Comparison of Coronal Prosthetic Alignment After Total Knee Arthroplasty Using 3 Computer-Assisted Navigation Systems

Area of Science:

• Orthopedic surgery
• Medical device technology
• Biomechanical analysis

Background:

• Accurate component implantation is crucial for successful total knee arthroplasty (TKA).
• Surgical navigation systems offer potential improvements in TKA accuracy.
• Limited comparative data exists on the accuracy of different navigation systems.

Purpose of the Study:

• To compare the postoperative coronal alignment accuracy of three distinct surgical navigation systems in TKA.
• To evaluate the rate of outliers beyond 3 degrees in coronal alignment across navigation and conventional TKA groups.

Main Methods:

• A comparative study involving 90 TKA patients divided into three navigation groups (Stryker, OrthoPilot, VectorVision) and one conventional (non-navigation) control group.
• Postoperative coronal mechanical axis, femoral, and tibial component angles were assessed using long-leg standing radiographs.
• The primary outcome measure was the proportion of outliers exceeding 3 degrees from the ideal coronal alignment.

Main Results:

• No significant differences were found in the mean femoral and tibial component angles among the four groups.
• The conventional TKA group exhibited a significantly higher proportion of outliers beyond 3 degrees compared to all three navigation groups.
• No significant differences in outlier rates were observed among the Stryker, OrthoPilot, and VectorVision navigation systems.

Conclusions:

• The three evaluated navigation systems (Stryker, OrthoPilot, VectorVision) provide equally accurate coronal mechanical alignment in TKA.
• Surgical navigation systems significantly reduce outliers in coronal alignment compared to the conventional surgical method.
• These navigation technologies enhance the precision of component implantation in total knee arthroplasty.