Navigation assisted total knee arthroplasty in 54,114 patients: No increased risk in acute complications and hospital utilisation

Abstract

Background The advent of navigation in total knee arthroplasty (TKA) has generated interest in attempt to improve component positioning as desired and clinical outcomes. The aim of this study was to evaluate 90‐day complication and cost of navigation‐assisted TKAs (NTKA) compared to conventional TKAs (CTKA) using a national database. Methods A retrospective review of national database was conducted on all patients who underwent TKA from 2010 and 2017. The cohort was stratified into NTKA and CTKA subcohorts, excluding cases utilizing robotics. Results NTKA was associated with a significant decrease in 90‐day postoperative major and minor complications. NTKA was also associated with a decrease in 90‐day hospital utilization with lower rates of emergency department visits and readmissions. The cost of hospitalization and total 90‐day costs were lower in NTKA, with an average savings of $800. Conclusion The adoption of navigation in TKA is safe and efficaceous compared to CTKA. Level of Evidence III. Retrospective cohort study.

A comparison of utilization and short-term complications of technology-assisted versus conventional total knee arthroplasty

“…Patients undergoing TA-TKA had lower complication rates than those undergoing U-TKA. A recent meta-analysis comparing robotic and unassisted TKA observed similar complication rates between groups [ 30 ], though some analyses comparing computer-assisted and unassisted TKA have demonstrated lower complication rates in those undergoing computer-assisted TKA [ 8 , 13 ]. In our study, TA-TKA patients had significantly lower postoperative transfusion rates compared with U-TKA patients, which is consistent with prior findings [ 8 , 13 , 28 ] and associated with improved surgical outcomes [ 31 ].…”

“…Postoperative readmission rates did not significantly differ between groups. In prior national database analyses, computer-assisted TKA has yielded similar [ 25 ] and decreased [ 13 ] readmission rates. Further analysis revealed that patients in the TA-TKA cohort were readmitted primarily for superficial surgical site infections and hematological issues in addition to unspecified and other medical diagnoses.…”

“…Although TA-TKA has been available for several decades, TA-TKA has not been universally adopted [ 12 ] and accounts for only 5–10% of TKAs performed in the USA [ 13 , 14 ]. This low utilization rate may be attributable to costly capital investment for hospital systems, increased operative times, a significant learning curve alongside training burden, and skepticism from operators who have already achieved quality outcomes utilizing unassisted techniques [ 15 – 17 ].…”

Robotic arm‐assisted posterior‐stabilised total knee arthroplasty reduces the amount of tibial bone resection thickness without increasing the rate of postoperative flexion contracture in varus knees in the short term: Comparison with image‐free navigated total knee arthroplasty

“…With the need to enhance the accuracy of surgery, computer‐assisted surgery (CAS) has been continuously advancing in the domain of total knee arthroplasty (TKA) surgery 1–3 . CAS started a few decades ago as computed tomography (CT)‐based/imageless navigation surgery, and the technology developed into robotically assisted surgery.…”

Analysis of New Orthopaedic Technologies in Large Database Research

“…Hospital and surgeon volume is also known to be related to patient outcomes following THA and TKA, but these data are often not available in administrative claims databases and thus cannot be accounted for. Our review of the literature identified studies in which computer-assisted (9 studies) and/or robotic-assisted technology (11 studies) was evaluated with use of large databases, and none reported surgeon or hospital-specific volume (Table I) [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] .…”