nach oben

Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

26.08.2019 | KNEE

Improved implant alignment accuracy with an accelerometer-based portable navigation system in medial unicompartmental knee arthroplasty

verfasst von: Yoshihito Suda, Koji Takayama, Kazunari Ishida, Shinya Hayashi, Shingo Hashimoto, Takahiro Niikura, Takehiko Matsushita, Ryosuke Kuroda, Tomoyuki Matsumoto

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 9/2020

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study aimed to examine the accuracy of tibial implant alignment using an accelerometer-based portable navigation system in unicompartmental knee arthroplasty (UKA).

Methods

This retrospective matched case–control study reviewed 51 UKAs performed using an accelerometer-based portable navigation system, matched with 51 UKAs performed using conventional extramedullary rods. Coronal alignment and posterior slope of the tibial implant were measured on postoperative radiographs, and differences from preoperative planning were examined. Outliers and accuracy of tibial implant alignment were compared between the portable navigation and conventional groups using Fisher’s exact test and Mann–Whitney U test, respectively.

Results

In the portable navigation group, 100% of the implants were aligned within 3.0° of both target coronal and sagittal implant alignment. In the conventional group, 76.5% and 88.2% of the implants were within 3.0° of both target coronal and sagittal implant alignment. Statistical analysis revealed that outliers of coronal and sagittal alignment were significantly less in the portable navigation group than in the conventional group (P < 0.05). In addition, the absolute value difference between postoperative measurement and preoperative planning of both coronal and sagittal alignment was significantly smaller in the portable navigation group than in the conventional group (P < 0.05).

Conclusion

The portable navigation system improved the accuracy of tibial implant alignment in UKA. We found that 100% of the implants were aligned within 3.0° of both target coronal and sagittal implant alignment. The portable navigation system decreased the outliers of tibial coronal and sagittal alignment.

Level of evidence

Retrospective case–control study, Level III.

Aleto TJ, Berend ME, Ritter MA, Faris PM, Meneghini RM (2008) Early failure of unicompartmental knee arthroplasty leading to revision. J Arthroplasty 23:159–163CrossRef

Bell SW, Anthony I, Jones B, MacLean A, Rowe P, Blyth M (2016) Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty: data from a prospective, randomized controlled study. J Bone Jt Surg Am 98:627–635CrossRef

Brin YS, Nikolaou VS, Joseph L, Zukor DJ, Antoniou J (2011) Imageless computer assisted versus conventional total knee replacement. A Bayesian meta-analysis of 23 comparative studies. Int Orthop 35:331–339CrossRef

Chatellard R, Sauleau V, Colmar M, Robert H, Raynaud G, Brilhault J (2013) Medial unicompartmental knee arthroplasty: does tibial component position influence clinical outcomes and arthroplasty survival? Orthop Traumatol Surg Res 99:S219–S225CrossRef

Chona D, Bala A, Huddleston JI 3rd, Goodman SB, Maloney WJ, Amanatullah DF (2018) Effect of computer navigation on complication rates following unicompartmental knee arthroplasty. J Arthroplasty 33:3437–3440CrossRef

Cip J, Obwegeser F, Benesch T, Bach C, Ruckenstuhl P, Martin A (2018) Twelve-year follow-up of navigated computer-assisted versus conventional total knee arthroplasty: a prospective randomized comparative trial. J Arthroplasty 33:1404–1411CrossRef

Citak M, Dersch K, Kamath AF, Haasper C, Gehrke T, Kendoff D (2014) Common causes of failed unicompartmental knee arthroplasty: a single-centre analysis of four hundred and seventy one cases. Int Orthop 38:961–965CrossRef

Cobb J, Henckel J, Gomes P et al (2006) Hands-on robotic unicompartmental knee replacement: a prospective, randomised controlled study of the acrobot system. J Bone Jt Surg Br 88:188–197CrossRef

Collier MB, Eickmann TH, Sukezaki F, McAuley JP, Engh GA (2006) Patient, implant, and alignment factors associated with revision of medial compartment unicondylar arthroplasty. J Arthroplasty 21:108–115CrossRef

10.

Fisher DA, Watts M, Davis KE (2003) Implant position in knee surgery: a comparison of minimally invasive, open unicompartmental, and total knee arthroplasty. J Arthroplasty 18:2–8CrossRef

11.

Foran JR, Brown NM, Della Valle CJ, Berger RA, Galante JO (2013) Long-term survivorship and failure modes of unicompartmental knee arthroplasty. Clin Orthop Relat Res 471:102–108CrossRef

12.

Gilmour A, MacLean AD, Rowe PJ et al (2018) Robotic-arm-assisted vs conventional unicompartmental knee arthroplasty. The 2-year clinical outcomes of a randomized controlled trial. J Arthroplasty 33:S109–S115CrossRef

13.

Grant AL, Doma KD, Hazratwala K (2017) Determination of the accuracy of navigated kinematic unicompartmental knee arthroplasty: a 2-year follow-up. J Arthroplasty 32:1443–1452CrossRef

14.

Gulati A, Chau R, Simpson DJ, Dodd CA, Gill HS, Murray DW (2009) Influence of component alignment on outcome for unicompartmental knee replacement. Knee 16:196–199CrossRef

15.

