Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years

Singisetti, Kiran; Muthumayandi, Karthikeyan; Abual-rub, Zaid; Weir, David J.

doi:10.1007/s00402-015-2314-7

Cited by 19 publications

(9 citation statements)

References 28 publications

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“…Although improvements in implant alignment and hospitalization times have been consistently demonstrated with the use of intraoperative technology [15, 35, 38, 45], it remains unclear whether this translates into superior clinical and functional outcomes compared to manual procedures [1, 6, 7, 11, 43, 52]. This partly stems from the limitations of the current literature, including inconsistency in patient reported outcome measures (PROMs) among individual studies [1], as well as limited pooled data analyses among systematic reviews.…”

Section: Introductionmentioning

confidence: 99%

Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain

Kim

Bernhard

Acuña

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Our systematic review and meta-analysis sought to assess how technology-assistance impacts (1) post-operative pain and (2) opioid use in patients undergoing primary total knee arthroplasty (TKA). Methods Four online databases were queried for studies published up to October 2021 that reported on pain and opioid usage between technology-assisted and manual TKA (mTKA) patients. Mantel-Haenszel (M-H) models were utilized to calculate pooled mean diference (MDs) and 95% conidence interval (CIs). Subgroup analyses were conducted to isolate robotic-arm assisted (RAA) and computed-assisted navigation (CAN) cohorts. Risk of bias was assessed for all included non-randomized studies with the Methodological Index for Non-Randomized Studies (MINORS) tool. For the randomized control trials included in our study, the Detsky scale was applied. Results Our analysis included 31 studies, reporting on a total of 761,300 TKAs (mTKA: n = 753,554; Computer-Assisted Navigation (CAN): n = 1,309; Robotic-Arm Assisted (RAA): n = 6437). No diferences were demonstrated when evaluating WOMAC (MD: 0.00, 95% CI − 0.69 to 0.69; p = 1.00), KSS (MD: 0.01, 95% CI − 1.46 to 1.49; p = 0.99), KOOS (MD − 2.91, 95% CI − 6.17 to 0.34; p = 0.08), and VAS (MD − 0.54, 95% CI − 1.01 to − 0.007; p = 0.02) pain scores between cohorts. There was mixed evidence regarding how opioid consumption difered between TKA techniques. Conclusion The present analysis demonstrated no diference in terms of pain across a variety of utilized patient-reported pain measurements. However, there were mixed results regarding how opioid consumption varied between manual and technology-assisted cohorts, particularly in the immediate post-operative period. Level of evidence III.

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Section: Introductionmentioning

confidence: 99%

Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain

Kim

Bernhard

Acuña

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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“…However, while improved implant alignment is considered to result in better clinical outcomes, the existing data on this topic are inconclusive. 4 Some authors 5 , 6 recently reported that CAS reduces revision surgery due to loosening and lysis, while other investigators found no differences in the short- and mid-term outcomes. 7 , 8 Despite the contradictory data found in the literature, 9 CAS appears to avoid outliers and large malalignments and, in a large percentage of cases, secure an optimum mechanical axis in the frontal plane.…”

Section: Discussionmentioning

confidence: 99%

Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

et al. 2016

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ObjectiveTo demonstrate that postoperative computed tomography (CT) is not needed if navigation is used to determine the rotational position of the femoral component during total knee replacement (TKR).MethodsPreoperative CT, navigational, and postoperative CT data of 70 TKR procedures were analysed. The correlation between the rotational angulation of the femur measured by CT and that measured by perioperative navigation was examined. The correlation between the femoral component rotation determined by navigation and that determined by CT was also assessed.ResultsThe mean femoral rotation determined by navigation was 2.64° ± 4.34°, while that shown by CT was 6.43° ± 1.65°. Postoperative rotation of the femoral component shown by CT was 3.09° ± 2.71°, which was closely correlated with the angle obtained through the intraoperative transepicondylar axis by navigation (Pearson’s R = 0.930).ConclusionsNavigation can be used to collect the preoperative, intraoperative, and postoperative data and final position of the TKR. The rotation of the femoral component can be determined using navigation without the need for CT.

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“…A retrospective comparative study37 of 200 knees illustrated that the femoral component alignment was more accurate with ASM navigation compared with conventional intramedullary instrumentation (90% within 3° of mechanical axis vs 74%). Singisetti et al 38 reported on the clinical outcomes using ASM navigation versus conventional instrumentation and did not find clinical differences in WOMAC, SF-36 and Quality of life scores. Finally Clement et al 39 concluded that ASM navigation significantly reduces the number of outliers for the femoral and tibial components when compared with conventional non-navigation alignment.…”

Section: Surface-mounted Navigationmentioning

confidence: 99%

New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

et al. 2018

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Navigation-assisted versus conventional total knee replacement: no difference in patient-reported outcome measures (PROMs) at 1 and 2 years

Abstract: The overall patient-reported outcome scores improved after total knee replacement but appear to be comparable in both groups at 1- and 2-year follow-up.

Cited by 19 publications

References 28 publications

Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain

Use of intraoperative technology in total knee arthroplasty is not associated with reductions in postoperative pain

Computed tomography is not necessary to assess rotation of the femoral component in navigation-assisted total knee replacement

New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

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