Navigation-enhanced instrumentation reduces outlier rate, improves cut accuracy during TKA
Compared with conventional instrumentation, navigation-enhanced instrumentation improved cut accuracy and reduced surgical outlier rates during total knee arthroplasty procedures, according to published results.
Two senior surgeons, two fellows and four orthopedic residents from the department of orthopedic surgery at Stanford Medicine performed a series of distal femoral and proximal tibial resections for TKA on varus, valgus and neutral knee models with and without navigation-assisted instrumentation.
According to the study, accuracy was defined by the rate of outliers, measured by any deviation from the planned cut by more than 2° or 2 mm. Additionally, the researchers analyzed the effect of physician experience level on instrumentation mastery and cut accuracy.
“Navigation-enhanced instrumentation resulted in significant improvements in accuracy across all training levels,” the researchers wrote in the study.
Compared with conventional instrumentation, navigation enhancement reduced total outlier rate from 35% to 4% for experienced users and 34% to 10% for trainees, investigators added. They also found limited effect of experience on instrumentation mastery.
“Overall, the results provide insight into modifiable factors that account for surgical accuracy. Experience level does not correlate with improved outlier rates, nor does experience confer an advantage for most cuts,” the researchers wrote. “Navigation-enhanced instrumentation is a promising and novel hybrid system of instrumentation, with minimal deviation from conventional surgical technique and a ‘measure twice; cut once’ effect that may extend beyond navigation,” they concluded.
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