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The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty

BACKGROUND: This study aimed to determine whether the accelerometer-based navigation (ABN) could improve the accuracy of restoring mechanical axis (MA), component positioning, and clinical outcomes compared to conventional (CON) total knee arthroplasty (TKA). METHODS: A total of 301 consecutive pati...

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Autores principales: Gao, Jiaxiang, Hou, Yunfei, Li, Rujun, Ke, Yan, Li, Zhichang, Lin, Jianhao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045229/
https://www.ncbi.nlm.nih.gov/pubmed/33849489
http://dx.doi.org/10.1186/s12891-021-04213-9
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author Gao, Jiaxiang
Hou, Yunfei
Li, Rujun
Ke, Yan
Li, Zhichang
Lin, Jianhao
author_facet Gao, Jiaxiang
Hou, Yunfei
Li, Rujun
Ke, Yan
Li, Zhichang
Lin, Jianhao
author_sort Gao, Jiaxiang
collection PubMed
description BACKGROUND: This study aimed to determine whether the accelerometer-based navigation (ABN) could improve the accuracy of restoring mechanical axis (MA), component positioning, and clinical outcomes compared to conventional (CON) total knee arthroplasty (TKA). METHODS: A total of 301 consecutive patients (ABN: 27, CON: 274) were included. A 1:4 propensity score matching (PSM) was performed between the two groups according to preoperative demographic and clinical parameters. The postoperative MA, femoral coronal angle (FCA), femoral sagittal angle (FSA), tibial coronal angle (TCA) and tibial sagittal angle (TSA) were compared. Absolute deviations of aforementioned angles were calculated as the absolute value of difference between the exact and ideal value and defined as norms if within 3°, otherwise regarded as outliers. Additional clinical parameters, including the Knee Society knee and function scores (KSKS and KSFS) and range of motion (ROM), were assessed at final follow-up (FU) (mean FU was 21.88 and 21.56 months respectively for ABN and CON group). A secondary subgroup analysis and comparison on clinical outcomes were conducted between norms and outliers in different radiological parameters. RESULTS: A total of 98 patients/102 knees were analyzed after the PSM (ABN: 21 patients/24 knees, CON: 77 patients/78 knees). In the ABN group, the mean MA, FCA and TSA were significantly improved (p = 0.019, 0.006, < 0.001, respectively). Proportions of TKAs within a ± 3°deviation were significantly improved in all the postoperative radiological variables except for TCA (p = 0.003, 0.021, 0.042, 0.013, respectively for MA, FCA, FSA, and TSA). The absolute deviations of FSA and TSA were also significantly lower in the ABN group (p = 0.020, 0.048, respectively). No significant differences were found in either mean value, absolute deviation or outlier ratio of TCA between two groups. On clinical outcomes, there were no significant differences between two groups, although KSKS, KSFS and ROM (p < 0.01, respectively) dramatically improved compared to baseline. The subgroup analysis also demonstrated no statistical difference on clinical outcomes between the outliers and norms in varied radiological parameters. CONCLUSIONS: The ABN could improve the accuracy and precision of mechanical alignment and component positioning without significant improvement of clinical outcomes. Further high quality studies with long term FU are warranted to comprehensively evaluate the value of the ABN.
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spelling pubmed-80452292021-04-14 The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty Gao, Jiaxiang Hou, Yunfei Li, Rujun Ke, Yan Li, Zhichang Lin, Jianhao BMC Musculoskelet Disord Research Article BACKGROUND: This study aimed to determine whether the accelerometer-based navigation (ABN) could improve the accuracy of restoring mechanical axis (MA), component positioning, and clinical outcomes compared to conventional (CON) total knee arthroplasty (TKA). METHODS: A total of 301 consecutive patients (ABN: 27, CON: 274) were included. A 1:4 propensity score matching (PSM) was performed between the two groups according to preoperative demographic and clinical parameters. The postoperative MA, femoral coronal angle (FCA), femoral sagittal angle (FSA), tibial coronal angle (TCA) and tibial sagittal angle (TSA) were compared. Absolute deviations of aforementioned angles were calculated as the absolute value of difference between the exact and ideal value and defined as norms if within 3°, otherwise regarded as outliers. Additional clinical parameters, including the Knee Society knee and function scores (KSKS and KSFS) and range of motion (ROM), were assessed at final follow-up (FU) (mean FU was 21.88 and 21.56 months respectively for ABN and CON group). A secondary subgroup analysis and comparison on clinical outcomes were conducted between norms and outliers in different radiological parameters. RESULTS: A total of 98 patients/102 knees were analyzed after the PSM (ABN: 21 patients/24 knees, CON: 77 patients/78 knees). In the ABN group, the mean MA, FCA and TSA were significantly improved (p = 0.019, 0.006, < 0.001, respectively). Proportions of TKAs within a ± 3°deviation were significantly improved in all the postoperative radiological variables except for TCA (p = 0.003, 0.021, 0.042, 0.013, respectively for MA, FCA, FSA, and TSA). The absolute deviations of FSA and TSA were also significantly lower in the ABN group (p = 0.020, 0.048, respectively). No significant differences were found in either mean value, absolute deviation or outlier ratio of TCA between two groups. On clinical outcomes, there were no significant differences between two groups, although KSKS, KSFS and ROM (p < 0.01, respectively) dramatically improved compared to baseline. The subgroup analysis also demonstrated no statistical difference on clinical outcomes between the outliers and norms in varied radiological parameters. CONCLUSIONS: The ABN could improve the accuracy and precision of mechanical alignment and component positioning without significant improvement of clinical outcomes. Further high quality studies with long term FU are warranted to comprehensively evaluate the value of the ABN. BioMed Central 2021-04-13 /pmc/articles/PMC8045229/ /pubmed/33849489 http://dx.doi.org/10.1186/s12891-021-04213-9 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Gao, Jiaxiang
Hou, Yunfei
Li, Rujun
Ke, Yan
Li, Zhichang
Lin, Jianhao
The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title_full The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title_fullStr The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title_full_unstemmed The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title_short The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
title_sort accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8045229/
https://www.ncbi.nlm.nih.gov/pubmed/33849489
http://dx.doi.org/10.1186/s12891-021-04213-9
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