• Arch Orthop Trauma Surg · Mar 2017

    The accuracy of a hand-held navigation system in total knee arthroplasty.

    • Bryan Loh, Jerry Yongqiang Chen, Andy Khye Soon Yew, Hee Nee Pang, Darren Keng Jin Tay, Shi-Lu Chia, Ngai Nung Lo, and Seng Jin Yeo.
    • Department of Orthopaedic Surgery, Singapore General Hosptial, The Academia, 20 College Road, Singapore, 169856, Singapore. zantesuken@hotmail.com.
    • Arch Orthop Trauma Surg. 2017 Mar 1; 137 (3): 381-386.

    IntroductionThis study aims to evaluate the effectiveness of a new hand-held navigation system. The authors of this study hypothesize that this navigation system will improve overall lower limb alignment and implant placement without causing a delay in surgery.Patients And MethodsTwo hundred consecutive patients diagnosed with tricompartmental osteoarthritis and underwent total knee arthroplasty by a senior surgeon were included in this study. One hundred patients underwent TKA using the hand-held navigation system, while the other 100 patients underwent TKA using the conventional technique. The primary outcomes of this study were the overall alignment of the lower limb and the position of the components. This was determined radiologically using the: (1) Hip-Knee-Ankle angle (HKA) for lower limb alignment; (2) Coronal Femoral-Component angle (CFA); and (3) Coronal Tibia-Component angle (CTA) for component position. Normal alignment was taken as 180° ± 3° for the HKA and 90° ± 3° for both the CFA and CTA.ResultsFor the CFA, the proportion of outliers was 7 and 17% in the hand-held navigation and conventional group, respectively (p = 0.030). For the HKA and CTA, there was no difference in the proportion of outliers between the two groups. The duration of surgery was 73 ± 9 min and 87 ± 15 min in the hand-held navigation and conventional group, respectively (p < 0.001).ConclusionThis hand-held navigation system is an effective intraoperative tool for reducing the proportion of outliers for femoral implant placement as well as the duration of surgery. The authors conclude that it can be considered for use to check femoral implant placement intra-operatively.Level Of EvidenceIII.

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