in association with PTOA. Therefore, we aimed to compare the lower limb MA between ABN-assisted TKA (ABN-TKA) and conventional TKA in patients with PTOA.
Methods
We conducted a retrospective analysis of 28 PTOA patients who underwent TKA using a conventional system (cTKA group, n = 16) and the ABN system (iTKA group, n = 12). Standing long-leg radiographs were assessed for MA and prosthesis alignment as primary outcomes. A postoperative MA deviating beyond ± 3° was defined as an outlier. Perioperative outcomes, Oxford Knee Score (OKS) at 2-year follow-up, and complications were also assessed.
Results
The cTKA group and the iTKA group had a mean age of 63.07 years and 65.25 years, respectively. The iTKA group had significantly better MA accuracy when compared to the cTKA group (1.60° ± 2.09° vs. 3.59° ± 1.34°,
p
= 0.01). The iTKA group showed significantly less MA outlier than the cTKA group (78.6% vs. 25.0%,
p
= 0.02). The prosthesis alignment and OKS were comparable between the groups. There were 2 periprosthetic joint infections in the cTKA group and 1 periprosthetic fracture of the distal femur in the iTKA group.
Conclusions
For PTOA of the knee, both conventional TKA and ABN-TKA significantly improved the postoperative mechanical alignment and functional outcomes. The ABN-TKA seemed to offer higher accuracy and less MA outlier when compared to conventional TKA, and thus ABN could be a good alternative option.
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