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Speaker recommends routine use of handheld navigation in TKR

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ORLANDO, Fla. — The use of handheld navigation should be adopted by surgeons performing total knee replacement because it is easy to use and adds little additional time to surgery, according to a presenter at the Current Concepts in Joint Replacement Winter Meeting, here.

“I believe handheld navigation for total knee replacement is easy and fast, it’s accurate, it’s relatively cheap and it’s like your smart phone – it’s hard to imagine life now without it – and in my opinion there is no reason not to use it,” Edwin P. Su, MD, said in his presentation.

Edwin P. Su

Su noted that although there is no evidence of a clinical benefit for computer-navigated total knee replacement (TKR), some studies have shown 8° of varus alignment of the tibial component could carry a risk of failure. Critics also cite high costs as a reason to stay away from computer-navigated surgery, but the KneeAlign System (OrthAlign; Aliso Viejo, Calif.) is a handheld device that uses accelerometers and gyroscopes similar to technology seen in smartphones, according to Su.

“You can use it for both the tibial and femoral cuts,” Su said. “It doesn’t disrupt your flow at all. You attach the first guide to your distal femur, it’s going to help you make your distal femoral varus/valgus cut. You don’t need an IM rod, you just put it at the center of the knee, affix it to the bone, attach your sensors and you go through a quick registration process.”

The accuracy of the device is comparable to larger computer navigation units and assists in making cuts within 2° of the desired alignment, according to the abstract. Su cited one study where the 96% of the handheld navigation unit tibial cuts were within 2° of the coronal plane alignment compared to 68% in the conventional cutting guide group; another study found no difference in radiographic results between handheld navigation units and conventional imageless computer navigation units. – by Jeff Craven

Reference:

Su Ep. Paper #114. Presented at: Current Concepts in Joint Replacement Winter Meeting; December 12-14, 2013; Orlando, Fla.

Disclosure: Su is a consultant for Smith & Nephew.