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Radiological outcomes of pinless navigation in total knee arthroplasty: a randomized controlled trial

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aimed to investigate the accuracy of pinless navigation (BrainLAB® VectorVision® Knee 2.5 Navigation System) as an intra-operative alignment guide in total knee arthroplasty (TKA). The authors hypothesized that pinless navigation would reduce the proportion of outliers in conventional TKA, without a significant increase in the duration of surgery.

Methods

Between 2011 and 2012, 100 patients scheduled for a unilateral primary TKA were randomized into two groups: pinless navigation and conventional surgery. All TKAs were performed with the surgical aim of achieving neutral coronal alignment with a 180° mechanical axis. The primary outcomes of this study were post-operative radiographic assessment of lower limb alignment using hip–knee–ankle angle (HKA) and components placement using coronal femoral-component angle (CFA) and coronal tibia-component angle (CTA).

Results

There was a smaller proportion of outliers for HKA, CFA and CTA at 10, 2 and 2 % respectively, in the pinless navigation group, compared to 32, 16 and 16 %, respectively, in the conventional group (p = 0.013, p = 0.032 and p = 0.032, respectively). The mean CFA was also more accurate at 90° in the pinless navigation group compared to 91° in the conventional group (p = 0.002). There was no difference in the duration of surgery between the two groups (n.s.).

Conclusions

Pinless navigation improves lower limb alignment and components placement without a significant increase in the duration of surgery. The authors recommend the use of pinless navigation to verify the coronal alignments of conventional cutting blocks in TKA before the bone cuts are made.

Level of evidence

I.

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Acknowledgments

This study was supported by the SingHealth Foundation Grant (SHF/FG538S/2011); fundings were provided for the use of this new pinless navigation system intra-operatively. The authors thank Yanni Xu and Stephanie Fook-Chong for their technical support.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Singapore General Hospital, Outram Road, Academia Building Level 4, Singapore, 119228, Singapore

    Jerry Yongqiang Chen, Pak Lin Chin, Zongxian Li, Andy Khye Soon Yew, Darren Keng Jin Tay, Shi-Lu Chia, Ngai Nung Lo & Seng Jin Yeo

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  1. Jerry Yongqiang Chen
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  2. Pak Lin Chin
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  3. Zongxian Li
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  7. Ngai Nung Lo
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Correspondence to Jerry Yongqiang Chen.

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Chen, J.Y., Chin, P.L., Li, Z. et al. Radiological outcomes of pinless navigation in total knee arthroplasty: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 23, 3556–3562 (2015). https://doi.org/10.1007/s00167-014-3226-8

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  • DOI: https://doi.org/10.1007/s00167-014-3226-8

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