1
|
Bäthis H, Perlick L, Beckmann J, Grifka J. [Trends in navigation-handheld systems]. ORTHOPADIE (HEIDELBERG, GERMANY) 2024; 53:85-92. [PMID: 38191756 DOI: 10.1007/s00132-023-04463-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/10/2024]
Abstract
Navigation-assisted surgical procedures in orthopedics and trauma surgery have become increasingly widespread over the last 20 years. In addition to applications in spinal surgery, they are primarily available for knee and hip endoprosthetics. On the one hand, computer-assisted procedures have been increasingly expanded with robotic assistance systems in recent years, and on the other hand, so-called handheld navigation systems have been developed, which enable specialized use directly in the operating field at lower acquisition costs. The aim of this overview is to describe current handheld systems and to present the respective technical principles and the available scientific results. Three handheld systems for TKA use, two for THA use and one system to support pedicle screw placement on the spine are presented.
Collapse
Affiliation(s)
- Holger Bäthis
- Lehrstuhl für Orthopädie für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland.
- Klinik für Orthopädie, Unfallchirurgie und Sporttraumatologie, Kliniken Stadt Köln gGmbH, Klinikum Köln-Merheim, Lehrstuhl der Universität Witten-Herdecke, Ostmerheimer Str. 200, 51109, Köln, Deutschland.
| | - Lars Perlick
- Lehrstuhl für Orthopädie für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland
- Klinik für Orthopädie und Unfallchirurgie, Asklepios Paulinen Klinik, Wiesbaden, Deutschland
| | - Johannes Beckmann
- Lehrstuhl für Orthopädie für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland
- Klinik für Orthopädie und Unfallchirurgie, Krankenhaus Barmherzige Brüder München, München, Deutschland
| | - Joachim Grifka
- Lehrstuhl für Orthopädie für die Universität Regensburg, Asklepios Klinikum Bad Abbach, Bad Abbach, Deutschland
| |
Collapse
|
2
|
Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty-a randomized controlled study. Knee Surg Sports Traumatol Arthrosc 2023; 31:786-792. [PMID: 34997248 DOI: 10.1007/s00167-021-06842-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE There are limited studies in the literature comparing the alignment accuracy of the large console, imageless, computer-assisted navigation (CAN) and portable, hand-held, accelerometer-based navigation (ABN) in total knee arthroplasty (TKA). This study was aimed to compare the operative time, blood loss, radiological, clinical and functional outcomes between CAN- and ABN-guided bilateral TKA. METHODS From Jan 2016 to Dec 2017, 50 patients who underwent bilateral TKA were randomized to undergo either CAN-guided or ABN-guided TKA. Tourniquet time and blood loss were recorded, and intra-op complications were noted. Post-op radiological outcomes at 2 weeks were compared between the groups. The clinical and functional outcomes using the American Knee Society Scores (KSS) and Oxford Knee Score (OKS) were recorded pre-operatively and post-operatively at 3, 6, 12 months and at the end of the study with a minimum follow-up of 48 months. RESULTS Both groups were well-matched in terms of patient demographic parameters. The mean surgical time per knee was significantly lower in the ABN group (54.5 ± 5.6 min) compared to the CAN group (61.7 ± 13.7 min; p < 0.01). Mean blood loss per knee in the ABN group was 592.1 ± 245.3 mL compared to 682.8 ± 322.0 in the CAN group (p = 0.11). In the ABN group, the mean post-op mechanical axis was 1.2 ± 3.2° (vs 1.5 ± 2.2° in the CAN group, p 0.6), the frontal femoral angle was 88.8 ± 2.3° (vs 88.8 ± 1.8° in the CAN group, p 1.0) and frontal tibial angle was 90.1 ± 1.6° (vs 89.7 ± 1.1° in the CAN group, p 0.14). At 48 month follow-up, the mean functional KSS in the ABN group was 89.0 ± 5.7 (vs 88.1 ± 4.5 in the CAN group, p 0.37) and the mean OKS was 40.5 ± 2.8 (vs 39.6 ± 3.2 in the CAN group, p 0.12). CONCLUSION Portable, hand-held ABN offers alignment accuracy and functional outcomes in TKA similar to that with CAN, with a reduced duration of surgery. There was no advantage of either of the techniques in terms of clinical or functional outcomes at 48 month follow-up. LEVEL OF EVIDENCE 1.
Collapse
|
3
|
A gyroscope-based system for intraoperative measurement of tibia coronal plane alignment in total knee arthroplasty. MEDICINE IN NOVEL TECHNOLOGY AND DEVICES 2022. [DOI: 10.1016/j.medntd.2021.100112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
4
|
Tsubosaka M, Kamenaga T, Kuroda Y, Takayama K, Hashimoto S, Ishida K, Hayashi S, Kuroda R, Matsumoto T. Accelerometer-Based Portable Navigation System Is Useful for Tibial Bone Cutting in Modified Kinematically Aligned Total Knee Arthroplasty. J Knee Surg 2021; 34:870-876. [PMID: 31891963 DOI: 10.1055/s-0039-3402481] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several studies have reported better clinical outcomes following kinematically aligned total knee arthroplasty (KA-TKA) than mechanically aligned TKA. Consistent reproduction of a KA-TKA is aided by accurate tibial bone resections using computer navigation systems. This study compares an accelerometer-based portable navigation system with a conventional navigation system on tibial bone resection and clinical outcomes in KA-TKA. This study included 60 knees of patients who underwent primary KA-TKA between May 2015 and September 2017. They were randomly assigned to the OrthoPilot and iASSIST groups. A tibial bone cut was performed with 3 degree varus and 7 degree posterior slope in relation to the mechanical axis in all cases. The tibial component angle (TCA) and posterior slope angle (PSA) were evaluated by postoperative radiography, and those that deviated more than 2 degree were set as outliers. The clinical outcomes were the knee range of motion (ROM) and 2011 Knee Society Score (KSS) evaluated at 1 year postoperation. The groups were compared in terms of the TCA, PSA, number of outliers, ROM, and 2011 KSS (p < 0.05). No significant difference was observed between the groups in terms of the mean TCA, PSA, number of outliers, ROM, and categories of the 2011 KSS (objective knee indicators, symptoms, satisfaction, expectations, and functional activities). Although tibial bone cuts were performed with 3 degree varus and 7 degree posterior slope, no significant difference was observed between the OrthoPilot and iASSIST groups in terms of the accuracy of cuts or postoperative clinical result. The iASSIST was found to be a simple and useful navigation system for KA-TKA.
