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Accuracy of different navigation systems for femoral and tibial implantation in total knee arthroplasty: a randomised comparative study

  • Knee Arthroplasty
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

It remains to be established whether optical computed tomography (CT)-free and acceleration-based navigation systems differ in terms of implantation accuracy and clinical outcomes for total knee arthroplasty. This randomised prospective study compared the implantation accuracy of these two navigation systems in total knee arthroplasty.

Methods

Optical CT-free navigation (ExactechGPS) or acceleration-based navigation (KneeAlign2) was randomly assigned to the left or right knee of 45 patients who underwent a single-stage bilateral total knee arthroplasty: the ExactechGPS (n = 45) and KneeAlign2 groups (n = 45) were compared. Component alignments were evaluated using three-dimensional computed tomography and radiography at pre- and post-surgery. Implantation accuracy of the component alignment, proportion of outliers, postoperative range of motion, and Japanese Orthopaedic Association (JOA) score were compared between the systems.

Results

The implantation accuracies of the lower-extremity mechanical alignment, coronal femoral component angle, coronal tibial component angle, sagittal femoral component, axial femoral angle, and axial tibial angle had no significant difference between the groups. The implantation accuracy of the sagittal tibial component angle was superior in the ExactechGPS than the KneeAlign2 group (1.3° vs. 1.8°, P = 0.034). The proportions of outliers, range of motion, and JOA score had no significant difference between the groups.

Conclusion

In the tibial sagittal plane, there was a significant difference in the implantation accuracy, but its difference did not affect the clinical outcomes. Both navigation systems have clinically acceptable implantation accuracy.

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Funding

No external funding was received in support of this study.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa City, Ishikawa, 920-0934, Japan

    Yoshitomo Saiki, Tamon Kabata & Hiroyuki Tsuchiya

  2. Department of Rehabilitation Physical Therapy, Faculty of Health Science, Fukui Health Science University, 55-13-1 Egami, Fukui City, Fukui, 910-3190, Japan

    Yoshitomo Saiki

  3. Department of Orthopaedic Surgery, Fukui General Hospital, 58-16-1 Egami, Fukui City, Fukui, 910-8561, Japan

    Tomohiro Ojima & Seigaku Hayashi

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  1. Yoshitomo Saiki
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The following are the four criteria for authorship. Substantial contributions to the conception or design, acquisition, analysis, or interpretation of data for the work. Drafting the work or revising it critically for important content. Final approval of the version to be published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Tomohiro Ojima.

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This study was approved by our institutional ethics committee and the UMIN clinical trial registry (Trial Registration No. UMIN000032420).

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Saiki, Y., Ojima, T., Kabata, T. et al. Accuracy of different navigation systems for femoral and tibial implantation in total knee arthroplasty: a randomised comparative study. Arch Orthop Trauma Surg 141, 2267–2276 (2021). https://doi.org/10.1007/s00402-021-04205-3

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  • DOI: https://doi.org/10.1007/s00402-021-04205-3

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