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Similar clinical results seen with accelerometer-based vs computer-assisted navigation for TKA
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Results from this prospective matched study demonstrated total knee arthroplasty performed with the use of an accelerometer-based navigation system was as accurate as optical computer-assisted navigation with regard to providing a neutral mechanical axis, proper implant positioning and joint line restoration.
Researchers evaluated 76 consecutive patients who underwent total knee arthroplasty (TKA) and were matched for gender, BMI, age and preoperative measures. Of these patients, 38 underwent TKA with Zimmer’s iASSIST accelerometer-based navigation system and 38 patients underwent TKA with an optical computer-assisted navigation system (CAS). Preoperative range of motion, Knee Society scores (KSS), Oxford Knee Scores (OKS) and SF-36 scores were available for all patients.
At 1-month follow-up, investigators took postoperative weight-bearing radiographs of patients. Picture archiving communication systems were used to evaluate lower limb alignment. In addition to patients’ age, BMI, length of hospital stay and duration of surgery, investigators recorded traditional complications and pin-tract-related complications that occurred 30 days after surgery.
Results showed OKS, SF-36 scores, and objective and functional subscores of the KSS improved significantly in both groups from preoperative measures to 6 months postoperatively, and investigators found no significant differences between the TKA groups for any measured clinical outcomes. Investigators noted the CAS group compared with the iASSIST group had slightly higher patient satisfaction rates.
The iASSIST group had a mechanical axis of 1.8°, and the mechanical axis of the CAS group was 2.1°. According to researchers, iASSIST was able to restore the joint line with accuracy similar to that of the CAS, with no significant difference between the groups with regard to joint line deviation. The groups were also similar regarding the number of outliers for the coronal femoral-component and tibial-component angles.
No complications were seen in either group. Researchers noted longer surgical times for the CAS group and “the added cost of accelerometer-based navigation was approximately $1,000 per operation,” they wrote. ‒ by Monica Jaramillo
Disclosures: Goh reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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