{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:09:55Z","timestamp":1782817795288,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T00:00:00Z","timestamp":1532995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T00:00:00Z","timestamp":1532995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study aimed to compare prosthetic alignment using three\u2010dimensional (3D) measurements following total knee arthroplasty (TKA) performed using an accelerometer\u2010based portable navigation system (KneeAlign2) versus the conventional technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 159 patients who had primary osteoarthritis of the knee with varus deformity underwent TKA. The KneeAlign2 system was used for distal femoral resection and tibial resection in 78\u00a0knees, and the conventional instrumentation (intramedullary for the femur and extramedullary for the tibia) was used in 81\u00a0knees. 3D computed tomography (CT) scans of the whole leg were taken after TKA. Femoral and tibial prosthetic alignments in the coronal, sagittal, and axial planes were measured using computer software. The operation time and estimated blood loss were calculated. Deep venous thrombosis (DVT) and pulmonary embolism (PE) were evaluated using the contrast\u2010enhanced multi\u2010detector row CT at 1 week after TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the femoral coronal plane, the mean and standard deviation of prosthetic alignment from neutral alignment were 1.2\u00b0 [95% confidence interval (CI) 1.0\u00b0\u20131.4\u00b0) in the navigation group and 1.6\u00b0 (95% CI 1.3\u00b0\u20132.0\u00b0) in the conventional group (<jats:italic>p<\/jats:italic>\u2009=\u20090.03). The femoral component outliers (&gt;\u20093\u00b0 away from the goal alignment) using the navigation system and the conventional technique were 3 and 15%, respectively, in the coronal plane (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), and 15 and 43%, respectively, in the sagittal plane (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). The outliers in tibial coronal and tibial sagittal planes were not statistically different between the two groups. There were no statistically significant differences between the two groups in operation time, blood loss, DVT, and PE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Using an accelerometer\u2010based portable navigation system decreased the outliers of prosthetic alignment in femoral coronal and sagittal planes, and did not increase the complications such as operation time, blood loss, DVT, and PE. To our knowledge, this study is the first to investigate the usefulness of an accelerometer\u2010based portable navigation system using the validated 3D measurement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-018-5082-4","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T17:28:14Z","timestamp":1533058094000},"page":"1580-1586","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["An accelerometer\u2010based portable navigation system improved prosthetic alignment after total knee arthroplasty in 3D measurements"],"prefix":"10.1002","volume":"27","author":[{"given":"Hideki","family":"Ueyama","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihide","family":"Minoda","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Sugama","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Ohta","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Yamamura","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Nakamura","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susumu","family":"Takemura","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Orthopedic Surgery Osaka City University Graduate School of Medicine 1\u20104\u20103 Asahimachi, Abeno ward 545\u20108585 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,31]]},"reference":[{"key":"e_1_2_8_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086\u2010200403000\u201000030"},{"key":"e_1_2_8_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00264\u2010010\u20101008\u20106"},{"key":"e_1_2_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999\u2010012\u20102528\u20108"},{"key":"e_1_2_8_5_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B4.18470"},{"key":"e_1_2_8_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.12.012"},{"key":"e_1_2_8_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12306\u2010017\u20100477\u20109"},{"key":"e_1_2_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010011\u20101695\u20106"},{"key":"e_1_2_8_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg111"},{"key":"e_1_2_8_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2012.03.014"},{"key":"e_1_2_8_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010008\u20100683\u2010y"},{"key":"e_1_2_8_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.93B5.25893"},{"key":"e_1_2_8_13_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.99B8.BJJ\u20102016\u20100596.R3"},{"key":"e_1_2_8_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.medengphy.2016.09.006"},{"key":"e_1_2_8_15_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.89B4.18878"},{"key":"e_1_2_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcm.2016.02.012"},{"key":"e_1_2_8_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2014.06.016"},{"key":"e_1_2_8_18_2","first-page":"78","article-title":"A computer\u2010assisted, tibia\u2010first technique for improved femoral component rotation in total knee arthroplasty","volume":"18","author":"Lee CM","year":"2017","journal-title":"Arthroplast Today"},{"key":"e_1_2_8_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000007388"},{"key":"e_1_2_8_20_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.F.00386"},{"key":"e_1_2_8_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2010.03.002"},{"key":"e_1_2_8_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010009\u20100927\u20105"},{"key":"e_1_2_8_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2012.03.007"},{"key":"e_1_2_8_24_2","first-page":"224","article-title":"Prediction of blood volume in normal human adults","volume":"51","author":"Nadler SB","year":"1962","journal-title":"Surgery"},{"key":"e_1_2_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.02.007"},{"key":"e_1_2_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2012.04.023"},{"key":"e_1_2_8_27_2","first-page":"610","article-title":"Does computer\u2010assisted surgical navigation total knee arthroplasty reduce venous thromboembolism compared with conventional total knee arthroplasty?","volume":"49","author":"Ooi LH","year":"2008","journal-title":"Singap Med J"},{"key":"e_1_2_8_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2017.09.041"},{"key":"e_1_2_8_29_2","volume-title":"R: a language and environment for statistical computing","author":"R","year":"2014"},{"key":"e_1_2_8_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.06.020"},{"key":"e_1_2_8_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010014\u20103496\u20101"},{"key":"e_1_2_8_32_2","doi-asserted-by":"publisher","DOI":"10.3928\/01477447\u201020170223\u201001"},{"key":"e_1_2_8_33_2","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2001.23621"}],"container-title":["Knee Surgery, Sports Traumatology, Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-018-5082-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00167-018-5082-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00167-018-5082-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00167-018-5082-4","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T10:09:21Z","timestamp":1760868561000},"score":1,"resource":{"primary":{"URL":"https:\/\/esskajournals.onlinelibrary.wiley.com\/doi\/10.1007\/s00167-018-5082-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,31]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1007\/s00167-018-5082-4"],"URL":"https:\/\/doi.org\/10.1007\/s00167-018-5082-4","archive":["Portico"],"relation":{},"ISSN":["0942-2056","1433-7347"],"issn-type":[{"value":"0942-2056","type":"print"},{"value":"1433-7347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,31]]},"assertion":[{"value":"25 March 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 July 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 July 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conficts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all patients before their enrolment.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}