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

摘要

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.