Hamilton WG, Collier MB, Tarabee E, McAuley JP, Engh CA Jr, Engh GA (2006) Incidence and reasons for reoperation after minimally invasive unicompartmental knee arthroplasty. J Arthroplasty 21:98–107CrossRef

16.

Hernigou P, Deschamps G (2004) Posterior slope of the tibial implant and the outcome of unicompartmental knee arthroplasty. J Bone Jt Surg Am 86:506–511CrossRef

17.

Ikawa T, Takemura S, Kim M, Takaoka K, Minoda Y, Kadoya Y (2017) Usefulness of an accelerometer-based portable navigation system in total knee arthroplasty. Bone Jt J 99:1047–1052CrossRef

18.

Insall J, Aglietti P (1980) A five to seven-year follow-up of unicondylar arthroplasty. J Bone Jt Surg Am 62:1329–1337CrossRef

19.

Inui H, Taketomi S, Yamagami R, Sanada T, Tanaka S (2016) Twice cutting method reduces tibial cutting error in unicompartmental knee arthroplasty. Knee 23:173–176CrossRef

20.

Iorio R, Mazza D, Drogo P et al (2015) Clinical and radiographic outcomes of an accelerometer-based system for the tibial resection in total knee arthroplasty. Int Orthop 39:461–466CrossRef

21.

Jung KA, Kim SJ, Lee SC, Hwang SH, Ahn NK (2010) Accuracy of implantation during computer-assisted minimally invasive Oxford unicompartmental knee arthroplasty: a comparison with a conventional instrumented technique. Knee 17:387–391CrossRef

22.

Kamenaga T, Hiranaka T, Hida Y, Fujishiro T, Okamoto K (2018) Effect of tibial component position on short-term clinical outcome in Oxford mobile bearing unicompartmental knee arthroplasty. J Orthop Sci 23:807–810CrossRef

23.

Keene G, Simpson D, Kalairajah Y (2006) Limb alignment in computer-assisted minimally-invasive unicompartmental knee replacement. J Bone Jt Surg Br 88:44–48CrossRef

24.

Laskin RS (1978) Unicompartmental tibiofemoral resurfacing arthroplasty. J Bone Jt Surg Am 60:182–185CrossRef

25.

Pearle AD, van der List JP, Lee L, Coon TM, Borus TA, Roche MW (2017) Survivorship and patient satisfaction of robotic-assisted medial unicompartmental knee arthroplasty at a minimum two-year follow-up. Knee 24:419–428CrossRef

26.

Rosenberger RE, Fink C, Quirbach S, Attal R, Tecklenburg K, Hoser C (2008) The immediate effect of navigation on implant accuracy in primary mini-invasive unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 16:1133–1140CrossRef

27.

Swienckowski J, Page BJ (1989) Medial unicompartmental arthroplasty of the knee Use of the L-cut and comparison with the tibial inset method. Clin Orthop Relat Res 239:161–167

28.

Takayama K, Ishida K, Muratsu H et al (2018) The medial tibial joint line elevation over 5 mm restrained the improvement of knee extension angle in unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 26:1737–1742CrossRef

29.

Takayama K, Matsumoto T, Muratsu H et al (2016) The influence of posterior tibial slope changes on joint gap and range of motion in unicompartmental knee arthroplasty. Knee 23:517–522CrossRef

30.

Ueyama H, Minoda Y, Sugama R, Ohta Y, Yamamura K, Nakamura S et al (2018) An accelerometer-based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D measurements. Knee Surg Sports Traumatol Arthrosc 27:1580–1586CrossRef

31.

van der List JP, McDonald LS, Pearle AD (2015) Systematic review of medial versus lateral survivorship in unicompartmental knee arthroplasty. Knee 22:454–460CrossRef

32.

van der List JP, Zuiderbaan HA, Pearle AD (2016) Why do medial unicompartmental knee arthroplasties fail today? J Arthroplasty 31:1016–1021CrossRef

33.

Whiteside LA (2005) Making your next unicompartmental knee arthroplasty last: three keys to success. J Arthroplasty 20:2–3CrossRef

34.

Zambianchi F, Digennaro V, Giorgini A, Grandi G, Fiacchi F, Mugnai R et al (2015) Surgeon's experience influences UKA survivorship: a comparative study between all-poly and metal back designs. Knee Surg Sports Traumatol Arthrosc 23:2074–2080CrossRef

Titel: Improved implant alignment accuracy with an accelerometer-based portable navigation system in medial unicompartmental knee arthroplasty
verfasst von: Yoshihito Suda
Koji Takayama
Kazunari Ishida
Shinya Hayashi
Shingo Hashimoto
Takahiro Niikura
Takehiko Matsushita
Ryosuke Kuroda
Tomoyuki Matsumoto
Publikationsdatum: 26.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 9/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-019-05669-y

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2020

Treatment strategies for ischiofemoral impingement: a systematic review

Patients return to work sooner after unicompartmental knee arthroplasty than after total knee arthroplasty

Effect of additional distal femoral resection on flexion deformity in posterior-stabilized total knee arthroplasty

Medial unicompartmental knee arthroplasty to patients with a ligamentous deficiency can cause biomechanically poor outcomes

High congruency MB insert design: stabilizing knee joint even with PCL deficiency