Systematic Review of Accelerometer Based Navigation in Total Knee Arthroplasty: Improved Alignment, Clinical Results, and Patient Reported Outcomes Compared to Conventional Guides?

Author Info

Stephen T. Duncan Cale Jacobs Lucian Warth Syed K. Mehdi

Corresponding Author

Stephen T. Duncan
Department of Orthopaedic Surgery, University of Kentucky, Lexington, Kentucky, USA

A B S T R A C T

Background: There have been significant advancements to restore knee alignment postoperatively in the TKA population. This includes the use of accelerometer-based portable navigation (ABN). ABN can lead to a more precise restoration of the neutral mechanical axis, improve efficiency and potentially decrease early- and long-term complications. The degree with which ABN can achieve this remains unclear. We performed a systematic review to answer this question. Methods: We performed a systematic review in accordance with Cochrane guidelines of controlled studies (prospective and retrospective) in MEDLINE with an emphasis on studies comparing postoperative outcomes such as mechanical axis alignment, operative time, blood loss, complications and clinical outcome scores in total knee arthroplasty patients using ABN versus conventional intramedullary guides. Results: ABN was associated with significantly fewer outliers in hip-knee-ankle alignment (p = 0.0006), femoral component alignment (p < 0.0001). ABN was associated with significantly less estimated blood loss (p = 0.05) and no difference in operative times (p = 0.21). Finally, there was no difference regarding functional outcomes or DVT. Conclusion: ABN more accurately achieves neutral mechanical alignment with a smaller incidence of outliers. There was not an increase in operative time with using ABN and there were reductions in blood loss as well. We conclude that ABN offers the benefit of improved mechanical alignment.

Article Info

Article Type

Review Article

Publication history

Received: Tue 23, Jun 2020
Accepted: Wed 08, Jul 2020
Published: Wed 15, Jul 2020

Copyright

© 2023 Stephen T. Duncan. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSR.2020.01.05