scholarly journals Similar radiological results with accelerometer-based navigation versus conventional technique in total knee arthroplasty

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877237 ◽  
Author(s):  
Ing How Moo ◽  
Jerry Yong Qiang Chen ◽  
Dickson Hong Him Chau ◽  
See Wei Tan ◽  
Adrian Cheng Kiang Lau ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Conventional Method ◽  
Knee Arthroplasty ◽  
Lower Limb ◽  
Mechanical Axis ◽  
Computer Assisted ◽  
Mechanical Alignment ◽  
Component Placement ◽  
Duration Of Surgery ◽  
Total Knee

Background: The Zimmer iASSIST system is an accelerometer-based, portable navigation device for total knee arthroplasty (TKA) that does not require the use of a large console for alignment feedback as required in computer-assisted surgery. The purpose of this study was to determine the accuracy of the accelerometer-based system in component positioning and overall mechanical alignment. Methods: Two groups of 30 patients each with primary osteoarthritis underwent TKA using either conventional method or Zimmer iASSIST navigation in 2013 was retrospectively studied. Patients were matched according to body mass index (BMI), gender and age. A senior arthroplasty surgeon performed all the operation using the same surgical approach. Perioperative and post-operative regimens were the same. All patients had standardized radiographs performed post-operatively to determine the lower limb mechanical alignment and component placement. Results: There was no difference between the two groups for age, BMI, gender, side of operated knee and preoperative mechanical axis ( p > 0.05). There was no difference in the proportion of outliers for mechanical axis ( p = 0.38), coronal femoral angle ( p = 0.50), coronal tibia angle ( p = 0.11), sagittal femoral angle ( p = 0.28) and sagittal tibia angle ( p = 0.33). The duration of surgery, post-operative drop in haemoglobin level and transfusion incidence did not show statistically significant differences between the two groups ( p > 0.05). Conclusions: Our article showed that iASSIST was safe and remains a useful tool to restore mechanical axis. However, our data demonstrated no difference in lower limb alignment and component placement between the TKA that used accelerometer-based system and those that underwent conventional method.

scholarly journals Bone Cement Solidifiliation Influence the Limb Alignment and Gap Balance during TKA

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Dongquan Shi ◽  
Xingquan Xu ◽  
Anyun Guo ◽  
Jin Dai ◽  
Zhihong Xu ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Bone Cement ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Statistical Significance ◽  
Mechanical Alignment ◽  
Early Loosening ◽  
Flexion Extension ◽  
Before And After ◽  
Total Knee

Introduction. Mechanical alignment deviation after total knee arthroplasty is a major reason for early loosening of the prosthesis. Achieving optimum cement penetration during fixation of the femoral and tibial component is an essential step in performing a successful total knee arthroplasty. Bone cement is used to solidify the bone and prosthesis. Thickness imbalance of bone cement leads to the deviation of mechanical alignment. To estimate the influence of bone cement, a retrospective study was conducted.Materials and Methods. A total of 36 subjects were studied. All the TKA were performed following the standard surgical protocol for navigated surgery by medial approach with general anaesthesia. Prostheses were fixed by bone cement.Results. We compared the mechanical axis, flexion/extension, and gap balance before and after cementation. All the factors were different compared with those before and after cementation. Internal rotation was reached with statistical significance (P=0.03).Conclusion. Bone cement can influence the mechanical axis, flexion/extension, and gap balance. It also can prompt us to make a change when poor knee kinematics were detected before cementation.

Computer-Assisted Navigation Increases Precision of Component Placement in Total Knee Arthroplasty

2005 ◽  
Vol &NA; (433) ◽  
pp. 152-159 ◽  
Author(s):  
Rolf G Haaker ◽  
Martin Stockheim ◽  
Michael Kamp ◽  
Gunnar Proff ◽  
Johannes Breitenfelder ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Computer Assisted ◽  
Component Placement ◽  
Assisted Navigation ◽  
Total Knee

scholarly journals Change in mechanical axis alignment highly correlates with increased limb loading after total knee arthroplasty

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0001
Author(s):  
Hagen Hommel
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Lower Limb ◽  
Mechanical Axis ◽  
Weight Bearing ◽  
Complete Extension ◽  
Limb Loading ◽  
Axis Alignment ◽  
Total Knee ◽  
Long Leg Radiographs

