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Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study
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 tim...
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| Published in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2023-03, Vol.31 (3), p.786-792 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
| container_volume | 31 |
| creator | Swamy, Arun M Malhotra, Rajesh Digge, Vijaykumar Manhas, Vikrant gautam, Deepak Srivastava, Deep Narayana |
| description | 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
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| doi_str_mv | 10.1007/s00167-021-06842-y |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2618226318</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2618226318</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-aa433eabb63a46c19591c0f176300e4b6b6ae5f33cd6d5ab99fcf333f1e60cf93</originalsourceid><addsrcrecordid>eNp9kctu1TAQhi1ERQ-FF2CBLLFhQYoviRMvqwpopUpsYG1NnMkhJYmD7SCFFQ_BK_BiPAnTnnIRCzb22PP9vy8_Y0-kOJVC1C-TENLUhVCyEKYpVbHdYztZal3Uuqzvs52wtKlEZY7Zw5SuhaCytA_YsS6trVXZ7Nj3M-9xxBgmzBiLFhJ2fAkxQzsin-HzsIc8hPkFB95DIobv16FD7sO0QCQ4h9t6vZFDSgMx3V9CPsy8HUagNowEZxo_zogcYv4QwzKS6fbj6zfgEeYuTMMXkvsw5xjGkcqU1257xI56GBM-vptP2PvXr96dXxRXb99cnp9dFV7XVS4A6PEIbWs0lMZLW1npRS9ro4XAsjWtAax6rX1nugpaa3tPK91LNML3Vp-w5wffJYZPK6bspiHR_4wwY1iTU0Y2ShktG0Kf_YNehzXOdDun6tqaRkuriFIHyseQUsTeLXGYIG5OCncTojuE6ChEdxui20j09M56bSfsfkt-pUaAPgCJWvMe45-z_2P7E34Srhc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2779683192</pqid></control><display><type>article</type><title>Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study</title><source>Wiley</source><source>Springer Nature</source><source>EBSCOhost SPORTDiscus - Ebooks</source><creator>Swamy, Arun M ; Malhotra, Rajesh ; Digge, Vijaykumar ; Manhas, Vikrant ; gautam, Deepak ; Srivastava, Deep Narayana</creator><creatorcontrib>Swamy, Arun M ; Malhotra, Rajesh ; Digge, Vijaykumar ; Manhas, Vikrant ; gautam, Deepak ; Srivastava, Deep Narayana</creatorcontrib><description>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.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-021-06842-y</identifier><identifier>PMID: 34997248</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Accelerometers ; Alignment ; Arthroplasty (knee) ; Blood ; Complications ; Joint replacement surgery ; Knee ; Medicine ; Medicine & Public Health ; Orthopaedic implants ; Orthopedics ; Patients ; Portability ; Sports Medicine</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-03, Vol.31 (3), p.786-792</ispartof><rights>The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2022</rights><rights>2022. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).</rights><rights>The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-aa433eabb63a46c19591c0f176300e4b6b6ae5f33cd6d5ab99fcf333f1e60cf93</citedby><cites>FETCH-LOGICAL-c375t-aa433eabb63a46c19591c0f176300e4b6b6ae5f33cd6d5ab99fcf333f1e60cf93</cites><orcidid>0000-0001-5971-003X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34997248$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swamy, Arun M</creatorcontrib><creatorcontrib>Malhotra, Rajesh</creatorcontrib><creatorcontrib>Digge, Vijaykumar</creatorcontrib><creatorcontrib>Manhas, Vikrant</creatorcontrib><creatorcontrib>gautam, Deepak</creatorcontrib><creatorcontrib>Srivastava, Deep Narayana</creatorcontrib><title>Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>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.</description><subject>Accelerometers</subject><subject>Alignment</subject><subject>Arthroplasty (knee)</subject><subject>Blood</subject><subject>Complications</subject><subject>Joint replacement surgery</subject><subject>Knee</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopaedic implants</subject><subject>Orthopedics</subject><subject>Patients</subject><subject>Portability</subject><subject>Sports Medicine</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1TAQhi1ERQ-FF2CBLLFhQYoviRMvqwpopUpsYG1NnMkhJYmD7SCFFQ_BK_BiPAnTnnIRCzb22PP9vy8_Y0-kOJVC1C-TENLUhVCyEKYpVbHdYztZal3Uuqzvs52wtKlEZY7Zw5SuhaCytA_YsS6trVXZ7Nj3M-9xxBgmzBiLFhJ2fAkxQzsin-HzsIc8hPkFB95DIobv16FD7sO0QCQ4h9t6vZFDSgMx3V9CPsy8HUagNowEZxo_zogcYv4QwzKS6fbj6zfgEeYuTMMXkvsw5xjGkcqU1257xI56GBM-vptP2PvXr96dXxRXb99cnp9dFV7XVS4A6PEIbWs0lMZLW1npRS9ro4XAsjWtAax6rX1nugpaa3tPK91LNML3Vp-w5wffJYZPK6bspiHR_4wwY1iTU0Y2ShktG0Kf_YNehzXOdDun6tqaRkuriFIHyseQUsTeLXGYIG5OCncTojuE6ChEdxui20j09M56bSfsfkt-pUaAPgCJWvMe45-z_2P7E34Srhc</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Swamy, Arun M</creator><creator>Malhotra, Rajesh</creator><creator>Digge, Vijaykumar</creator><creator>Manhas, Vikrant</creator><creator>gautam, Deepak</creator><creator>Srivastava, Deep Narayana</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5971-003X</orcidid></search><sort><creationdate>20230301</creationdate><title>Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study</title><author>Swamy, Arun M ; Malhotra, Rajesh ; Digge, Vijaykumar ; Manhas, Vikrant ; gautam, Deepak ; Srivastava, Deep Narayana</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-aa433eabb63a46c19591c0f176300e4b6b6ae5f33cd6d5ab99fcf333f1e60cf93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Accelerometers</topic><topic>Alignment</topic><topic>Arthroplasty (knee)</topic><topic>Blood</topic><topic>Complications</topic><topic>Joint replacement surgery</topic><topic>Knee</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopaedic implants</topic><topic>Orthopedics</topic><topic>Patients</topic><topic>Portability</topic><topic>Sports Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swamy, Arun M</creatorcontrib><creatorcontrib>Malhotra, Rajesh</creatorcontrib><creatorcontrib>Digge, Vijaykumar</creatorcontrib><creatorcontrib>Manhas, Vikrant</creatorcontrib><creatorcontrib>gautam, Deepak</creatorcontrib><creatorcontrib>Srivastava, Deep Narayana</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Swamy, Arun M</au><au>Malhotra, Rajesh</au><au>Digge, Vijaykumar</au><au>Manhas, Vikrant</au><au>gautam, Deepak</au><au>Srivastava, Deep Narayana</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>31</volume><issue>3</issue><spage>786</spage><epage>792</epage><pages>786-792</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>34997248</pmid><doi>10.1007/s00167-021-06842-y</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5971-003X</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023-03, Vol.31 (3), p.786-792 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2618226318 |
| source | Wiley; Springer Nature; EBSCOhost SPORTDiscus - Ebooks |
| subjects | Accelerometers Alignment Arthroplasty (knee) Blood Complications Joint replacement surgery Knee Medicine Medicine & Public Health Orthopaedic implants Orthopedics Patients Portability Sports Medicine |
| title | Accelerometer-based portable navigation, a faster guide compared to computer-assisted navigation in bilateral total knee arthroplasty—a randomized controlled study |
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