TY - JOUR
AR - JSR-2020-1-105
TI - Systematic Review of Accelerometer Based Navigation in Total Knee Arthroplasty: Improved Alignment, Clinical Results, and Patient Reported Outcomes Compared to Conventional Guides?
AU - Stephen T., Duncan
AU - Cale , Jacobs
AU - Lucian , Warth
AU - Syed K., Mehdi
JO - Journal of Surgery and Rehabilitation
PY - 2020
DA - Wed 15, Jul 2020
SN - 2733-2551
DO - http://dx.doi.org/10.31487/j.JSR.2020.01.05
UR - https://www.sciencerepository.org/systematic-review-of-accelerometer-based-navigation-in-total-knee-arthroplasty_JSR-2020-1-105 
KW - Accelerometer-based navigation, computer-assisted navigation, total knee arthroplasty, outcomes, knee, joint
AB - Background: There have been significant advancements to restore knee alignment postoperatively in the
TKA population. This includes the use of accelerometer-based portable navigation (ABN). ABN can lead
to a more precise restoration of the neutral mechanical axis, improve efficiency and potentially decrease
early- and long-term complications. The degree with which ABN can achieve this remains unclear. We
performed a systematic review to answer this question.
Methods: We performed a systematic review in accordance with Cochrane guidelines of controlled studies
(prospective and retrospective) in MEDLINE with an emphasis on studies comparing postoperative
outcomes such as mechanical axis alignment, operative time, blood loss, complications and clinical outcome
scores in total knee arthroplasty patients using ABN versus conventional intramedullary guides.
Results: ABN was associated with significantly fewer outliers in hip-knee-ankle alignment (p = 0.0006),
femoral component alignment (p < 0.0001). ABN was associated with significantly less estimated blood
loss (p = 0.05) and no difference in operative times (p = 0.21). Finally, there was no difference regarding
functional outcomes or DVT.
Conclusion: ABN more accurately achieves neutral mechanical alignment with a smaller incidence of
outliers. There was not an increase in operative time with using ABN and there were reductions in blood
loss as well. We conclude that ABN offers the benefit of improved mechanical alignment.