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Alignment analysis of Brainlab knee 3 navigation-guided total knee arthroplasty using the adjusted mechanical method
Yuqi Pan1, Bowei Jiang1, Yige Li2
1Department of Joint Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Frontiers in Surgery
|November 25, 2022
Summary
Brainlab Knee3 navigation-guided total knee arthroplasty using the Adjusted Mechanical Alignment (AMA) principle significantly improved hip-knee-ankle angle and medial proximal tibia angle. This navigation technique offers reliable control of lower limb coronal alignment.
Area of Science:
- Orthopedic Surgery
- Medical Technology
- Biomechanical Engineering
Background:
- Navigation technology in Total Knee Arthroplasty (TKA) aims to enhance lower limb alignment.
- Brainlab Knee3 represents a novel software solution for navigated TKA, addressing existing challenges.
- The Adjusted Mechanical Alignment (AMA) principle prioritizes soft tissue balance during TKA procedures.
Purpose of the Study:
- To evaluate lower limb alignment changes in patients undergoing Brainlab Knee3 navigation-guided TKA using the AMA method.
- To assess the efficacy of the Brainlab Knee3 system in achieving desired coronal plane alignment.
- To determine if the AMA principle in navigated TKA leads to significant improvements in key alignment parameters.
Main Methods:
- A cohort of 50 patients undergoing TKA with the Brainlab Knee3 system was studied.
- Preoperative and postoperative full-length lower limb X-rays were used to measure Hip-Knee-Ankle Angle (HKAA), Femur Tibia Angle (FTA), Lateral Distal Femoral Angle (LDFA), and medial proximal tibia angle (MPTA).
- Statistical analysis, including paired t-tests and Wilcoxon tests, was performed to compare preoperative and postoperative alignment.
Main Results:
- A statistically significant improvement was observed in the Hip-Knee-Ankle Angle (HKAA) post-surgery (P=0.000).
- The medial proximal tibia angle (MPTA) also showed a statistically significant improvement (P=0.000).
- No statistically significant differences were found in the Femur Tibia Angle (FTA) (P=0.140) or Lateral Distal Femoral Angle (LDFA) (P=0.052).
Conclusions:
- The AMA alignment technique applied with Brainlab Knee3 navigation-assisted TKA effectively controls knee alignment in the coronal plane.
- This navigated approach, prioritizing soft tissue balance, demonstrates reliability in achieving improved lower limb alignment.
- Minimally adjusted osteotomy angles based on soft tissue status reduce the need for extensive soft tissue release.