Collapse
Affiliation(s)
- Masanori Tsubosaka
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Kamenaga
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yuichi Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koji Takayama
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shingo Hashimoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazunati Ishida
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Shinya Hayashi
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ryosuke Kuroda
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tomoyuki Matsumoto
- Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
5
|
Tsuda K, Shibuya T, Okamoto N, Shiigi E, Shirakawa N, Hosaka K, Akagi R, Ohdera T. Can accuracy with the iASSIST navigation be confirmed by assessment? A multi-center prospective randomized controlled trial with independent three-dimensional image assessment. Knee 2021; 30:344-352. [PMID: 34038856 DOI: 10.1016/j.knee.2021.04.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/17/2021] [Accepted: 04/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND iASSIST is one of the novel accelerometer-based navigation systems for total knee arthroplasty (TKA). Although the accuracy of iASSIST compared with conventional instruments has been reported, such evaluations were performed on two-dimensional (2D) images (X-rays). This multi-center prospective randomized controlled trial aimed to assess component positioning between TKA with and without iASSIST by 3D image assessment, and to clarify whether the iASSIST provides any benefit with regard to alignment accuracy. METHODS Eighty-three knees with primary knee osteoarthritis were enrolled in this study. iASSIST was used for distal femoral and proximal tibial resection in 42 knees (iA group) and a conventional guide was used in 41 knees (CONV group). At 6 months postoperatively, component alignment was evaluated with 3D images by the independent orthopaedic surgeons, and surgical parameters, range of motion and clinical outcomes were examined. RESULTS The rate of knees who have the alignment within 3° of neutral compared with the iA group and CONV group were 92.9% (39/42) vs. 87.8% (36/41) for femur and 76.2% (32/42) vs. 56.1% (23/41) for tibia in the coronal plane, respectively, whereas in the sagittal plane, the rate was 85.7% (36/42) vs. 58.5% (24/41) for femur and 83.3% (35/42) vs. 78.0% (32/41) for tibia, respectively. Compared with the CONV group, the iA group had a significantly improved femoral alignment in the sagittal plane (P = 0.006). There were no clinical or patient-reported differences at 6 months postoperatively. CONCLUSIONS The iASSIST provides technically high accuracy in femoral resection at TKA compared with a conventional procedure.
Collapse
Affiliation(s)
- Kosuke Tsuda
- Department of Orthopaedic Surgery, Sumitomo Hospital, Osaka, Japan.
| | - Takaaki Shibuya
- Department of Orthopaedic Surgery, Sumitomo Hospital, Osaka, Japan
| | - Nobukazu Okamoto
- Department of Orthopaedic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Eiichi Shiigi
- Department of Orthopaedic Surgery, Yamaguchi Prefectural Grand Medical Center, Yamaguchi, Japan
| | - Nobuyuki Shirakawa
- Department of Orthopaedic Surgery, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Kunihiro Hosaka
- Department of Orthopaedic Surgery, Nihon University Itabashi Hospital, Tokyo, Japan
| | - Ryuichiro Akagi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Toshihiro Ohdera
- Department of Orthopaedic Surgery, Fukuoka Orthopedic Hospital, Fukuoka, Japan
| |
Collapse
|
6
|
Ehrendorfer S, Erdmenger U, Bocanegra LM, Boyd M, Canal J, Canal J, Hoch A, Windhager R, Niehaus R. Limb and component alignment after total knee arthroplasty comparing 28 consecutive iAssist and 28 conventional TKAs: A prospective study. Knee 2020; 27:1881-1888. [PMID: 33212313 DOI: 10.1016/j.knee.2020.07.101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/28/2020] [Accepted: 07/30/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND The objective of this study was to assess limb and component alignment after total knee arthroplasty (TKA) on long leg X-rays and to compare the use of iAssist, an accelerometric based computer-assisted device (CAD), with conventional jigs. METHODS We prospectively recruited 56 consecutive patients undergoing primary unilateral TKA by a single surgeon into this study. In the first 28 patients iAssist navigation system was utilized and in the following 28 conventional jigs were used. The groups were comparable with regard to age, sex distribution, body mass index and preoperative hip-knee-ankle (HKA) angle. Our aim was to restore neutral coronal alignment and a five degree tibial slope. RESULTS The mean postoperative mechanical axis was 179.4° in the CAD group and 180.1° in the conventional group (P = 0.187). There were five TKAs deviating more than three degrees from neutral (18.5%) in the conventional group and none in the CAD group (P = 0.051). The mean femoral mechanical-condyles-angle was significantly closer (P < 0.001) to our target of 90° in the conventional group but contained more outliers (P = 0.67). The sagittal tibial slope was closer (P = 0.047) to our target of 85° in CAD-navigated TKAs with fewer outliers (P < 0.0001). The Oxford Knee Score showed comparable (P = 0.271) and good clinical outcome in both groups. The mean operation time was significantly longer in the CAD group (P < 0.001). CONCLUSIONS This study shows that the use of iAssist accelerometric CAD facilitates comparable good leg alignment after TKA in the frontal plane and more accurate tibial slope with fewer outliers in the sagittal plane compared with a conventional technique. Our operation time was longer with CAD.
