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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (4): 728-733. doi: 10.19723/j.issn.1671-167X.2021.04.018

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Comparison of alignment and operative time between portable accelerometer-based navigation device and computer assisted surgery in total knee arthroplasty

WANG Xin-guang1,2,GENG Xiao1,2,LI Yang1,2,WU Tian-chen3,LI Zi-jian1,2,Δ(),TIAN Hua1,2   

  1. 1. Department of Orthopaedics, Peking University Third Hospital, Beijing 100191, China
    2. Engineering Research Center of Bone and Joint Precision Medicine, Ministry of Education, Beijing 100191, China
    3. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing 100191, China
  • Received:2020-06-08 Online:2021-08-18 Published:2021-08-25
  • Contact: Zi-jian LI E-mail:li_zijian@bjmu.edu.cn

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Abstract:

Objective: To explore the differences of alignment and operative time between portable accelerometer-based navigation device (PAD) and computer assisted surgery (CAS) in total knee arthroplasty (TKA). Methods: Data of patients using iASSIST (a kind of PAD) and OrthoPilot (a kind of CAS) for TKA in Peking University Third Hospital from December 2017 to December 2019 were retrospectively collected. The differences of preoperative general data, preoperative alignment, operative time and postoperative alignment were studied between the two groups. Results: A total of 82 patients were enrolled in our study, including 40 patients in the PAD group and 42 patients in the CAS group. Gender, age, body mass index (BMI), surgical side, preoperative hip-knee-ankle (HKA) angle and preoperative HKA angle deviation didn’t show statistically significant difference between the PAD group and the CAS group (P>0.05). Postoperative HKA angle (180.8°±2.2° vs.181.8±1.6°, t=-2.458, P=0.016) and postoperative coronal femoral-component angle (CFA, 90.6°±1.8° vs. 91.6°±1.6°, t =-2.749, P=0.007) of the PAD group were smaller than those of the CAS group, but there was no significant difference in coronal tibia-component angle (CTA, 90.0°±1.3° vs.89.6°±1.4°, t=1.335, P=0.186) between the two groups. There was no significant difference in the rate of outliers (varus or valgus>3°) for postoperative HKA angle (10.0% vs.11.9%,χ2 =0.076,P=0.783), CFA (12.5% vs. 14.3%, χ2=0.056, P=0.813) and CTA (2.5% vs. 0%, χ2=1.063, P=0.303). There was no significant difference in the accuracy of postoperative HKA angle (2.1° vs. 2.0°, t=0.055, P=0.956), CFA (1.4° vs. 1.8°, t=-1.365, P=0.176) and CTA (1.0° vs. 1.1°, t=-0.828, P=0.410) between the two groups. The precision of postoperative HKA angle (1.1° vs. 1.3°, F=1.251, P=0.267), CFA (1.3° vs. 1.4°, F=0.817, P=0.369) and CTA (0.8° vs. 0.9°, F=0.937, P=0.336) were also not significantly different. We also didn’t find statistically significant difference in operative time between the two groups [(83.4±25.6) min vs. (86.5±17.7) min, t=-0.641,P=0.524]. Conclusion: PAD and CAS had similar accuracy and precision in alignment in TKA, and there was no significant difference in operative time, which indicates that PAD has a broad application prospect in TKA.

Key words: Portable accelerometer-based navigation device, Computer assisted surgery, Total knee arthroplasty

CLC Number: 

  • R687.4

Figure 1

Diagram of X-ray measurement after total knee arthroplasty HKA,hip-knee-ankle; CFA, coronal femoral-component angle; CTA, coronal femoral-component angle."

Table 1

Comparison of preoperative general data of patients"

Group Gender,
male :female		 Age/years,
$\bar{x}±s$		 BMI / (kg/m2),
$\bar{x}±s$		 Side, left :right Preoperative HKA
angle/(°), $\bar{x}±s$		 Preoperative HKA angle
deviation/(°), $\bar{x}±s$
PAD 5 :35 66.3±6.1 26.6±3.9 18 :22 187.9±11.5 12.5±5.9
CAS 6 :36 67.2±7.0 27.7±2.8 17 :25 189.7±6.6 11.2±3.6
Statistic value χ2 =0.056 t=-0.614 t=-1.517 χ2=0.171 t=0.876 t=1.330
P 0.813 0.541 0.133 0.679 0.384 0.187

Table 2

Comparison of postoperative alignment and prosthesis position between PAD group and CAS group"

Group Postoperative
HKA
angle/(°),
$\bar{x}±s$		 Postoperative
HKA angle
deviation/(°),
$\bar{x}±s$		 Outliers of
postoperative
HKA angle		 Postoperative
CFA /(°),
$\bar{x}±s$		 Postoperative
CFA
deviation/(°),
$\bar{x}±s$		 Outliers of
postoperative
CFA		 Postoperative
CTA /(°),
$\bar{x}±s$		 Postoperative
CTA
deviation/(°),
$\bar{x}±s$		 Outliers of
postoperative
CTA
PAD 180.8±2.2 2.1±1.1 10.0%(4/40) 90.6±1.8 1.4±1.3 12.5%(5/40) 90.0±1.3 1.0±0.8 2.5%(1/40)
CAS 181.8±1.6 2.0±1.3 11.9%(5/42) 91.6±1.6 1.8±1.4 14.3%(6/42) 89.6±1.4 1.1±0.9 0 (0/42)
Statistic value t=-2.458 t=0.055/
F=1.251		 χ2 =0.076 t=-2.749 t=-1.365/
F=0.817		 χ2 =0.056 t=1.335 t=-0.828/
F=0.937		 χ2 =1.063
P P=0.016 P=0.956/
P=0.267		 P=0.783 P=0.007 P=0.176/
P=0.369		 P=0.813 P=0.186 P=0.410/
P=0.336		 P=0.303

Figure 2

Scatter plots of postoperative HKA angle, CFA and CTA between PAD group and CAS group A, postoperative HKA angle; B, postoperative HKA angle deviation; C, postoperative CFA; D, postoperative CFA deviation; E, postoperative CTA; F, postoperative CTA deviation. PAD, portable accelerometer-based navigation device; CAS, computer assisted surgery; HKA, hip-knee-ankle; CFA, coronal femoral-component angle; CTA, coronal tibia-component angle."

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