Mechanical axis of the lower limb assessed in standing long-leg radiographs was demonstrated to change within the first three postoperative months after total knee arthroplasty (TKA). The underlying mechanism including the influence of limb loading for the change in mechanical axis alignment after TKA has not been evaluated so far. Mechanical axis of the lower limb and limb loading were evaluated in 115 patients 10 days and 12 weeks after TKA. Mechanical axis was measured in standing long-leg radiographs while limb loading was simultaneously assessed using a scale. Absolute and relative limb loading with their correlation to the mechanical axis were calculated. Mechanical axis in patients with postoperative complete extension (n = 100) changed from an initial -0.82° ± 1.9° valgus alignment to a varus axis of +0.6° ± 1.5 (p < 0.01). This change in alignment was accompanied by an increased limb loading from 89.9% 10.7% to 93.0% 7.0% (p < 0.01). The mechanical axis highly/significantly correlated with relative limb loading in both measurements (r = 0.804, p < 0.001 respectively r = 0.562, p < 0.001). These alterations and distinctions were much more pronounced in patients with postoperative incomplete extension. Mechanical axis of the leg significantly changes while limb loading increases within the first three postoperative months after TKA. The postoperative alignment highly correlates with the loading of the lower limb. Therefore, the actual mechanical axis can only be assessed at physiological limb loading in long-leg radiographs at complete extension with full weight bearing.

scholarly journals Comparison of Total Knee Arthroplasty Using Computer-Assisted Navigation versus Conventional Guiding Systems: A Prospective Study

2009 ◽  
Vol 17 (2) ◽  
pp. 170-173 ◽  
Author(s):  
CH Pang ◽  
WL Chan ◽  
CH Yen ◽  
SC Cheng ◽  
SB Woo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Varus Deformity ◽  
Osteoarthritis Of The Knee ◽  
Computer Assisted ◽  
Assisted Navigation ◽  
Alignment Correction ◽  
Total Knee ◽  
A Prospective Study

Purpose. To compare knee alignments in total knee arthroplasty (TKA) using computer-assisted navigation versus conventional guiding systems. Methods. Five men and 49 women aged 49 to 79 years underwent TKA for primary osteoarthritis of the knee with varus deformity. All valgus knees were associated with inflammatory arthritis and thus excluded. Computer-assisted navigation was used for the first 35 TKAs, whereas conventional extramedullary tibial and intramedullary femoral guiding systems were used for the next 35 TKAs. The mechanical axis, coronal tibial and femoral angles, sagittal tibial and femoral angles in the 2 groups were compared. Results. Sagittal tibial and femoral angles aligned more optimally in TKAs using computer-assisted navigation. In the respective computer-assisted navigation and conventional guiding systems, 33 (94%) and 26 (74%) of the TKAs attained a postoperative mechanical axis of <3° varus/valgus. Conclusion. Computer-assisted navigation gives a more consistent alignment correction and reduces outliers during implant positioning.

scholarly journals Reliable Alignment in Total Knee Arthroplasty by the Use of an iPod-Based Navigation System

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Paola Koenen ◽  
Marco M. Schneider ◽  
Matthias Fröhlich ◽  
Arne Driessen ◽  
Bertil Bouillon ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Navigation System ◽  
Mean Difference ◽  
Computer Assisted ◽  
Good Precision ◽  
Axial Alignment ◽  
Duration Of Surgery ◽  
Total Knee ◽  
The Mean

Axial alignment is one of the main objectives in total knee arthroplasty (TKA). Computer-assisted surgery (CAS) is more accurate regarding limb alignment reconstruction compared to the conventional technique. The aim of this study was to analyse the precision of the innovative navigation system DASH® by Brainlab and to evaluate the reliability of intraoperatively acquired data. A retrospective analysis of 40 patients was performed, who underwent CAS TKA using the iPod-based navigation system DASH. Pre- and postoperative axial alignment were measured on standardized radiographs by two independent observers. These data were compared with the navigation data. Furthermore, interobserver reliability was measured. The duration of surgery was monitored. The mean difference between the preoperative mechanical axis by X-ray and the first intraoperatively measured limb axis by the navigation system was 2.4°. The postoperative X-rays showed a mean difference of 1.3° compared to the final navigation measurement. According to radiographic measurements, 88% of arthroplasties had a postoperative limb axis within ±3°. The mean additional time needed for navigation was 5 minutes. We could prove very good precision for the DASH system, which is comparable to established navigation devices with only negligible expenditure of time compared to conventional TKA.