Collapse
Affiliation(s)
| | - Uwe Erdmenger
- Department of Orthopaedic Surgery, Kantonsspital Uri (KSU), Altdorf, Switzerland
| | | | - Marcus Boyd
- Department of Orthopaedic Surgery, Kantonsspital Uri (KSU), Altdorf, Switzerland
| | - Johannes Canal
- Department of Orthopaedic Surgery, Kantonsspital Uri (KSU), Altdorf, Switzerland
| | - Julian Canal
- Department of Orthopaedic Surgery, Kantonsspital Uri (KSU), Altdorf, Switzerland
| | - Armando Hoch
- Department of Orthopaedic Surgery, Kantonsspital Baden (KSB), Baden, Switzerland
| | - Reinhard Windhager
- University Department Orthopaedics and Trauma Surgery, AKH, Vienna, Austria
| | - Richard Niehaus
- Department of Orthopaedic Surgery, Kantonsspital Baden (KSB), Baden, Switzerland
| |
Collapse
|
7
|
Lai HYC, Tang YHB, Wong HL. Comparison of early results of total knee replacement performed with Zimmer iASSIST versus conventional technique. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720941208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Zimmer iASSIST knee is an accelerometer-based navigation system with the aim of achieving better alignment in total knee arthroplasty (TKA). We have started using this system since early 2016. This is a retrospective case–control study, which aims to compare the radiological alignment, operation time, and blood loss of TKAs performed using the iASSIST system and those using conventional techniques. Materials and Methods: 42 TKAs using Zimmer iASSIST and 44 TKAs using conventional instrumentation were recruited. The overall coronal alignment and the coronal and sagittal alignment of the femoral and tibial component were compared. For coronal alignment, additional analysis of the absolute deviation from neutral mechanical axis was performed to avoid canceling out of varus/valgus deviation. The number of outliers, operation time, and blood loss in terms of maximal hemoglobin drop were also compared. Results: When comparing the alignment of the iASSIST group with the conventional group, there were no significant differences ( p > 0.05) in the number of outliers, mean coronal alignments, mean deviation from neutral coronal mechanical axis (2.9° vs. 2.9°), and femoral component flexion angle (4.9° vs. 4.7°). The difference in the mean tibial component posterior slope was significant (5.7° vs. 7.1°, p < 0.05). The mean operation time was significantly longer by 13 min ( p < 0.05) in the iASSIST group. There were no significant differences in the mean hemoglobin drop between the two groups. Conclusion: The results demonstrated no significant differences in terms of coronal radiological alignment, femoral flexion angle, outliers, and blood loss between iASSIST and conventional technique. There was a small but statistically significant difference in tibial posterior slope. The iASSIST group needed a longer operation time.
Collapse
Affiliation(s)
- Ho Yeung Cyrus Lai
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong
| | - Yan Ho Bruce Tang
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong
| | - Hok Leung Wong
- Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong
| |
Collapse
|
8
|
The use of accelerometer-based navigation for coronal TKA alignment: a prospective, single surgeon comparative study. Arch Orthop Trauma Surg 2020; 140:1169-1174. [PMID: 31776659 DOI: 10.1007/s00402-019-03295-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Indexed: 02/09/2023]
Abstract
INTRODUCTION There is the need for a device that can be used to accurately position components during total knee arthroplasty (TKA) with minimal impact on procedure time, workflow and cost. This study aimed to investigate the accuracy and time efficiency of a novel, accelerometer-based navigation system (ABN). METHODS This prospective, single surgeon study of patients undergoing TKA for osteoarthritis over a 5 year period involved a total of 138 patients: 110 using the ABN system and 28 without. The ABN system consists of two coupled inertial pods that are secured to resection guides, providing a body-fixed 3D coordinate system for limb segments. Post-operative coronal alignment was measured from standardised long-leg AP radiographs. Deviation of the femur and tibia from the neutral coronal mechanical axis was recorded. Intra-observer repeatability was performed on three independent blinded data sets. The BMI and the surgical time (skin to skin) were recorded for all patients. RESULTS The mean BMI was 34 in the ABN group and 33 in the control group (p = 0.92). The skin-to-skin time was also similar between the groups; 105 min in the navigation group and 100 min in the control group (p = 0.297). The use of navigation resulted in significantly fewer outliers as defined by < 3º deviation from the target angle. 3 of 110 navigated patients recorded an AP femur angle of more than 3º from the target of 90º, where 5 of 28 control patients fell outside of the ± 3º window (p = 0.009, Fig. 1). CONCLUSION The use of the ABN system significantly improved accuracy of implant position and alignment without increasing surgical time.
