A study on radiological outcomes of accelerometer based hand held navigation system in total knee arthroplasty

Background: The goal of obtaining more accurate component alignment in total knee arthroplasty (TKA) has led to the development of techniques like portable accelerometer-based handheld navigation system, computer assisted system, patient specific instrumentation. Among which hand held navigation has showed promising results for achieving accurate resection and alignment and only few studies were done to assess radiological outcome or the effective component alignment using portable accelerometer-based hand held navigation system in TKA.Methods: TKA using portable accelerometer-based hand held navigation system (Smith and Nephew- knee align) was done on 25 knees with primary osteoarthritis. Preoperative and post-operative mechanical axis and component alignments were measured using hip-to-ankle radiographs.Results: Among the femoral components, 92.0% were placed within 90°±2° to the femoral mechanical axis in the coronal and   96.0% of the tibial components were placed within 90°±2° to the mechanical axis in the coronal plane, 94.3% of the TKAs had an overall lower extremity alignment within 3° of neutral to the mechanical axis, based on postoperative hip-to-ankle radiographs.Conclusions: The degree of accuracy in positioning the femoral and tibial component in TKA using portable accelerometer-based hand held navigation system (knee align) is very much promising and is an effective intraoperative tool for reducing the proportion of outliers for component placement and thus decreasing the chances of instability and early wear and tear of the components in TKA

Functional outcomes after modified Sauve-Kapandji arthrodesis for distal radioulnar joint dysfunction

Background: The distal radioulnar joint (DRUJ) dysfunction manifests as pain, weakness and reduced range of motion. There are various treatments for DRUJ dysfunction. Modified Sauvé-Kapandji procedure involves arthrodesis of the distal radioulnar joint combined with the creation of a pseudarthrosis of the distal ulna to maintain forearm pronation and supination, and stabilization of proximal ulnar stump. This study was performed to evaluate the clinical outcomes of modified Sauve-Kapandji procedure for patients with DRUJ dysfunction.Methods: Fourteen patients with DRUJ dysfunction were treated by modified Sauve-Kapandji procedure and followed up for 2 years post-operatively. Functional assessment was evaluated according to modified mayo wrist score (MMWS) system and severity of pain by visual analog scale. Posteroanterior and lateral radiographs were used to assess fusion.Results: There was a significant improvement in VAS of wrist pain (p<0.001) and MMWS (p<0.001) at 2 years follow up. Excellent outcome was reported in 64.3% (n=9) patients. Radiographic fusion was seen in all 14 cases.Conclusions: The modified Sauve-Kapandji procedure for DRUJ dysfunction is a safe and effective procedure with excellent radiological fusion and significant improvement in functional outcomes.