The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty

Abstract Background Tibial rotational alignment is the most prone to error among the placement angles of the prosthesis in total knee arthroplasty (TKA). The augmented reality (AR)-aided navigation system enables surgeons to visualize the tibial anteroposterior axis established on the pre-resection...

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Main Authors: Sachiyuki Tsukada, Hiroyuki Ogawa, Masayoshi Saito, Shizuka Minagawa, Miki Kurita, Naoyuki Hirasawa
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08955-8
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author Sachiyuki Tsukada
Hiroyuki Ogawa
Masayoshi Saito
Shizuka Minagawa
Miki Kurita
Naoyuki Hirasawa
author_facet Sachiyuki Tsukada
Hiroyuki Ogawa
Masayoshi Saito
Shizuka Minagawa
Miki Kurita
Naoyuki Hirasawa
author_sort Sachiyuki Tsukada
collection DOAJ
description Abstract Background Tibial rotational alignment is the most prone to error among the placement angles of the prosthesis in total knee arthroplasty (TKA). The augmented reality (AR)-aided navigation system enables surgeons to visualize the tibial anteroposterior axis established on the pre-resection surface superimposed on the bone surface after proximal tibial resection. Methods We compared the axial, coronal, and sagittal alignments of the tibial baseplate between 58 TKAs performed using an AR-aided navigation system and 64 TKAs in which the rotational alignment was determined manually. To assess alignment, the three-dimensional coordinates of the lower limb from preoperative CT data were overlaid onto postoperative CT data using a surface-matching algorithm. Results The absolute difference between the anteroposterior axis and the rotational angle of the tibial baseplate was significantly smaller in the AR-aided group compared to the control group (3.7 ± 3.4° vs. 5.1 ± 4.4°, p = 0.047). In both coronal and sagittal alignments, the absolute differences between the target angle and the measured angle were not significantly different between the two groups (1.1 ± 0.9° vs. 1.2 ± 1.0°, p = 0.75 in coronal alignment, and 1.9 ± 1.3° vs. 1.7 ± 1.4°, p = 0.43 in sagittal alignment, respectively). Conclusions The AR-aided navigation system slightly but significantly improved the accuracy of tibial rotational alignment.
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spelling doaj-art-d8e922ecc77d45889de152a2509d39952025-08-20T03:42:22ZengBMCBMC Musculoskeletal Disorders1471-24742025-07-012611910.1186/s12891-025-08955-8The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplastySachiyuki Tsukada0Hiroyuki Ogawa1Masayoshi Saito2Shizuka Minagawa3Miki Kurita4Naoyuki Hirasawa5Department of Orthopaedic Surgery, Hokusuikai Kinen HospitalDepartment of Orthopaedic Surgery, Hokusuikai Kinen HospitalDepartment of Orthopaedic Surgery, Hokusuikai Kinen HospitalDepartment of Radiology, Hokusuikai Kinen HospitalDepartment of Radiology, Hokusuikai Kinen HospitalDepartment of Orthopaedic Surgery, Hokusuikai Kinen HospitalAbstract Background Tibial rotational alignment is the most prone to error among the placement angles of the prosthesis in total knee arthroplasty (TKA). The augmented reality (AR)-aided navigation system enables surgeons to visualize the tibial anteroposterior axis established on the pre-resection surface superimposed on the bone surface after proximal tibial resection. Methods We compared the axial, coronal, and sagittal alignments of the tibial baseplate between 58 TKAs performed using an AR-aided navigation system and 64 TKAs in which the rotational alignment was determined manually. To assess alignment, the three-dimensional coordinates of the lower limb from preoperative CT data were overlaid onto postoperative CT data using a surface-matching algorithm. Results The absolute difference between the anteroposterior axis and the rotational angle of the tibial baseplate was significantly smaller in the AR-aided group compared to the control group (3.7 ± 3.4° vs. 5.1 ± 4.4°, p = 0.047). In both coronal and sagittal alignments, the absolute differences between the target angle and the measured angle were not significantly different between the two groups (1.1 ± 0.9° vs. 1.2 ± 1.0°, p = 0.75 in coronal alignment, and 1.9 ± 1.3° vs. 1.7 ± 1.4°, p = 0.43 in sagittal alignment, respectively). Conclusions The AR-aided navigation system slightly but significantly improved the accuracy of tibial rotational alignment.https://doi.org/10.1186/s12891-025-08955-8KneePrimary arthroplastySmartphoneComputer-assisted surgeryAugmented reality
spellingShingle Sachiyuki Tsukada
Hiroyuki Ogawa
Masayoshi Saito
Shizuka Minagawa
Miki Kurita
Naoyuki Hirasawa
The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
BMC Musculoskeletal Disorders
Knee
Primary arthroplasty
Smartphone
Computer-assisted surgery
Augmented reality
title The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
title_full The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
title_fullStr The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
title_full_unstemmed The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
title_short The augmented reality-aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
title_sort augmented reality aided navigation system may improve rotational alignment of the tibial baseplate in total knee arthroplasty
topic Knee
Primary arthroplasty
Smartphone
Computer-assisted surgery
Augmented reality
url https://doi.org/10.1186/s12891-025-08955-8
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