Collapse
|
9
|
Wang M, Li D, Shang X, Wang J. A review of computer-assisted orthopaedic surgery systems. Int J Med Robot 2020; 16:1-28. [PMID: 32362063 DOI: 10.1002/rcs.2118] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 03/07/2020] [Accepted: 04/19/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Computer-assisted orthopaedic surgery systems have great potential, but no review has focused on computer-assisted surgery systems for the spine, hip, and knee. METHODS A systematic search was performed in Web of Science and PubMed. We searched the literature on computer-assisted orthopaedic surgery systems from 2008 to the present and focused on three aspects of systems: training, planning, and intraoperative navigation. RESULTS AND DISCUSSION In this review study, we reviewed 34 surgical training systems, 31 surgical planning systems, and 41 surgical navigation systems. The functions and characteristics of the surgical systems were compared and analysed, and the current concerns about and the impact of the surgical systems on doctors and surgery were clarified. CONCLUSION Computer-assisted orthopaedic surgery systems are still in the development stage. Future surgical training systems should include synthetic models with patient anatomy. Surgical planning systems with automatic planning should be developed, and surgical navigation systems with multimodal fusion, robotic assistance and imaging should be developed.
Collapse
Affiliation(s)
- Monan Wang
- Mechanical & Power Engineering College , Harbin University of Science and Technology, Harbin, China
| | - Donghui Li
- Mechanical & Power Engineering College , Harbin University of Science and Technology, Harbin, China
| | - Xiping Shang
- Mechanical & Power Engineering College , Harbin University of Science and Technology, Harbin, China
| | - Jian Wang
- Mechanical & Power Engineering College , Harbin University of Science and Technology, Harbin, China
| |
Collapse
|
10
|
Goh GS, Liow MHL. Total knee arthroplasty in the next decade: is navigation necessary? ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:665. [PMID: 32617285 PMCID: PMC7327330 DOI: 10.21037/atm.2020.03.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Graham S Goh
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | | |
Collapse
|
11
|
Shihab Z, Clayworth C, Nara N. Handheld, accelerometer-based navigation versus conventional instrumentation in total knee arthroplasty: a meta-analysis. ANZ J Surg 2020; 90:2068-2079. [PMID: 32479702 DOI: 10.1111/ans.15925] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 04/01/2020] [Accepted: 04/10/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Precise and accurate alignments in total knee arthroplasty are important predictors for survivorship and functional outcomes. We aim to compare accelerometer-based navigation (ABN) to conventional instrumentation (CONV), patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) in published literature. METHODS A systematic search of publications from databases (MEDLINE, EMBASE and Cochrane) was obtained from inception to 15 August 2018. A random-effects meta-analysis was used to pool odd ratios for outliers greater than 3° for the hip-knee-ankle, coronal and sagittal femoral and tibial angles (CFA, CTA, SFA, STA). Secondary outcomes included procedural characteristics and functional outcomes. RESULTS Thirteen studies, involving 1566 patients, met inclusion that compared ABN (50.2%) to CONV (49.8%) and five comparing ABN to CAS/PSI. The pooled odds ratios for percent outliers of greater than 3° from the mechanical axis for the hip-knee-ankle (relative risk 0.58, P = <0.05) and CFA (relative risk 0.42, P = 0.02) was significantly lower for ABN compared to CONV. The pooled odds ratios for CTA, SFA and STA were not significantly different. No differences were identified in comparison to PSI/CAS. There was no statistically significant difference in procedural characteristics and functional outcomes. CONCLUSIONS The use ABN in total knee arthroplasty is a successful method of increased precision and accuracy for the restoration of the mechanical axis. In addition, there is no significant compromise in procedural or functional outcomes.
Collapse
Affiliation(s)
- Zaid Shihab
- Department of Orthopaedics, Ballarat Health Services, Ballarat, Victoria, Australia
| | - Catriona Clayworth
- Department of Orthopaedics, Ballarat Health Services, Ballarat, Victoria, Australia
| | - Naveen Nara
- Department of Orthopaedics, Ballarat Health Services, Ballarat, Victoria, Australia.,Department of Orthopaedics, St John of God Hospital, Ballarat, Victoria, Australia.,Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
12
|
Shen Z, Wang H, Duan Y, Wang J, Wang F. Application of 3D printed osteotomy guide plate-assisted total knee arthroplasty in treatment of valgus knee deformity. J Orthop Surg Res 2019; 14:327. [PMID: 31639044 PMCID: PMC6802333 DOI: 10.1186/s13018-019-1349-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/28/2019] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION To analyze the application of 3D printed osteotomy guide plate-assisted total knee arthroplasty (TKA) for valgus knee deformity. METHODS The clinical data of 20 patients with valgus knee deformity admitted to our hospital from April 2012 to April 2017 were collected and analyzed. According to the treatment method, these patients were divided into two groups: 3D printed osteotomy guide plate-assisted TKA (combined treatment group, n = 10) and TKA (treatment group, n = 10). The operation time, intraoperative bleeding volume, postoperative mean femorotibial angle (MFTA), and Knee Society Score (KSS) of the two groups were statistically analyzed. RESULTS Compared with the treatment group, the operation time was significantly shorter (P < 0.05), the intraoperative blood loss and postoperative MFTA were significantly decreased (P < 0.05), and the clinical and functional scores were significantly increased (P < 0.05) in the combined treatment group. CONCLUSION 3D printed osteotomy guide plate-assisted TKA for valgus knee deformity is more effective than TKA alone.
