Randomized Trial of Computer-Assisted Knee Arthroplasty: Impact on Clinical and Radiographic Outcomes

Hiscox, C.; Bohm, Éric; Turgeon, Thomas R.; Hedden, David R.; Burnell, Colin

doi:10.1016/j.arth.2011.02.012

Cited by 31 publications

(16 citation statements)

References 21 publications

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“…Recently, various devices have been used to achieve accurate lower limb alignment, such as computer-assisted surgery (CAS), an extramedullary alignment guide for femoral resection, and a patient-matched instrument (PMI) [2], [3], [4].…”

Section: Introductionmentioning

confidence: 99%

Radiographic assessment and clinical outcomes after total knee arthroplasty using an accelerometer-based portable navigation device

et al. 2018

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It has been reported that an accelerometer-based portable navigation device can achieve accurate bone cuts, but there have been few studies of clinical outcomes after total knee arthroplasty (TKA) using such a device. The aim of this study was to evaluate lower limb alignment and clinical outcomes after TKA using an accelerometer-based portable navigation device. Thirty-five patients (40 knees) underwent primary TKAs using an accelerometer-based portable navigation device. Postoperative radiographic assessments included the hip-knee-ankle angle, femoral component angle (FCA), and tibial component angle (TCA) in the coronal plane and the sagittal FCA and sagittal TCA in the sagittal plane. Clinical outcomes were evaluated by the Japanese Orthopedic Association score for osteoarthritic knees, Japanese Knee Osteoarthritis Measure, and the New Knee Society Score. The frequency of outliers (>3 degrees) was 10% for the hip-knee-ankle angle, 8% for FCA, 0% for TCA, 19% for sagittal FCA, and 9% for sagittal TCA. The Japanese Orthopedic Association score and Japanese Knee Osteoarthritis Measure were significantly improved postoperatively. The postoperative New Knee Society Score was 67.2% for symptoms, 50.3% for satisfaction, 58.6% for expectation, and 44.1% for function. TKA using an accelerometer-based portable navigation device achieved good results for both lower limb alignment and clinical outcomes.

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Section: Introductionmentioning

confidence: 99%

Radiographic assessment and clinical outcomes after total knee arthroplasty using an accelerometer-based portable navigation device

et al. 2018

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“…Finally, 15 randomized, controlled trials were included in the metaanalysis ( Figure A, available at the end of the PDF of this article). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The study characteristics of the included studies are tabulated in Table A (available at the end of the PDF of this article).…”

Section: Resultsmentioning

confidence: 99%

Computer Navigation and Total Knee Arthroplasty

Shi¹,

Wei²,

Wang³

et al. 2014

Orthopedics

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Research has added evidence in favor of computer-navigated techniques over conventional surgery for total knee arthroplasty (TKA). The goal of the current meta-analysis was to compare the outcome of outliers in mechanical axis and postoperative complications in patients undergoing conventional vs computer-navigated techniques for TKA. English literature searches were performed in PubMed, EMBASE, Web of Science, and the Cochrane Library for studies published between January 2002 and August 2012. Randomized, controlled trials comparing computer navigation with conventional surgery for the measurement of mechanical axes in patients with primary osteoarthritis were considered eligible. Fifteen trials were eligible for inclusion. The baseline demographics of 2089 patients (computer-navigated=1111; conventional=978) were well matched. Publication bias was eliminated using the funnel plot. A mechanical axis of more than 30° was considered to be malalignment and an outlier in limb alignment. A significant increase of 16.9 minutes in mean operative time for computer-navigated TKA was observed (P=.046). Although patients undergoing computer-navigated TKA had fewer outliers in mechanical axis (13.4%) compared with the conventional technique (27.4%), the results did not achieve statistical significance (I2=0.0%; P=1.000). Fewer complications were observed in patients undergoing computer-navigated TKA (4%) compared with conventional TKA (6.5%).

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“…Five different measurement protocols were used in the included studies. The protocol of Berger et al [3] (center of proximal tibial plateau relative to the tip of the tubercle) was used in three studies [8,22,48], that of Matziolis et al [33](tibial fins relative to the line between the medial third of the tubercle and the geometric center of gravity of the tibia) in three studies [27,31,33], and the Perth protocol (posterior tibial condyles relative to the tuberosity) [9] in one study [10]. Tibial component rotation relative to the ankle was used in one study [41], and tibial component rotation relative to the posterior border of the proximal tibia also was used in one study [28].…”

Section: Discussionmentioning

confidence: 99%

“…Finally, Hetaimish et al [20] and Cheng et al [11] covered published evidence until November 30, 2009, and August 30, 2010, respectively. Since August 30, 2010, six studies comparing alignment after imageless CAS TKA versus conventional TKA have been published [5,22,32,41,47,48].…”

Section: Introductionmentioning

confidence: 99%

Does Imageless Computer-assisted TKA Lead to Improved Rotational Alignment or Fewer Outliers? A Systematic Review

Meijer

Reininga

Boerboom

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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More studies of high methodologic quality and with a sample size calculation based on the outcome measures will be helpful to assess whether an imageless CAS TKA improves femoral and tibial rotational alignment and tibiofemoral mismatch or decreases the number of femoral and tibial rotational outliers. To statistically analyze the results of different studies, the same measurement protocol should be used among the studies.

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Randomized Trial of Computer-Assisted Knee Arthroplasty: Impact on Clinical and Radiographic Outcomes

Cited by 31 publications

References 21 publications

Radiographic assessment and clinical outcomes after total knee arthroplasty using an accelerometer-based portable navigation device

Radiographic assessment and clinical outcomes after total knee arthroplasty using an accelerometer-based portable navigation device

Computer Navigation and Total Knee Arthroplasty

Does Imageless Computer-assisted TKA Lead to Improved Rotational Alignment or Fewer Outliers? A Systematic Review

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