scholarly journals Clinical outcomes of computer-assisted total knee arthroplasty using pinless navigation

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668431
Author(s):  
Lei Jiang ◽  
Jerry Yongqiang Chen ◽  
Hwei-Chi Chong ◽  
Shi-Lu Chia ◽  
Ngai-Nung Lo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Clinical Outcomes ◽  
Knee Arthroplasty ◽  
Oxford Knee Score ◽  
Computer Assisted Surgery ◽  
Computer Assisted ◽  
Retrospective Case ◽  
Duration Of Surgery ◽  
Total Knee ◽  
Cas A

This study aims to evaluate the 2-year post-operative clinical outcomes of patients undergoing total knee arthroplasty (TKA) with computer-assisted surgery (CAS) using the pinless BrainLAB® VectorVision® Knee 2.5 Navigation System versus standard CAS. A retrospective case–control study of 200 patients who underwent TKA with CAS from 2008 to 2012 was conducted. Patients in the pinless arm underwent a shorter duration of surgery compared to the standard CAS arm with 72 ± 13 min and 83 ± 11 min, respectively ( p < 0.001), with improvement in Oxford Knee Score from 34 ± 8 to 18 ± 5 and 34 ± 9 to 18 ± 5, respectively, without statistically significant differences in clinical outcomes at 2 years.

scholarly journals Systematic Review of Accelerometer Based Navigation in Total Knee Arthroplasty: Improved Alignment, Clinical Results, and Patient Reported Outcomes Compared to Conventional Guides?

2020 ◽  
pp. 1-8
Author(s):  
Stephen T. Duncan ◽  
Stephen T. Duncan ◽  
Cale Jacobs ◽  
Lucian Warth ◽  
Syed K. Mehdi
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Knee Arthroplasty ◽  
Operative Time ◽  
Mechanical Axis ◽  
Mechanical Alignment ◽  
Estimated Blood Loss ◽  
Patient Reported ◽  
Total Knee

Background: There have been significant advancements to restore knee alignment postoperatively in the TKA population. This includes the use of accelerometer-based portable navigation (ABN). ABN can lead to a more precise restoration of the neutral mechanical axis, improve efficiency and potentially decrease early- and long-term complications. The degree with which ABN can achieve this remains unclear. We performed a systematic review to answer this question. Methods: We performed a systematic review in accordance with Cochrane guidelines of controlled studies (prospective and retrospective) in MEDLINE with an emphasis on studies comparing postoperative outcomes such as mechanical axis alignment, operative time, blood loss, complications and clinical outcome scores in total knee arthroplasty patients using ABN versus conventional intramedullary guides. Results: ABN was associated with significantly fewer outliers in hip-knee-ankle alignment (p = 0.0006), femoral component alignment (p < 0.0001). ABN was associated with significantly less estimated blood loss (p = 0.05) and no difference in operative times (p = 0.21). Finally, there was no difference regarding functional outcomes or DVT. Conclusion: ABN more accurately achieves neutral mechanical alignment with a smaller incidence of outliers. There was not an increase in operative time with using ABN and there were reductions in blood loss as well. We conclude that ABN offers the benefit of improved mechanical alignment.

How Frequently Do Five Total Arthroplasty Methods Change the Alignment of the Joint Lines and Limb From Normal?

2012 ◽  
Author(s):  
Yu S. Gu ◽  
Joshua D. Roth ◽  
Stephen M. Howell ◽  
Maury L. Hull
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Mechanical Axis ◽  
Joint Line ◽  
Coronal Plane ◽  
Mechanical Alignment ◽  
Gap Balancing ◽  
Total Arthroplasty ◽  
Straight Line ◽  
Total Knee

One strategy for aligning the limb and positioning components in total knee arthroplasty (TKA) in the coronal plane is mechanical alignment, which has the goal of positioning the center of the hip, knee, and ankle on a straight-line by establishing a femoral and tibial joint line at the knee that is perpendicular to the mechanical axis of the femur and tibia respectively. Another strategy is gap balancing, which has the goal of creating equal gaps between the medial and lateral compartments at 0° of extension and 90° of flexion.

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