Collapse
Affiliation(s)
- Zhimin Shen
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyijie Road, Guiyang City, 550004, Guizhou Province, China
| | - Hong Wang
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyijie Road, Guiyang City, 550004, Guizhou Province, China
| | - Yiqiang Duan
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyijie Road, Guiyang City, 550004, Guizhou Province, China
| | - Jian Wang
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyijie Road, Guiyang City, 550004, Guizhou Province, China.
| | - Fengyan Wang
- Department of Orthopedics, The Affiliated Hospital of Guizhou Medical University, No. 28, Guiyijie Road, Guiyang City, 550004, Guizhou Province, China
| |
Collapse
|
13
|
Gao X, Sun Y, Chen ZH, Dou TX, Liang QW, Li X. Comparison of the accelerometer-based navigation system with conventional instruments for total knee arthroplasty: a propensity score-matched analysis. J Orthop Surg Res 2019; 14:223. [PMID: 31319875 PMCID: PMC6637591 DOI: 10.1186/s13018-019-1258-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 07/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The accelerometer-based navigation (ABN) system is an emerging navigation system for total knee arthroplasty (TKA). This study aimed to determine whether the ABN system could improve the accuracy of mechanical alignment, component positioning, and short-term clinical outcomes for TKA when compared to conventional instruments (CON). METHODS A total of 204 patients were selected and divided into two groups (CON: 135, ABN: 69) after applying the inclusion and exclusion criteria. Then, 1:1 propensity score matching was performed for age, gender, body mass index, hip-knee-ankle angle (HKA), Knee Society Score (KSS), Western Ontario and McMaster Universities (WOMAC) score, and follow-up times. A total of 82 consecutive patients (82 knees) underwent total knee arthroplasty using ABN (n = 41) or CON (n = 41) were enrolled in this study. The postoperative HKA, frontal femoral component (FFC) angle, frontal tibial component (FTC) angle, lateral femoral flexion (LFF) angle, and lateral tibial component (LTC) angle were compared between the two groups to evaluate mechanical alignment and component positioning. Additional clinical parameters, including haemoglobin reduction, the KSS, and the WOMAC score, were assessed at the final follow-up (the mean follow-up period was 20.9 months in the CON group and 21.2 months in the ABN group). RESULTS The ABN group had a significantly improved mean absolute deviation of HKA (P = 0.033), FFC (P = 0.004), FTC (P = 0.017), LFF (P = 0.023), and LTC (P = 0.031) compared to those of the CON group. The numbers of FFCs and LTCs within 3° were significantly different (P = 0.021, P = 0.023, respectively) between the two groups. However, no differences in the numbers of FTCs within 3° (P = 0.166) and LFF within 3° (P = 0.556) were found. The ABN group had a significantly higher KS function score (P = 0.032), and the pain and stiffness scores were significantly different (P = 0.034, P = 0.020, respectively) between the two groups. Moreover, the ABN system could reduce hidden blood loss postoperatively. However, no difference was found in the KS knee score and the total WOMAC score between the two groups. CONCLUSION This study demonstrates that ABN system improved TKA mechanical alignment and component positioning and decreased the hidden blood loss postoperatively compared to conventional instruments. However, no significant differences were found in short-term clinical outcomes between ABN and conventional instruments at the final follow-up. However, whether this system contributes to revision rates and long-term clinical outcomes requires further study.
Collapse
Affiliation(s)
- Xiang Gao
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| | - Yu Sun
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| | - Zhao-He Chen
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| | - Tian-Xu Dou
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| | - Qing-Wei Liang
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| | - Xu Li
- Department of Orthopedics, The First Hospital of China Medical University, 155, Shenyang, 110000 Liaoning Province People’s Republic of China
| |
Collapse
|
14
|
Dardenne G, Dib Z, Poirier N, Letissier H, Lefèvre C, Stindel E. What is the best hip center location method to compute HKA angle in computer-assisted orthopedic surgery? In silico and in vitro comparison of four methods. Orthop Traumatol Surg Res 2019; 105:55-61. [PMID: 30573397 DOI: 10.1016/j.otsr.2018.11.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/19/2018] [Accepted: 11/01/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND In computer-assisted orthopedic surgery, the hip center (HC) can be determined by calculating the center of rotation of the femur in relation to the pelvis. Several methods are available: Gamage, Halvorsen, Pivot or Least-Moving Point (LMP). To our knowledge, no studies have compared these four methods. We therefore conducted in silico and in vitro experiments to assess whether their accuracy and precision in locating the HC and calculating the hip-knee-ankle (HKA) angle were equivalent. HYPOTHESIS The four methods show similar accuracy and precision. PATIENTS AND METHODS The in silico experiment assessed the independent influence of four parameters (camera noise, acetabular noise, movement amplitude, and