An accelerometer-based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Medical Imaging

Background:

• Total knee arthroplasty (TKA) aims to restore joint function and alignment.
• Accurate prosthetic alignment is crucial for optimal TKA outcomes.
• Conventional TKA techniques may have limitations in achieving precise alignment.

Purpose of the Study:

• To compare prosthetic alignment accuracy in TKA using a novel accelerometer-based portable navigation system (KneeAlign2) versus conventional instrumentation.
• To evaluate the impact of the navigation system on femoral and tibial component placement in three planes (coronal, sagittal, axial).

Main Methods:

• 159 patients with knee osteoarthritis and varus deformity underwent TKA.
• The KneeAlign2 system was used in 78 knees; conventional methods in 81 knees.
• Three-dimensional (3D) CT scans assessed prosthetic alignment; operation time, blood loss, DVT, and PE were also evaluated.

Main Results:

• The navigation group showed significantly better femoral coronal alignment (1.2° vs. 1.6°, p=0.03).
• Femoral component outliers were reduced with navigation: 3% vs. 15% (coronal, p<0.01) and 15% vs. 43% (sagittal, p<0.01).
• No significant differences were found in tibial alignment, operation time, blood loss, or complication rates (DVT, PE).

Conclusions:

• Accelerometer-based navigation systems can decrease prosthetic alignment outliers in the femoral component during TKA.
• This technology offers improved accuracy without compromising safety or increasing operative burden.
• This is the first study to validate an accelerometer-based navigation system for TKA using 3D measurements.