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The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee
Sachiyuki Tsukada1, Hiroyuki Ogawa2, Masayoshi Saito1
1Department of Orthopaedic Surgery, Hokusuikai Kinen Hospital, 3-2-1 Higashihara, Mito, Ibaraki, 310-0035, Japan.
Background:
Tibial rotational alignment is the most prone to error among the placement angles of the prosthesis in total knee arthroplasty (TKA). The augmented reality (AR)-aided navigation system enables surgeons to visualize the tibial anteroposterior axis established on the pre-resection surface superimposed on the bone surface after proximal tibial resection.
Methods:
We compared the axial, coronal, and sagittal alignments of the tibial baseplate between 58 TKAs performed using an AR-aided navigation system and 64 TKAs in which the rotational alignment was determined manually. To assess alignment, the three-dimensional coordinates of the lower limb from preoperative CT data were overlaid onto postoperative CT data using a surface-matching algorithm.
Results:
The absolute difference between the anteroposterior axis and the rotational angle of the tibial baseplate was significantly smaller in the AR-aided group compared to the control group (3.7 ± 3.4° vs. 5.1 ± 4.4°, p = 0.047). In both coronal and sagittal alignments, the absolute differences between the target angle and the measured angle were not significantly different between the two groups (1.1 ± 0.9° vs. 1.2 ± 1.0°, p = 0.75 in coronal alignment, and 1.9 ± 1.3° vs. 1.7 ± 1.4°, p = 0.43 in sagittal alignment, respectively).
Conclusions:
The AR-aided navigation system slightly but significantly improved the accuracy of tibial rotational alignment.
