For nearly 58% of total knee arthroplasty (TKA) revisions, the reason for revision is exacerbated by component malalignment. Proper TKA component alignment is critical to functional outcomes/device longevity. Several methods exist for orthopedic surgeons to validate their cuts, however, each has its limitations. This study developed/validated an accurate, low-cost, easy to implement first-principles method for calculating 2D (sagittal/frontal plane) tibial tray orientation using a triaxial gyroscope rigidly affixed to the tibial plateau of a simulated leg jig and validated 2D tibial tray orientation in a human cadaveric model. An initial simulation assessed error in the sagittal/frontal planes associated with all geometric assumptions over a range of positions (±10°, ±10°, and −3°/0°/+3° in the sagittal, frontal, and transverse planes, respectively). Benchtop experiments (total positions - TP, clinically relevant repeated measures - RM, novice user - NU) were completed using a triaxial gyroscope rigidly affixed to and aligned with the tibial tray of the fully adjustable leg-simulation jig. Finally, two human cadaveric experiments were completed. A similar triaxial gyroscope was mounted to the tibial tray of a fresh frozen human cadaver to validate sagittal and frontal plane tibial tray orientation. In cadaveric experiment one, three unique frontal plane shims were utilized to measure changes in frontal plane angle. In cadaveric experiment two, measurements using the proprosed gyroscopic method were compared with computer navigation at a series of positions. For all experiments, one rotation of the leg was completed and gyroscopic data was processed through a custom analysis algorithm.Introduction
Methods
