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J Arthroplasty. 2014 Feb;29(2):288-94. doi: 10.1016/j.arth.2013.06.006. Epub 2013 Jul 19.

Extramedullary guides versus portable, accelerometer-based navigation for tibial alignment in total knee arthroplasty: a randomized, controlled trial: winner of the 2013 HAP PAUL award.

Author information

1
Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
2
Adult Reconstruction and Joint Replacement Service, Department of Orthopaedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York.

Abstract

Extramedullary (EM) tibial alignment guides have demonstrated a limited degree of accuracy in total knee arthroplasty (TKA). The purpose of this study was to compare the tibial component alignment obtained using a portable, accelerometer-based navigation device versus EM alignment guides. One hundred patients were enrolled in this prospective, randomized controlled study to receive a TKA using either the navigation device, or an EM guide. Standing AP hip-to-ankle and lateral knee-to-ankle radiographs were obtained at the first, postoperative visit. 95.7% of tibial components in the navigation cohort were within 2° of perpendicular to the tibial mechanical axis, versus 68.1% in the EM cohort (P<0.001). 95.0% of tibial components in the navigation cohort were within 2° of a 3° posterior slope, versus 72.1% in the EM cohort (P=0.007). A portable, accelerometer-based navigation device decreases outliers in tibial component alignment compared to conventional, EM alignment guides in TKA.

KEYWORDS:

component alignment; computer navigation; posterior slope; tibial alignment; total knee arthroplasty

PMID:
23871707
DOI:
10.1016/j.arth.2013.06.006
[Indexed for MEDLINE]
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