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Reliability of leg alignment using the OrthoPilot system depends on knee position: a cadaveric study

  • Knee
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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Despite the increase in clinical use of navigation systems in total knee arthroplasty, few studies have focused on the reproducibility of these systems. The aim of the present study was to assess the influence of knee position and observer experience on intra- and inter-observer agreement in limb alignment assessment with the OrthoPilot system. Limb alignment in the coronal plane and extension range of the knee were assessed in four embalmed cadaveric specimens by five independent observers and measurements were repeated four times to determine intra- and inter-observer agreement, expressed as intraclass correlation coefficients (ICCs). Additionally, navigation results were compared against figures from conventional measurement of leg alignment (ground truth). Intra- and inter-observer agreements were excellent for assessing the extension range (ICC, 0.97 and 0.95) and the coronal femuro-tibial axis in knee extension (ICC, 0.92 and 0.88) but were generally worse in knee flexion (ICC, 0.62 and 0.55). There was an increased tendency of intraobserver errors in observers with less clinical experience. Mean correlation with conventional measurements was fair (Spearman’s rho 0.61). The OrthoPilot system showed excellent reproducibility for assessment of extension range and coronal limb alignment. However, assessments of coronal limb alignment in flexion were prone to error and caution should be taken when relying on these measurements.

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Acknowledgments

The authors would like to thank Aesculap for providing the OrthoPilot system used in this study, and Prof. Martin Scaal from the University’s Institute for Anatomy, for granting access to the cadaveric specimens.

Conflict of interest statement

The authors state that there were no conflicts of interest for any of the authors. Observer D is an employee of Aesculap. With this exception, Aesculap was not involved in data acquisition. Aesculap was not involved in study design, data analysis and interpretation, or the writing of the manuscript and had no influence on the decision of publication of the study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Freiburg University Medical Center, Hugstetter Str. 55, 79106, Freiburg, Germany

    Oliver Hauschild, L. Konstantinidis, P. C. Strohm, P. Niemeyer, N. P. Suedkamp & P. Helwig

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  1. Oliver Hauschild
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  2. L. Konstantinidis
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  3. P. C. Strohm
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Correspondence to Oliver Hauschild.

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Hauschild, O., Konstantinidis, L., Strohm, P.C. et al. Reliability of leg alignment using the OrthoPilot system depends on knee position: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 17, 1143–1151 (2009). https://doi.org/10.1007/s00167-009-0825-x

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  • DOI: https://doi.org/10.1007/s00167-009-0825-x

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