Radiological Outcomes of Pinless Navigation in Total Knee Arthroplasty: a Randomized Controlled Trial

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2014 Aug 15

PMID 25119055

Citations 7

Authors

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

Affiliations

Soon will be listed here.

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.

Citing Articles

Comparison of the accuracy and efficacy of different assistive techniques in primary total knee arthroplasty: A network meta-analysis.

Zheng Y, Li Y, Yuan Z, Geng X, Tian H J Exp Orthop. 2024; 11(4):e70098.

PMID: 39619732 PMC: 11604599. DOI: 10.1002/jeo2.70098.

Navigated Versus Conventional Total Knee Arthroplasty: A Systematic Review and Meta-analysis of Prospective Randomized Controlled Trials.

Sheridan G, Abdelmalek M, Howard L, Neufeld M, Masri B, Garbuz D J Orthop. 2024; 50:99-110.

PMID: 38187368 PMC: 10770435. DOI: 10.1016/j.jor.2023.11.070.

Comparison of the radiographic outcomes and total blood loss between pinless navigation and conventional method in minimally invasive total knee arthroplasty.

Yen S, Lin P, Wang J J Orthop Surg Res. 2023; 18(1):254.

PMID: 36978115 PMC: 10043515. DOI: 10.1186/s13018-023-03534-w.

Navigated functional alignment total knee arthroplasty achieves reliable, reproducible and accurate results with high patient satisfaction.

Hazratwala K, Gouk C, Wilkinson M, OCallaghan W Knee Surg Sports Traumatol Arthrosc. 2023; 31(9):3861-3870.

PMID: 36917248 PMC: 10435654. DOI: 10.1007/s00167-023-07327-w.

Fragility Index as a Measure of Randomized Clinical Trial Quality in Adult Reconstruction: A Systematic Review.

Herndon C, McCormick K, Gazgalis A, Bixby E, Levitsky M, Neuwirth A Arthroplast Today. 2021; 11:239-251.

PMID: 34692962 PMC: 8517286. DOI: 10.1016/j.artd.2021.08.018.

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