Accuracy and outcome of a handheld accelerometer-based navigation device compared to conventional alignment method in total knee arthroplasty in a Chinese population

Abstract

Total knee arthroplasty (TKA) is a successful procedure in treatment of degenerative disease of the knee, and optimal component placement is essential for long-term implant survival. The purpose of this study was to compare the accuracy of the accelerometer-based KneeAlign 2 (KA2) navigation system against conventional methods for accurate positioning of the femoral and tibial components in TKA in a Chinese population. A total of 123 (37 conventional and 86 KA2) cases of elective primary TKA were reviewed. Hip-knee-ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), and anatomical lateral distal femoral angle (aLDFA) were measured from hip-to-ankle EOS radiographs. Accuracy of conventional alignment and KA2 navigation system was assessed by measuring the difference between intraoperative goal and postoperative radiographic measurements of the components for each respective case. There was no significant difference between conventional alignment methods and KA2 navigation in achieving a neutral mechanical alignment of the lower limb. KA2 navigation was significantly more accurate than conventional alignment methods for optimal positioning of the tibial component in both the coronal and sagittal plane, while no significant difference between the two groups was appreciated in the positioning of the femoral component in the coronal plane. TKA using the accelerometer-based KA2 system was found to offer a high degree of accuracy in component alignment, and in particular, significantly improved tibial component alignment in comparison with conventional alignment methods in a Chinese population. However, no significant improvements were observed in neutral mechanical axis of the lower limb alignment and femoral component placement in the coronal plane.