number of circumductions) on accuracy. The accuracy and precision of the four methods and the impact on HKA ankle calculation were assessed in an in vitro study on six cadaver limbs. RESULTS In the in silico experiment, all differences according to method were significant (p<0.0002). The Pivot method was the most accurate for acetabular and camera noise, number of circumductions, and movement amplitude. With the LMP, Pivot, Gamage and Halvorsen methods, error was respectively 23.07±8.40 (range 2.10-54.67) mm, 1.98±081 (0.15-4.89) mm, 28.18±3.42 (18.57-37.60) mm and 2.84±1.46 (0.11-9.44) mm depending on camera noise, 1.65±0.72 (0.13-4.80) mm, 0.52±0.22 (0.05-1.23) mm, 3.02±0.57 (0.60-4.78) mm and 0.61±0.27 (0.04-1.82) mm depending on movement amplitude, 0.50±0.20 (0.05-1.34) mm, 0.18±0.08 (0.01-0.44) mm, 0.36±0.14 (0.03-0.80) mm and 0.21±0.09 (0.01-0.55) mm depending on number of circumductions, and 11.30±5.77 (0.56-37.87) mm, 2.78±1.47 (0.10-8.77) mm, 88.08±8.85 (60.59-117.79) mm and 24.33±9.82 (1.40-66.17) mm depending on acetabular noise. In the in vitro experiment, differences were non-significant between the Pivot and LMP methods (p>0.98) and between the Gamage and Halvorsen methods (p>0.65). With the LMP, Pivot, Gamage and Halvorsen methods, precision was respectively 8.2±4.6 (3.3-23.6) mm, 7.3±3.6 (3.4-14.1) mm, 33.6±19.1 (4.7-111.4) mm and 35.0±25.0 (4.7-132.5) mm. Accuracy was 13.5±8.2 (3.2-40.7) mm. 12.3±6.4 (3.2-23.6) mm, 47.0±33.3 (6.2-176.6) mm and 40.3±27.8 (6.1-130.3) mm. The LMP and Pivot methods were thus more accurate and more precise than the Gamage and Halvorsen methods. HKA angle error was 1.1±0.9° (0.1-3.7) and 0.9±0.8° (0.0-2.5) with the LMP and Pivot methods, and 3.2±2.7° (0.0-12.7) and 3.8±3.5° (0.0-13.3) with the Gamage and Halvorsen methods. DISCUSSION The study highlighted differences between the four methods of HC location in computer-assisted surgery; the Pivot method was the most accurate and precise, thus falsifying the study hypothesis. LEVEL OF EVIDENCE III, prospective comparative in silico and in vitro study.
Collapse
Affiliation(s)
- Guillaume Dardenne
- LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France.
| | - Zoheir Dib
- LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; Université de Bretagne Occidentale, UBL, 3, rue des Archives, CS 93837, 29238 Brest, France
| | - Nicolas Poirier
- CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France; Université de Bretagne Occidentale, UBL, 3, rue des Archives, CS 93837, 29238 Brest, France
| | - Hoel Letissier
- LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France; Université de Bretagne Occidentale, UBL, 3, rue des Archives, CS 93837, 29238 Brest, France
| | - Christian Lefèvre
- LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France; Université de Bretagne Occidentale, UBL, 3, rue des Archives, CS 93837, 29238 Brest, France
| | - Eric Stindel
- LaTIM, Inserm, UMR 1101, SFR IBSAM, UFR médecine, 22, avenue Camille-Desmoulins, CS 93837, 29238 Brest cedex 3, France; CHU de Brest, 2, avenue Foch, 29609 Brest cedex, France; Université de Bretagne Occidentale, UBL, 3, rue des Archives, CS 93837, 29238 Brest, France
| |
Collapse
|
15
|
Jenny JY, Dillmann G, Gisonni V, Favreau H. Noninvasive navigated assessment of the lower limb axis prior to knee arthroplasty: a feasibility study. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2019; 29:855-860. [PMID: 30631945 DOI: 10.1007/s00590-019-02380-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
Abstract
The purpose of the study was to assess accuracy and repeatability of a noninvasive navigated (NIN) measurement of the lower limb axes by comparison with the conventional, invasive navigated (IN) technique. The tested hypothesis was that NIN measure will significantly differ from IN measure when performed on a supine patient under general anesthesia just prior to knee arthroplasty. The accuracy study involved 20 cases. The following measures were performed with both systems: maximal extension angle, coronal mechanical femoro-tibial angle at the previously assessed maximal extension angle, coronal mechanical femoro-tibial angle at 30° of knee flexion. NIN and IN measures were compared with the appropriate statistical tests. The repeatability study involved 14 cases. The same measures were performed with the NIN system twice by two independent observers. The intra- and inter-observer variability was assessed by the calculation of the intra-class correlation coefficient. After correction for the systematic biases, the differences between the two systems were not significant. A good correlation, a good coherence and an excellent agreement between NIN and IN measures of maximal extension angle and coronal femoro-tibial mechanical angle at maximal extension. But measures at 30° of flexion were inconsistent. The NIN system can be considered as an accurate and precise tool for the assessment of the knee extension angle and the coronal deformation at maximal extension prior to knee arthroplasty. But this system is less accurate and less repeatable when measuring coronal femoro-tibial mechanical angle at 30° of flexion and should not be used for this purpose.
Collapse
Affiliation(s)
- Jean-Yves Jenny
- Centre de Chirurgie Orthopédique et de la Main, Hôpitaux Universitaires de Strasbourg, 10 Avenue Baumann, 67400, Illkirch-Graffenstaden, France. .,Université de Strasbourg, Strasbourg, France.
