The Clinical Outcome of Computer-Navigated Compared with Conventional Knee Arthroplasty in the Same Patients

Kim, Young Hoo; Park, Jang Won; Kim, Jun Shik

doi:10.2106/jbjs.16.00791

Cited by 55 publications

(60 citation statements)

References 24 publications

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“…As the use of technology-assisted surgery has increased over the past 2 decades, multiple studies have demonstrated improved mechanical alignment with the use of computer navigation and robot-assisted surgeries [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] . However, studies have not been conclusive regarding the effects of technology assistance on revision rate, patient-reported outcomes, and complication rates [12] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] . Given the lack of conclusive data, the debate concerning the value of technology-assisted TKA and its cost-effectiveness continues.…”

Section: Introductionmentioning

confidence: 99%

Trends in computer navigation and robotic assistance for total knee arthroplasty in the United States: an analysis of patient and hospital factors

et al. 2019

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Background Computer navigation and robotic assistance technologies are used to improve the accuracy of component positioning in total knee arthroplasty (TKA), with the goal of improving function and optimizing implant longevity. The purpose of this study was to analyze trends in the use of technology-assisted TKA, identify factors associated with the use of these technologies, and describe potential drivers of cost. Methods The Nationwide Inpatient Sample database was used to identify patients who underwent TKA using conventional instrumentation, computer navigation, and robot-assisted techniques between 2005 and 2014. Variables analyzed include patient demographics, hospital and payer types, and hospital charges. Descriptive statistics were used to describe trends. Univariate and multivariate analyses were performed to identify differences between conventional and technology-assisted groups. Results Our analysis identified 6,060,901 patients who underwent TKA from 2005 to 2014, of which 273,922 (4.5%) used computer navigation and 24,084 (0.4%) used robotic assistance. The proportion of technology-assisted TKAs steadily increased over the study period, from 1.2% in 2005 to 7.0% in 2014. Computer navigation increased in use from 1.2% in 2005 to 6.3% in 2014. Computer navigation was more likely to be used in the Western United States, whereas robot-assisted TKAs were more likely to be performed in the Northeast. Increased hospital charges were associated with the use of technology assistance ($53,740.1 vs $47,639.2). Conclusions The use of computer navigation and robot-assisted TKA steadily increased over the study period, accounting for 7.0% of TKAs performed in the United States in 2014. Marked regional differences in the use of these technologies were identified. The use of these technologies was associated with increased hospital charges.

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Section: Introductionmentioning

confidence: 99%

Trends in computer navigation and robotic assistance for total knee arthroplasty in the United States: an analysis of patient and hospital factors

et al. 2019

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“…A limitation of the use of ABN for TKAs is no guide to rotational alignment, another important predictor of longterm survivorship and functional outcomes. 50,51 Rotation is therefore guided in the same approach to CONV and no study to date has evaluated if a difference exists in rotational alignment to other techniques. Other limitations include the lack of information regarding verification of bone resections, costs and inability to assess soft tissue balancing.…”

Section: Discussionmentioning

confidence: 99%

Handheld, accelerometer‐based navigation versus conventional instrumentation in total knee arthroplasty: a meta‐analysis

Shihab

Clayworth

Nara

2020

ANZ Journal of Surgery

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Background: Precise and accurate alignments in total knee arthroplasty are important predictors for survivorship and functional outcomes. We aim to compare accelerometer-based navigation (ABN) to conventional instrumentation (CONV), patient-specific instrumentation (PSI) and computer-assisted surgery (CAS) in published literature. Methods: A systematic search of publications from databases (MEDLINE, EMBASE and Cochrane) was obtained from inception to 15 August 2018. A random-effects meta-analysis was used to pool odd ratios for outliers greater than 3 for the hip-knee-ankle, coronal and sagittal femoral and tibial angles (CFA, CTA, SFA, STA). Secondary outcomes included procedural characteristics and functional outcomes. Results: Thirteen studies, involving 1566 patients, met inclusion that compared ABN (50.2%) to CONV (49.8%) and five comparing ABN to CAS/PSI. The pooled odds ratios for percent outliers of greater than 3 from the mechanical axis for the hip-knee-ankle (relative risk 0.58, P = <0.05) and CFA (relative risk 0.42, P = 0.02) was significantly lower for ABN compared to CONV. The pooled odds ratios for CTA, SFA and STA were not significantly different. No differences were identified in comparison to PSI/CAS. There was no statistically significant difference in procedural characteristics and functional outcomes. Conclusions: The use ABN in total knee arthroplasty is a successful method of increased precision and accuracy for the restoration of the mechanical axis. In addition, there is no significant compromise in procedural or functional outcomes.

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“…Additionally, studies so far did not show any significant differences of clinical function, position, and survivorship of the components between conventional approach and computer assisted systems in long-term follow-up over 12 years for knee replacement. 35 On the other hand, it appears that we will see more navigation and robotic systems involvement for arthroplasty operations in the near future. Finally, 'getting it right first time' by using the most reliable implants with proven survivorship 29 is one of the main key factors in the success of arthroplasty.…”

Section: Discussionmentioning

confidence: 99%

Common Post Lower Limb Arthroplasty Complications, Management Approaches and How to Minimize the Risks

Bayam

Drampalos

Erdem

2020

Online Türk Sağlık Bilimleri Dergisi

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Hem diz ve hem de kalça artroplastileri, ortopedinin oldukta başarılı ameliyatlarıdır. Mükemmel ve uzun yaşam sonuçları vardır. Artan ameliyat sayılarına ve başarı oranlarına rağmen, genel ve ciddi komplikasyonları da artış göstermektedir. Literatürden yaptığımız derlemede, kalça ve diz artroplastilerinin yaygın komplikasyonları olan enfeksiyon, dislokasyon, periprostatik kırıklar, septik gevşeme ve ven tromboembolisini taradık. Bu komplikasyonlar çok dramatik problemlere neden olabilmekte ve dikkatli tedavi gerekmektedir. Bu komplikasyonları minimuma indirgemek icin gerekenler, kendini geliştirmiş tecrübeli ortopedik cerrahlar ve konusunda özelleşmiş, uygun çevresel ortama sahip bir takım ve uygunluğu ispatlanmış protezlerin kullanılmasıdır.

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The Clinical Outcome of Computer-Navigated Compared with Conventional Knee Arthroplasty in the Same Patients

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 55 publications

References 24 publications

Trends in computer navigation and robotic assistance for total knee arthroplasty in the United States: an analysis of patient and hospital factors

Trends in computer navigation and robotic assistance for total knee arthroplasty in the United States: an analysis of patient and hospital factors

Handheld, accelerometer‐based navigation versus conventional instrumentation in total knee arthroplasty: a meta‐analysis

Common Post Lower Limb Arthroplasty Complications, Management Approaches and How to Minimize the Risks

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