Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis
Abstract Background The accelerometer-based navigation (ABN) system is an emerging navigation system for total knee arthroplasty (TKA). This study aimed to determine whether the ABN system could improve the accuracy of mechanical alignment, component positioning, and short-term clinical outcomes for...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13018-019-1258-y |
| _version_ | 1818007636421902336 |
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| author | Xiang Gao Yu Sun Zhao-He Chen Tian-Xu Dou Qing-Wei Liang Xu Li |
| author_facet | Xiang Gao Yu Sun Zhao-He Chen Tian-Xu Dou Qing-Wei Liang Xu Li |
| author_sort | Xiang Gao |
| collection | DOAJ |
| description | Abstract Background The accelerometer-based navigation (ABN) system is an emerging navigation system for total knee arthroplasty (TKA). This study aimed to determine whether the ABN system could improve the accuracy of mechanical alignment, component positioning, and short-term clinical outcomes for TKA when compared to conventional instruments (CON). Methods A total of 204 patients were selected and divided into two groups (CON: 135, ABN: 69) after applying the inclusion and exclusion criteria. Then, 1:1 propensity score matching was performed for age, gender, body mass index, hip-knee-ankle angle (HKA), Knee Society Score (KSS), Western Ontario and McMaster Universities (WOMAC) score, and follow-up times. A total of 82 consecutive patients (82 knees) underwent total knee arthroplasty using ABN (n = 41) or CON (n = 41) were enrolled in this study. The postoperative HKA, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, lateral femoral flexion (LFF) angle, and lateral tibial component (LTC) angle were compared between the two groups to evaluate mechanical alignment and component positioning. Additional clinical parameters, including haemoglobin reduction, the KSS, and the WOMAC score, were assessed at the final follow-up (the mean follow-up period was 20.9 months in the CON group and 21.2 months in the ABN group). Results The ABN group had a significantly improved mean absolute deviation of HKA (P = 0.033), FFC (P = 0.004), FTC (P = 0.017), LFF (P = 0.023), and LTC (P = 0.031) compared to those of the CON group. The numbers of FFCs and LTCs within 3° were significantly different (P = 0.021, P = 0.023, respectively) between the two groups. However, no differences in the numbers of FTCs within 3° (P = 0.166) and LFF within 3° (P = 0.556) were found. The ABN group had a significantly higher KS function score (P = 0.032), and the pain and stiffness scores were significantly different (P = 0.034, P = 0.020, respectively) between the two groups. Moreover, the ABN system could reduce hidden blood loss postoperatively. However, no difference was found in the KS knee score and the total WOMAC score between the two groups. Conclusion This study demonstrates that ABN system improved TKA mechanical alignment and component positioning and decreased the hidden blood loss postoperatively compared to conventional instruments. However, no significant differences were found in short-term clinical outcomes between ABN and conventional instruments at the final follow-up. However, whether this system contributes to revision rates and long-term clinical outcomes requires further study. |
| first_indexed | 2024-04-14T05:19:09Z |
| format | Article |
| id | doaj.art-20dd53da21bd4206987c2806533e2894 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-14T05:19:09Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-20dd53da21bd4206987c2806533e28942022-12-22T02:10:16ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2019-07-011411910.1186/s13018-019-1258-yComparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysisXiang Gao0Yu Sun1Zhao-He Chen2Tian-Xu Dou3Qing-Wei Liang4Xu Li5Department of Orthopedics, The First Hospital of China Medical UniversityDepartment of Orthopedics, The First Hospital of China Medical UniversityDepartment of Orthopedics, The First Hospital of China Medical UniversityDepartment of Orthopedics, The First Hospital of China Medical UniversityDepartment of Orthopedics, The First Hospital of China Medical UniversityDepartment of Orthopedics, The First Hospital of China Medical UniversityAbstract Background The accelerometer-based navigation (ABN) system is an emerging navigation system for total knee arthroplasty (TKA). This study aimed to determine whether the ABN system could improve the accuracy of mechanical alignment, component positioning, and short-term clinical outcomes for TKA when compared to conventional instruments (CON). Methods A total of 204 patients were selected and divided into two groups (CON: 135, ABN: 69) after applying the inclusion and exclusion criteria. Then, 1:1 propensity score matching was performed for age, gender, body mass index, hip-knee-ankle angle (HKA), Knee Society Score (KSS), Western Ontario and McMaster Universities (WOMAC) score, and follow-up times. A total of 82 consecutive patients (82 knees) underwent total knee arthroplasty using ABN (n = 41) or CON (n = 41) were enrolled in this study. The postoperative HKA, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, lateral femoral flexion (LFF) angle, and lateral tibial component (LTC) angle were compared between the two groups to evaluate mechanical alignment and component positioning. Additional clinical parameters, including haemoglobin reduction, the KSS, and the WOMAC score, were assessed at the final follow-up (the mean follow-up period was 20.9 months in the CON group and 21.2 months in the ABN group). Results The ABN group had a significantly improved mean absolute deviation of HKA (P = 0.033), FFC (P = 0.004), FTC (P = 0.017), LFF (P = 0.023), and LTC (P = 0.031) compared to those of the CON group. The numbers of FFCs and LTCs within 3° were significantly different (P = 0.021, P = 0.023, respectively) between the two groups. However, no differences in the numbers of FTCs within 3° (P = 0.166) and LFF within 3° (P = 0.556) were found. The ABN group had a significantly higher KS function score (P = 0.032), and the pain and stiffness scores were significantly different (P = 0.034, P = 0.020, respectively) between the two groups. Moreover, the ABN system could reduce hidden blood loss postoperatively. However, no difference was found in the KS knee score and the total WOMAC score between the two groups. Conclusion This study demonstrates that ABN system improved TKA mechanical alignment and component positioning and decreased the hidden blood loss postoperatively compared to conventional instruments. However, no significant differences were found in short-term clinical outcomes between ABN and conventional instruments at the final follow-up. However, whether this system contributes to revision rates and long-term clinical outcomes requires further study.http://link.springer.com/article/10.1186/s13018-019-1258-yPrimary total knee arthroplastyAccelerometer-based navigationSurgical techniqueMechanical axisBlood loss |
| spellingShingle | Xiang Gao Yu Sun Zhao-He Chen Tian-Xu Dou Qing-Wei Liang Xu Li Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis Journal of Orthopaedic Surgery and Research Primary total knee arthroplasty Accelerometer-based navigation Surgical technique Mechanical axis Blood loss |
| title | Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis |
| title_full | Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis |
| title_fullStr | Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis |
| title_full_unstemmed | Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis |
| title_short | Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis |
| title_sort | comparison of the accelerometer based navigation system with conventional instruments for total knee arthroplasty a propensity score matched analysis |
| topic | Primary total knee arthroplasty Accelerometer-based navigation Surgical technique Mechanical axis Blood loss |
| url | http://link.springer.com/article/10.1186/s13018-019-1258-y |
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