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Archives of Orthopaedic and Trauma Surgery

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01-04-2019 | Knee Arthroplasty

An accelerometer-based navigation did not improve the femoral component positioning compared to a modified conventional technique of pre-operatively planned placement of intramedullary rod in total knee arthroplasty

Authors: Tadashi Tsukeoka, Yoshikazu Tsuneizumi, Kensuke Yoshino

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2019

Abstract

Introduction

Although the most commonly used method of femoral component alignment in total knee arthroplasty (TKA) is intramedullary (IM) guides, this method demonstrated a limited degree of accuracy. Because of the femoral anterior bowing, the tip of the guide rod will impinge on the anterior cortex if a long rod is inserted. We hypothesized that the pre-operative planned insertion depth of the rod could increase the accuracy of the femoral component positioning in conventional TKA (modified conventional technique). Accelerometer-based, portable navigation device has been postulated to have better accuracy than conventional TKA in component positioning. The purpose of this study was to compare the post-operative femoral component alignment of TKA using the modified conventional technique with the accelerometer-based navigation.

Materials and methods

Fifty-five knees underwent TKA using the modified conventional technique and femoral component positioning was compared with 55 knees performed using the accelerometer-based navigation device. The femoral component alignment was evaluated with a CT-based three-dimensional software.

Results

The mean absolute deviation from targeted alignment in the sagittal plane was significantly less in the modified conventional cohort than in the accelerometer-based navigation cohort (1.1° vs 2.6°, P < 0.001). In the modified conventional cohort, 96.4% had an alignment within 3° of a targeted angle in the coronal plane (vs 89.1% with the accelerometer-based navigation, P = 0.14), and 96.4% in the sagittal plane (vs 74.5% with the accelerometer-based navigation, P < 0.001).

Conclusion

The modified conventional technique is a simple and equal to or more accurate method than the accelerometer-based navigation in positioning the femoral component in TKA at a mid-volume hospital.

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Title: An accelerometer-based navigation did not improve the femoral component positioning compared to a modified conventional technique of pre-operatively planned placement of intramedullary rod in total knee arthroplasty
Authors: Tadashi Tsukeoka
Yoshikazu Tsuneizumi
Kensuke Yoshino
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03147-1

At a glance: The STEP trials

Springer Medicine

An accelerometer-based navigation did not improve the femoral component positioning compared to a modified conventional technique of pre-operatively planned placement of intramedullary rod in total knee arthroplasty

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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