| | - Gauthier Dillmann
- Centre de Chirurgie Orthopédique et de la Main, Hôpitaux Universitaires de Strasbourg, 10 Avenue Baumann, 67400, Illkirch-Graffenstaden, France
| | - Vincent Gisonni
- Centre de Chirurgie Orthopédique et de la Main, Hôpitaux Universitaires de Strasbourg, 10 Avenue Baumann, 67400, Illkirch-Graffenstaden, France
| | - Henri Favreau
- Centre de Chirurgie Orthopédique et de la Main, Hôpitaux Universitaires de Strasbourg, 10 Avenue Baumann, 67400, Illkirch-Graffenstaden, France
| |
Collapse
|
16
|
Jones CW, Jerabek SA. Current Role of Computer Navigation in Total Knee Arthroplasty. J Arthroplasty 2018; 33:1989-1993. [PMID: 29506932 DOI: 10.1016/j.arth.2018.01.027] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 01/18/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Computer-assisted surgical (CAS) navigation has been developed with the aim of improving the accuracy and precision of total knee arthroplasty (TKA) component positioning and therefore overall limb alignment. The historical goal of knee arthroplasty has been to restore the mechanical alignment of the lower limb by aligning the femoral and tibial components perpendicular to the mechanical axis of the femur and tibia. Despite over 4 decades of TKA component development and nearly 2 decades of interest in CAS, the fundamental question remains; does the alignment goal and/or the method of achieving that goal affect the outcome of the TKA in terms of patient-reported outcome measures and/or overall survivorship? The quest for reliable and reproducible achievement of the intraoperative alignment goal has been the primary motivator for the introduction, development, and refinement of CAS navigation. Numerous proprietary systems now exist, and rapid technological advancements in computer processing power are stimulating further development of robotic surgical systems. Three categories of CAS can be defined: image-based large-console navigation; imageless large-console navigation, and more recently, accelerometer-based handheld navigation systems have been developed. CONCLUSION A review of the current literature demonstrates that there are enough well-designed studies to conclude that both large-console CAS and handheld navigation systems improve the accuracy and precision of component alignment in TKA. However, missing from the evidence base, other than the subgroup analysis provided by the Australian Orthopaedic Association National Joint Replacement Registry, are any conclusive demonstrations of a clinical superiority in terms of improved patient-reported outcome measures and/or decreased cumulative revision rates in the long term. Few authors would argue that accuracy of alignment is a goal to ignore; therefore, in the absence of clinical evidence, many of the arguments against the use of large-console CAS navigation center on the prohibitive cost of the systems. The utilization of low-cost, handheld CAS navigation systems may therefore bridge this important gap, and over time, further clinical evidence may emerge.
Collapse
Affiliation(s)
- Christopher W Jones
- Complex Joint Reconstruction Center, Hospital for Special Surgery, New York City, NY
| | - Seth A Jerabek
- Complex Joint Reconstruction Center, Hospital for Special Surgery, New York City, NY
| |
Collapse
|
17
|
Lo CK, Li HY, Wong YC, Wai YL. Total Knee Replacement with iASSIST Navigation System. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2018. [DOI: 10.1016/j.jotr.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Background/Purpose The iASSIST system is a novel navigation system for total knee replacement. It is based on accelerometers built within electronic pods attached to the instruments within the operative field. The objective of this study was to compare the accuracy of iASSIST navigation with that of the conventional alignment technique. Methods A total of 91 patients (92 knees) retrospectively matched for age, gender, preoperative range of motion, and lower limb deformity underwent total knee replacement using iASSIST navigation (45 patients, 46 knees) or conventional instrumentation (46 patients, 46 knees). Operative time and radiological alignments were compared. Results The use of iASSIST navigation resulted in fewer outliners (as defined by >3° deviation from the neutral mechanical axis) in lower limb alignment. Operative time with iASSIST navigation was not longer than that using conventional instruments. Conclusion iASSIST navigation reduces the incidence of lower limb malalignment without adding extra time to the procedure.
Collapse
Affiliation(s)
- Chi-Kin Lo
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong, China
| | - Hok-Yin Li
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong, China
| | - Yiu-Chung Wong
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong, China
| | - Yuk-Leung Wai
- Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, Hong Kong, China
| |
Collapse
|
18
|
Putman S, Argenson JN, Bonnevialle P, Ehlinger M, Vie P, Leclercq S, Bizot P, Lustig S, Parratte S, Ramdane N, Colmar M. Ten-year survival and complications of total knee arthroplasty for osteoarthritis secondary to trauma or surgery: A French multicentre study of 263 patients. Orthop Traumatol Surg Res 2018; 104:161-164. [PMID: 29292123 DOI: 10.1016/j.otsr.2017.11.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/15/2017] [Accepted: 11/19/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Previous surgical procedures raise technical challenges in performing total knee arthroplasty (TKA) and may affect TKA outcomes. Survival rates of TKA done after trauma or surgery to the knee have not been accurately determined in large populations. The objectives of this retrospective study in 263 patients with TKA after knee trauma or surgery and a follow-up of 10 years were to assess survival, functional outcomes, and the nature and frequency of complications. HYPOTHESIS Knee trauma or surgery before TKA increases the risk of complications and decreases implant survival. MATERIAL AND METHODS Two hundred and sixty-three patients (122 [47%] females and 141 [53%] males) underwent TKA between 2005 and 2009 at nine centres in France. Mean age at surgery was 61 years. The patients had knee osteoarthritis secondary to a fracture (n=66), osteotomy (n=131), or ligament injury (n=66). Mean time from trauma or surgery to TKA was 145 months (range, 72-219 months). RESULTS Major complications were infection (n=12, 4.5%), skin problems (n=8, 3%), and stiffness (n=8, 3%). Ten-year survival to implant exchange for any reason was 89%±2.8%. Flexion range increased by 2.5°±17° (p=0.02) to a mean of 110° (range, 30° to 140°); extension range increased by 4°±7° (p<0.001) to a mean of -1.19 (range, -20° to 0°). Of the 263 patients, 157 (60%) reported little or no pain at last follow-up. Mean postoperative hip-knee-ankle angle was 179°±3.2° (range, 171°-188°). CONCLUSION TKA performed after knee injury or surgery carries a risk of specific complications (infection, skin problems, and stiffness) and may have a lower survival rate compared to primary TKA. LEVEL OF EVIDENCE IV, retrospective cohort study.
