Abstract
BackgroundBilateral one-stage total knee arthroplasty (BTKA) have increased because it provides a number of advantages. Recently, Accelerometer-based navigation (ABN) system which guide the cutting plane without intramedullary disturbance might result in less endothelial and microvascular damage. Therefore, we hypothesized that the ABN may reduce blood loss, reduce postoperative pain, and better restore BTKA alignment compared to conventional instruments.MethodsWe retrospectively compared 44 consecutive patients receiving ABN assisted BTKA (iBTKA) to 57 patients with conventional instruments (cBTKA). Identical pre- and post-operative care was utilized to all patients. The outcome measures assessed were hemoglobin (Hb), calculated blood loss (CBL), blood transfusion, VAS score for pain, morphine consumption, knee flexion angle, and length of stay (LOS). Radiographic assessment included mechanical axis (MA) and component positioning at 3–6 months of follow up.ResultsBoth iBTKA and cTKA groups had equivalent demographic data. Postoperative Hb of the cBTKA group was significantly lower than those in the iBTKA group at 24 h (p = 0.02), but there was no significant difference in drain volume, CBL, and blood transfusion rate. For radiographic measures, the iBTKA group had more accurate MA and component orientation, and had a lower number of outliers than those in the cBTKA group (p ≤ 0.01), except for the sagittal femoral component angle.ConclusionThe ABN assisted BTKA could not reduce blood loss or postoperative pain more than cBTKA, nor improve functional recovery. However, the ABN significantly improved the accuracy of MA and prostheses positioning.Trial registrationThe protocol of this study was registered in the Thai Clinical Trials Registry database No. TCTR20180731001# on 25 July 2018.
Highlights
Bilateral one-stage total knee arthroplasty (BTKA) have increased because it provides a number of advantages
Other outcomes including operative time, drain volume, hemoglobin (Hb), calculated blood loss (CBL), allogeneic blood transfusion, intensity of pain determined by the 10-cm visual analog scale (VAS), morphine consumption, maximal angle of knee flexion that the patient could tolerate as measure by the continuous passive motion (CPM) device, and length of stay (LOS) that were prospectively collected at our institution, were compared between groups
Data are presented with mean ± standard deviation (SD.) except for No of patients, gender For anatomical distal femoral and proximal tibial angle, the angle >90o was defined as a valgus position, whereas the angle
Summary
This investigation was a retrospective, cohort study of patients who had undergone BTKA with either conventional instruments (cBTKA) or accelerometer-based navigation (iBTKA) by a single, senior arthroplasty surgeon (AL) who expertise in both conventional and iASSISTTM system. Other outcomes including operative time, drain volume, hemoglobin (Hb), calculated blood loss (CBL), allogeneic blood transfusion, intensity of pain determined by the 10-cm visual analog scale (VAS), morphine consumption, maximal angle of knee flexion that the patient could tolerate as measure by the CPM device, and length of stay (LOS) that were prospectively collected at our institution, were compared between groups. Data are presented with mean ± standard deviation (SD.) except for No of patients, gender For anatomical distal femoral and proximal tibial angle, the angle >90o was defined as a valgus position, whereas the angle
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