Application of computer-assisted navigation (iASSIST Technology) in total knee arthroplasty

WEI Hui; YANG Shu-hua; LIU Xian-zhe

doi:10.3969/j.issn.2095-252X.2018.04.002

Abstract：Objective To explore the accuracy, advantages and disadvantages of computer-assisted navigation (iASSIST Technology). Methods Twenty-three patients (24 knees) with severe degenerative knee osteoarthritis in our hospital underwent total knee arthroplasty from June 2016 to September 2016. They were randomly divided into the navigation group (12 knees of 11 cases) and the traditional group (12 knees of 12 cases). The two groups were matched with age, BMI, preoperative force line error and KSS score by paired t test, and the results showed no significant differences between the 2 groups (P ＞ 0.05). Postoperative general data of the 2 groups were compared: postoperative KSS score, intraoperative and postoperative bleeding, amount of hemoglobin decrease at day 3 postoperation, and the duration of surgery. X-ray examination was performed 3 months after the operation. The line deviation of the lower extremity and the position deviation angle of the coronal and sagittal planes between the 2 groups were then compared. Results The average KSS score of the navigation group was (85.83 ± 4.303), which was significantly higher than that of the traditional group (80.08 ± 5.178) (t =2.959, P =0.007). The mean postoperative blood loss in the navigation group (482.50 ± 48.453) ml was less than that in the traditional group (707.50 ± 78.059) ml (t =8.484, P =0.000). The navigation group had a mean decrease of hemoglobin value 3 days post-operation (10.42 ±2.021) g / L compared with the traditional group (19.08 ± 2.778) g / L, with statistical significance (t =8.739, P =0.000). The duration of operation in the navigation group (67.42 ± 4.999 min) was longer than that in the traditional group (63.33 ± 5.015 min), with no significant differences between the 2 groups (t =1.998, P =0.058). The average deviation angle of the hip-knee-ankle angle of the navigation group 3 months post-operation (1.24 ± 0.452) ° was smaller than that of the traditional group (2.33 ± 0.619) ° (t =4.885, P =0.000). The average angular deviation of the frontal femoral component in the navigation group (0.86 ± 0.193) ° was smaller than that in the traditional group (2.01 ± 0.474) ° (t =7.788, P =0.000). The mean deviation angle of the frontal tibial component in the navigation group was (1.06 ± 0.258) ° which was smaller than that in the traditional group (1.32 ± 0.225) °, with statistical significance (t =2.617, P =0.016). The average deviation angle of the flexion angle of the lateral femoral component in the navigation group (6.43 ± 1.435) ° was smaller than that of the traditional group (9.43 ± 1.395) ° (t =5.208, P =0.000). The mean deviation angle of the lateral tibial component in the navigation group (2.13 ± 0.259) ° was smaller than that in the traditional group (3.25 ± 0.582) °, with statistical significance (t =6.112, P =0.000). Conclusions Computer-assisted navigation (iASSIST Technology) has the advantages of accurate positioning, less surgical injury, short learning cycle, etc.