Accelerometer-Based Navigation versus Conventional Total Knee Arthroplasty for Posttraumatic Knee Osteoarthritis

Abstract

Background Posttraumatic osteoarthritis (PTOA) frequently comprises femoral or tibial deformity, which makes it difficult to perform total knee arthroplasty (TKA). Accelerometer-based navigation (ABN) could be effective in restoring a neutral mechanical axis (MA) in TKA, but a limited number of studies have been reported in association with PTOA. Therefore, we aimed to compare the lower limb MA between ABN-assisted TKA (ABN-TKA) and conventional TKA in patients with PTOA. Methods We conducted a retrospective analysis of 28 PTOA patients who underwent TKA using a conventional system (cTKA group, n = 16) and the ABN system (iTKA group, n = 12). Standing long-leg radiographs were assessed for MA and prosthesis alignment as primary outcomes. A postoperative MA deviating beyond ± 3° was defined as an outlier. Perioperative outcomes, Oxford Knee Score (OKS) at 2-year follow-up, and complications were also assessed. Results The cTKA group and the iTKA group had a mean age of 63.07 years and 65.25 years, respectively. The iTKA group had significantly better MA accuracy when compared to the cTKA group (1.60° ± 2.09° vs. 3.59° ± 1.34°, p = 0.01). The iTKA group showed significantly less MA outlier than the cTKA group (78.6% vs. 25.0%, p = 0.02). The prosthesis alignment and OKS were comparable between the groups. There were 2 periprosthetic joint infections in the cTKA group and 1 periprosthetic fracture of the distal femur in the iTKA group. Conclusions For PTOA of the knee, both conventional TKA and ABN-TKA significantly improved the postoperative mechanical alignment and functional outcomes. The ABN-TKA seemed to offer higher accuracy and less MA outlier when compared to conventional TKA, and thus ABN could be a good alternative option.

Change in Cartilage Status of Medial Compartment after Open-Wedge High Tibial Osteotomy without Cartilage Regeneration Procedure: Second Look Arthroscopic Assessment

“…The hip–knee–ankle (HKA) angle was defined as the angle between the lines drawn (1) from the center of the femoral head to the center of the knee and (2) drawn from the center of the ankle to the center of the knee on the whole standing leg radiographs. The negative and positive HKA angles were defined valgus and varus, respectively [ 19 , 20 ]. The medial proximal tibial angle (MPTA) was measured as the angle between the tibial mechanical axis and the articular surface of the proximal tibia on whole leg standing radiographs [ 21 , 22 , 23 ].…”

Is the Direct Fixation of Displaced Quadrilateral Plates in Acetabular Fractures Necessary?

“…Acetabular fracture patterns were analyzed and sorted according to the Judet and Letournel classification system [9,10,27]; the displacement patterns of the quadrilateral plate were also analyzed. Post-traumatic osteoarthritis is like the radiological characteristics of general degenerative osteoarthritis in the lower extremity joint, and in this study, Matta's grading was used for the hip joint [28]. Using Matta's grading system for radiological outcome, the assessment of the primary outcome was based on the postoperative survivorship of the hip joint as post-traumatic osteoarthritis [29].…”