Collapse
Affiliation(s)
- S Putman
- Département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, rue Emile-laine, 59037 Lille, France.
| | - J-N Argenson
- Département de chirurgie orthopédique, hôpital Sainte-Marguerite, hôpital universitaire de Marseille, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - P Bonnevialle
- Département d'orthopédie et de traumatologie, hôpital P.P.-Riquet, place Baylac, 31052 Toulouse cedex, France
| | - M Ehlinger
- Service de chirurgie orthopédique et de traumatologie, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France
| | - P Vie
- Clinique du Cèdre, 950, rue de la Haie, 76230 Bois-Guillaume, France
| | - S Leclercq
- CHP Saint-Martin, 18, rue des Roquemonts, 14000 Caen, France
| | - P Bizot
- Service de chirurgie orthopédique et traumatologique, hôpital Lariboisière, université Paris Diderot, 3, rue Amboise-Paré, 75010 Paris, France
| | - S Lustig
- Département de chirurgie orthopédique, centre Albert-Trillat, hôpital de la Croix-Rousse, 103, boulevard de la Croix-Rousse, 69004 Lyon, France
| | - S Parratte
- Département de chirurgie orthopédique, hôpital Sainte-Marguerite, hôpital universitaire de Marseille, 270, boulevard Sainte-Marguerite, 13009 Marseille, France
| | - N Ramdane
- EA 2694 - Santé publique : épidémiologie et qualité des soins, université de Lille, CHU de Lille, 59000 Lille, France
| | - M Colmar
- Hôpital privé des Côtes-d'Armor, 12, rue François-Jacob, 22198 Plerin, France
| | -
- 56, rue Boissonade, 75014 Paris cedex, France
| |
Collapse
|
19
|
Ninomiya JT. Does Assessment with a Single Postoperative Radiograph Predict Long-Term Success of Total Knee Arthroplasty?: Commentary on an article by Matthew P. Abdel, MD, et al.: "Effect of Postoperative Mechanical Axis Alignment on Survival and Functional Outcomes of Modern Total Knee Arthroplasties with Cement. A Concise Follow-up at 20 Years. J Bone Joint Surg Am 2018; 100:e38. [PMID: 29557874 DOI: 10.2106/jbjs.17.01361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- James Toshio Ninomiya
- Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin
| |
Collapse
|
20
|
Pflugi S, Vasireddy R, Lerch T, Ecker TM, Tannast M, Boemke N, Siebenrock K, Zheng G. Augmented marker tracking for peri-acetabular osteotomy surgery. Int J Comput Assist Radiol Surg 2017; 13:291-304. [PMID: 29188423 DOI: 10.1007/s11548-017-1690-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 11/20/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To develop a hybrid augmented marker-based navigation system for acetabular reorientation during peri-acetabular osteotomy (PAO). METHODS The system consists of a tracking unit attached to the patient's pelvis, augmented marker attached to the acetabular fragment and a host computer to do all the computations and visualization. The augmented marker is comprised of an external planar Aruco marker facing toward the tracking unit and an internal inertial measurement unit (IMU) to measure its orientation. The orientation output from the IMU is sent to the host computer. The tracking unit streams a live video of the augmented marker to the host computer, where the planar marker is detected and its pose is estimated. A Kalman filter-based sensor fusion combines the output from marker tracking and the IMU. We validated the proposed system using a plastic bone study and a cadaver study. Every time, we compared the inclination and anteversion values measured by the proposed system to those from a previously developed optical tracking-based navigation system. RESULTS Mean absolute differences for inclination and anteversion were 1.34 ([Formula: see text]) and 1.21 ([Formula: see text])[Formula: see text], respectively, for the cadaver study. Mean absolute differences were 1.63 ([Formula: see text]) and 1.55 ([Formula: see text])[Formula: see text] for inclination and anteversion for the plastic bone study. In both validation studies, very strong correlations were observed. CONCLUSION We successfully demonstrated the feasibility of our system to measure the acetabular orientation during PAO.
Collapse
Affiliation(s)
- Silvio Pflugi
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland.
| | - Rakesh Vasireddy
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| | - Till Lerch
- Department of Orthopedic Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Timo M Ecker
- Department of Orthopedic Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Moritz Tannast
- Department of Orthopedic Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Nane Boemke
- Institute for Anatomy, University of Bern, Bern, Switzerland
| | - Klaus Siebenrock
- Department of Orthopedic Surgery, Inselspital, University of Bern, Bern, Switzerland
| | - Guoyan Zheng
- Institute for Surgical Technology and Biomechanics, University of Bern, Bern, Switzerland
| |
Collapse
|
21
|
Abstract
Total knee arthroplasty has been an effective treatment for advanced degenerative joint disease. Traditional knee designs and surgical approaches have resulted in consistently high performance, but some patients may remain dissatisfied after their surgery. Several surgical innovations, including accelerometer-based navigation, patient-specific instrumentation, and robotic-assisted total knee arthroplasty, have been developed to improve the accuracy and precision of total knee arthroplasty surgery, with anticipated secondary benefits of improved functional outcomes and implant survivorship. This article reviews the current status of these technologies as reported in contemporary orthopedic literature. [Orthopedics. 2016; 39(4):217-220.].
Collapse
|