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Hand-held navigation may improve accuracy in minimally invasive total knee arthroplasty: a prospective randomized controlled trial

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Abstract

Introduction

A novel hand-held navigation combines gyroscopes, accelerometers and a secure local wireless channel to guide the distal femoral and proximal tibial cutting positions by displaying to the surgeon directly on the pods within the surgical field. No previous study has reported on its accuracy.

Materials and methods

A prospective randomized controlled trial was performed to compare radiographic outcomes in minimally invasive surgery total knee arthroplasty (MIS-TKA) with (40 patients, 40 knees) and without (40 patients, 40 knees) the novel hand-held navigation.

Results

The use of hand-held navigation resulted in fewer outliers (> ± 3° malalignment) in all frontal alignment: the hip-knee-ankle, the femoral component, and the tibial component. Tibial slope was also better achieved with the navigation. Femoral component flexion was not significantly different. Operation time and bone cutting time with the navigation were not longer than those without. Blood loss from drainage was not significantly different.

Conclusion

The hand-held navigation improves accuracy for mechanical alignment and positioning of the prosthesis without additional surgical time.

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Acknowledgments

The patients’ expenses for the TKA were covered by a public healthcare program. NK received a scholarship for her MS study from Thailand Graduate Institute of Science and Technology (TGIST), TG-CPMO 01-56-008.

Conflict of interest

ST is a paid consultant for Zimmer. The remaining authors declare that they have no conflict of interest.

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Orthopaedics, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok, 10300, Thailand

    Satit Thiengwittayaporn & Chanintorn Jarupongprapa

  2. Department of Physical Medicine and Rehabilitation, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, 681 Samsen Rd, Dusit, Bangkok, 10300, Thailand

    Yupadee Fusakul

  3. Center of Calcium and Bone Research (COCAB), and Department of Physiology, Faculty of Science, Mahidol University, 272 Rama VI Road, Ratchathewi District, Bangkok, 10400, Thailand

    Nunnapat Kangkano & Narattaphol Charoenphandhu

Authors
  1. Satit Thiengwittayaporn
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  2. Yupadee Fusakul
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  3. Nunnapat Kangkano
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  4. Chanintorn Jarupongprapa
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  5. Narattaphol Charoenphandhu
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Correspondence to Satit Thiengwittayaporn.

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Thiengwittayaporn, S., Fusakul, Y., Kangkano, N. et al. Hand-held navigation may improve accuracy in minimally invasive total knee arthroplasty: a prospective randomized controlled trial. International Orthopaedics (SICOT) 40, 51–57 (2016). https://doi.org/10.1007/s00264-015-2848-x

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  • DOI: https://doi.org/10.1007/s00264-015-2848-x

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