ArticleArchives of orthopaedic and trauma surgery2026
Concurrent validation of a novel intraoperative navigation platform for total knee arthroplasty.
Article in Archives of orthopaedic and trauma surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
inroductionThis cadaveric study aimed to assess the accuracy of the Next-AR navigation platform in terms of implant alignment, kinematics, and collateral ligament elongations in comparison to gold standard measurement tools. MATERIALS AND
methodsComputed tomography of 7 fresh-frozen legs were acquired for patient-specific guide design, identification of bony landmarks and collateral ligaments to acquire real-time feedback for bone resection, alignment and collateral ligament elongations using Next-AR system. The specimens underwent medially-stabilized TKA (Medacta) based on the mechanical alignment technique. The difference between target and achieved implant alignment parameters was assessed. The relative change in tibiofemoral kinematics, medial collateral ligament- (MCL), and lateral collateral ligament (LCL) elongations acquired with the Next-AR system were compared to reference values acquired with bone-pin mounted motion trackers (Vicon, UK) while performing quasistatic squatting in an ex vivo knee simulator.
resultsThe mean differences between achieved and target hip-knee-ankle angle, femoral varus, femoral flexion, femoral rotation, tibial varus, and tibial slope measured -1.5°, 0.5°, 0.07°, -0.14°, 0.79° and -0.36°, respectively, with no statistically significant differences found (p ≥ 0.12). Knee flexion (p=0.32) and valgus orientation (p=0.63), obtained from Next-AR and Vicon systems were comparable. Collateral ligament elongations derived from Next-AR exhibited similar values for the anterior bundle of MCL (p=0.18) and LCL in the anterior and middle bundles (p>0.3) obtained from the Vicon system.
conclusionsOur findings showed that the Next-AR system achieved postoperative implant alignment close to the planned targets, with small systematic deviation (mean bias ≤ 1.5°), limited total error (RMSE ≤ 2.3°), and variability of paired differences ≤ 1.87°, while additionally providing quantitative real-time assessment of tibiofemoral kinematics and collateral ligament elongations.
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