The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty.
The accelerometer-based navigation system demonstrated superior radiological outcomes in restoring mechanical alignment and component sagittal positioning in total knee arthroplasty.
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DOI：
10.1186/s12891-021-04213-9
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发表时间：
2021-04-13
影响因子：
2.3
通讯作者：
Lin J
中科院分区：
文献类型：
--
作者：
Gao J;Hou Y;Li R;Ke Y;Li Z;Lin J
本研究旨在确定基于加速度计的导航(ABN)与传统(CON)全膝关节置换术(TKA)相比是否能提高恢复机械轴(MA)、假体定位和临床结果的准确性。共有301名连续患者(ABN：27，CON：274)纳入研究。根据术前人口学和临床参数进行1：4倾向评分匹配(PSM)。比较两组患者术后MA、股骨冠状角(FCA)、股骨矢状角(FSA)、胫骨冠状角(TCA)、胫骨矢状角(TSA)。上述角度的绝对偏差计算为精确值与理想值之差的绝对值，如果在3°以内则定义为正常，否则定义为异常值。在末次随访(FU)时评估膝关节协会膝关节和功能评分(KSKS和KSFS)和活动范围(平均FU分别为21.88和21.56 月)。对不同放射学参数的正常值和异常值之间的临床结果进行次级亚组分析和比较。PSM术后共98例102膝(ABN 21例24膝，CON 77例78膝)。在ABN组，平均MA、FCA和TSA均有显著改善(p = 分别为0.019、0.006和 0.001)。除TCA外， ± 3°偏差范围内的TKA所占比例在术后所有放射学指标中均显著改善( = 分别为0.003、0.021、0.042、0.013，分别为MA、FCA、FSA和TSA)。两组间的绝对偏差也有显著差异(p = 分别为0.020和0.048)。两组间TCA均值、绝对偏差和异常值比率均无显著差异。在临床结果方面，两组之间没有显著差异，尽管KSK、KSFS和ROM(分别为p <； 0.01)与基线相比有显著改善。亚组分析也表明，在不同的放射学参数中，异常值和正常值之间的临床结果没有统计学差异。ABN可以在不明显改善临床结果的情况下，提高机械对准和部件定位的准确性和精确度。为了全面评价ABN的价值，有必要进行进一步的高质量的长期FU研究。
This study aimed to determine whether the accelerometer-based navigation (ABN) could improve the accuracy of restoring mechanical axis (MA), component positioning, and clinical outcomes compared to conventional (CON) total knee arthroplasty (TKA). A total of 301 consecutive patients (ABN: 27, CON: 274) were included. A 1:4 propensity score matching (PSM) was performed between the two groups according to preoperative demographic and clinical parameters. The postoperative MA, femoral coronal angle (FCA), femoral sagittal angle (FSA), tibial coronal angle (TCA) and tibial sagittal angle (TSA) were compared. Absolute deviations of aforementioned angles were calculated as the absolute value of difference between the exact and ideal value and defined as norms if within 3°, otherwise regarded as outliers. Additional clinical parameters, including the Knee Society knee and function scores (KSKS and KSFS) and range of motion (ROM), were assessed at final follow-up (FU) (mean FU was 21.88 and 21.56 months respectively for ABN and CON group). A secondary subgroup analysis and comparison on clinical outcomes were conducted between norms and outliers in different radiological parameters. A total of 98 patients/102 knees were analyzed after the PSM (ABN: 21 patients/24 knees, CON: 77 patients/78 knees). In the ABN group, the mean MA, FCA and TSA were significantly improved (p = 0.019, 0.006, < 0.001, respectively). Proportions of TKAs within a ± 3°deviation were significantly improved in all the postoperative radiological variables except for TCA (p = 0.003, 0.021, 0.042, 0.013, respectively for MA, FCA, FSA, and TSA). The absolute deviations of FSA and TSA were also significantly lower in the ABN group (p = 0.020, 0.048, respectively). No significant differences were found in either mean value, absolute deviation or outlier ratio of TCA between two groups. On clinical outcomes, there were no significant differences between two groups, although KSKS, KSFS and ROM (p < 0.01, respectively) dramatically improved compared to baseline. The subgroup analysis also demonstrated no statistical difference on clinical outcomes between the outliers and norms in varied radiological parameters. The ABN could improve the accuracy and precision of mechanical alignment and component positioning without significant improvement of clinical outcomes. Further high quality studies with long term FU are warranted to comprehensively evaluate the value of the ABN.
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影响因子：
5.3
作者：
Catani, Fabio;Biasca, Nicola;Giannini, Sandro
通讯作者：
Giannini, Sandro
影响因子：
3.5
作者：
Jones, Christopher W.;Jerabek, Seth A.
通讯作者：
Jerabek, Seth A.
DOI：
10.1302/0301-620x.73b5.1894655
发表时间：
1991-09-01
影响因子：
--
作者：
JEFFERY, RS;MORRIS, RW;DENHAM, RA
通讯作者：
DENHAM, RA
影响因子：
3.5
作者：
Huang, Eddie H.;Copp, Steven N.;Bugbee, William D.
通讯作者：
Bugbee, William D.
影响因子：
1.9
作者：
An, Vincent V. G.;Twiggs, Joshua;Fritsch, Brett A.
通讯作者：
Fritsch, Brett A.