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In Vitro Application of a Wireless Sensor in Flexion-Extension Gap Balance of Unicompartmental Knee Arthroplasty
Published on: May 5, 2023
749
No Benefit to Sensor-guided Balancing Compared With Freehand Balancing in TKA: A Randomized Controlled Trial
Nana O Sarpong1, Michael B Held, Matthew J Grosso
1Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Clinical Orthopaedics and Related Research
|April 8, 2022
Summary
This study found that using sensor-guided devices for total knee arthroplasty (TKA) soft tissue balancing did not improve patient outcomes like knee range of motion (ROM) or patient-reported outcome measures (PROMs) compared to traditional freehand techniques. The sensor-guided approach led to longer operative times without significant clinical benefits.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Clinical trials
Background:
- Traditional total knee arthroplasty (TKA) relies on subjective surgeon feedback for soft tissue balancing.
- Objective feedback methods using sensor-guided devices have been proposed but their impact on patient outcomes remains unclear.
Purpose of the Study:
- To compare the effectiveness of sensor-guided versus freehand soft tissue balancing in TKA.
- To evaluate knee range of motion (ROM), patient-reported outcome measures (PROMs), and surgical parameters at a minimum of 2 years postoperatively.
Main Methods:
- A randomized controlled trial (RCT) involving 130 patients undergoing primary TKA for osteoarthritis.
- Patients were randomized to either freehand balancing or sensor-guided balancing using a device with a wireless sensor.
- Outcomes including knee ROM, SF-12, WOMAC, Knee Society Functional Scores (KSFS), operative time, and length of stay (LOS) were assessed at 3 months, 1 year, and 2 years.
Main Results:
- No significant differences were observed in knee ROM or PROMs between the sensor-guided and freehand groups at any follow-up point.
- Operative time was significantly longer in the sensor-guided group (107 minutes) compared to the freehand group (84 minutes).
- No differences were found in length of stay, surgical complications, or reoperation rates between the groups.
Conclusions:
- Sensor-guided devices for soft tissue balancing in TKA do not offer additional benefits in knee ROM, PROMs, or clinical outcomes at 2 years postoperatively.
- The increased operative time and associated costs of sensor-guided devices suggest they should not be routinely used by experienced surgeons.
- Further research may explore specific patient populations or surgical scenarios where sensor-guided balancing could be advantageous.
