Two-year Outcomes of Computed Tomography-based and Computed Tomography Free Navigation for Total Knee Arthroplasties

Martin, Arno; Strempel, Archibald von

doi:10.1097/01.blo.0000218738.69247.d8

Cited by 37 publications

(37 citation statements)

References 29 publications

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“…We identified 13 clinical series for comparison with the current navigation series (Table 2). Seven studies were prospective, randomized studies [1,7,23,25,28,29,34] and six were retrospective case-control series [2,12,17,[20][21][22]. We compared the characteristics of the patients and the radiographic results of the current case series with those in the literature.…”

Section: Methodsmentioning

confidence: 99%

Computer Navigation Did Not Improve Alignment in a Lower-volume Total Knee Practice

Yau

Chiu

Zuo

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Postoperative alignment of the implanted prosthesis in computer-navigated TKA has been reported to be superior to that using the conventional technique. There is an assumption that use of computer navigation techniques can make an inexperienced or occasional TKA surgeon perform more like an expert TKA surgeon. To assess improved accuracy in recreation of mechanical alignment in TKA performed using computer navigation, a retrospective review of the experience of one of the authors (WPY) before and after using computer navigation was performed. We reviewed the radiographic results of 104 TKAs (52 computer navigation, 52 conventional technique) and found the accuracy of postoperative radiographic alignment of the implanted prosthesis was not improved by using computer navigation as judged by (1) overall limb alignment (case: varus 1.3°; control: varus 0.3°); (2) femoral component alignment (case: 90.3°; control: 90.3°); and (3) tibial component alignment (case: 89°; control: 90°). Significant factors that affected postoperative overall mechanical alignment in the current navigation series included severity of the preoperative deformity, amount of error in making bone cuts, and experience of the surgeon in using the computer navigation system. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Section: Methodsmentioning

confidence: 99%

Computer Navigation Did Not Improve Alignment in a Lower-volume Total Knee Practice

Yau

Chiu

Zuo

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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“…There is, however, little information about the clinical outcome [19][20][21][22]. This study was conducted to test the hypothesis that there are differences for subjective (WOMAC Score) as well as for objective (Knee Society Score, degree of flexion) criteria between CAS TKR and freehand TKR after 5.6-7.3 years.…”

Section: Discussionmentioning

confidence: 99%

“…Numerous studies have shown its superiority regarding postoperative long leg alignment and component orientation [15,16,18,19]. Only a few studies focussed on the clinical outcome, and most of them evaluated only a short-term outcome [19][20][21][22]. We aimed to test the hypothesis that there is no difference either for subjective [Western Ontario and McMaster Universities (WOMAC) scores] or for objective (Knee Society Score, degree of flexion) criteria between CAS TKR and freehand TKR after 5.6-7.3 years.…”

Section: Introductionmentioning

confidence: 99%

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

Lüring

Kauper

Bäthis

et al. 2011

International Orthopaedics (SICOT)

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Purpose Computer-assisted knee surgery has become established in routine clinical practice. Still, there is no study investigating midterm clinical outcome after five to seven years postoperatively. We aimed to test the hypothesis that there is no difference either for subjective [Western Ontario and McMaster Universities (WOMAC) scores] or for objective (Knee Society Score, degree of flexion) criteria between computer-assisted total knee replacement (TKR) and freehand TKR after 5.6-7.3 years. Methods We performed a matched-pair analysis; 100 patients who received a primary TKR were investigated after a median follow-up of 6.25 years. Group A was operated on with the support of a computer system, while surgery on patients in group B was performed with the freehand technique. We determined WOMAC Score, Knee Society Score and degree of flexion.

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“…A number of studies suggest navigation can increase the accuracy of component alignment, although it can also increase operative time and complications (Table 4) [6,8,10,17,18,[20][21][22]. A prospective, randomized study compared 60 conventional with 60 navigated TKAs and found the percentage of knees in which the mechanical axes deviated more than 3°was 20% and 1.7% in the two groups, respectively [8].…”

Section: Discussionmentioning

confidence: 99%

Computer Navigation-assisted versus Minimally Invasive TKA

Bonutti

Dethmers

Ulrich

et al. 2008

Clinical Orthopaedics &Amp; Related Research

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Computer-navigated and minimally invasive TKAs are emerging technologies that have distinct strengths and weaknesses. We compared duration of surgery, length of hospitalization, Knee Society scores, radiographic alignments, and complications in two unselected groups of 81 consecutive knees that underwent TKA using either a minimally invasive approach or computer navigation. The two groups were operated on by two different surgeons over differing timeframes. The mean surgical time was longer in the navigated group by 63 minutes. The Knee Society scores and lengths of hospitalization of the two groups were similar. The postoperative component alignments of the two groups were similar; the mean femoral valgus and tibial varus angles of the navigation group changed from 96°and 88°p reoperatively to 95°and 89°postoperatively, respectively, and in the minimally invasive group, the mean femoral valgus angles and tibial varus angles changed from 97°and 88°preoperatively to 95°and 89°postoperatively, respectively. There were 11 major and three minor complications in the navigation group, including one revision, two femoral shaft fractures, four reoperations for knee stiffness, and four instances of bleeding from tracker sites. We believe the higher incidence of complications in addition to the longer operative time in the navigated group may outweigh any potential radiographic benefits. Level of Evidence: Level II, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Two-year Outcomes of Computed Tomography-based and Computed Tomography Free Navigation for Total Knee Arthroplasties

Abstract: Therapeutic Study, Level II. See the Guidelines for Authors for a complete description of levels of evidence.

Cited by 37 publications

References 29 publications

Computer Navigation Did Not Improve Alignment in a Lower-volume Total Knee Practice

Computer Navigation Did Not Improve Alignment in a Lower-volume Total Knee Practice

A five to seven year follow-up comparing computer-assisted vs freehand TKR with regard to clinical parameters

Computer Navigation-assisted versus Minimally Invasive TKA

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