Does the sequential addition of accelerometer-based navigation and sensor-guided ligament balancing improve outcomes...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Clinical Outcomes Research

Background:

• Patient dissatisfaction persists after total knee arthroplasty (TKA).
• Conventional instrumentation for TKA may have limitations in achieving optimal alignment and outcomes.
• Technological advancements aim to improve surgical precision and patient results.

Purpose of the Study:

• To evaluate if accelerometer-based navigation and sensor-guided ligament balancing enhance TKA outcomes.
• To compare complication rates, radiological alignment, and patient-reported outcomes (PROMs) with conventional TKA techniques.
• To determine the cost-effectiveness of advanced navigation and sensor technologies in TKA.

Main Methods:

• Retrospective cohort study of 371 total knee arthroplasties (TKAs).
• Comparison of a historical control group (conventional instrumentation) with two navigated groups (accelerometer-based femoral navigation and sensor-guided balancing).
• Assessment of PROMs (PROMIS, KOOS), radiological alignment, range of motion, and complications at 12 months postoperatively.

Main Results:

• No significant differences in PROMs, complication rates, or range of motion between conventional and navigated TKA groups.
• Slightly fewer mechanical axis outliers in navigated groups, but not statistically significant.
• No significant improvement in patient-reported outcomes or complication rates with added navigation and sensor technologies.

Conclusions:

• Sequential addition of navigation for femoral cuts and sensor-guided balancing did not improve short-term PROMs or radiological outcomes in TKA.
• These advanced technologies did not reduce complication rates compared to conventional TKA methods.
• The increased costs associated with these technologies may not be justified by the observed outcomes.