International Orthopaedics

, Volume 43, Issue 6, pp 1355–1363 | Cite as

Conventional versus computer-assisted surgery in total knee arthroplasty: comparison at ten years follow-up

  • Michele d’Amato
  • Andrea Ensini
  • Alberto Leardini
  • Paolo Barbadoro
  • Andrea Illuminati
  • Claudio BelvedereEmail author
Original Paper



Computer-assisted systems (CAS) for total knee arthroplasty (TKA) were expected to result in more accurate prosthesis implantation, better patient outcomes, and longer implant survival when compared to conventional instrumentation (CI). The aim of this study was to compare two groups of patients operated using CAS or CI at ten years follow-up.


One hundred twenty TKA patients, 60 using CAS and 60 using CI, were contacted after a decade for follow-up. Eligible patients received radiological examination to assess the lower-limb mechanical axis. They were also clinically assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Knee Society Score for Knee (KSS-K) and Function (KSS-F) Scoring. Kaplan-Meier survival analysis was performed to assess revisions, not for post-traumatic reasons.


In CAS and CI groups, the lower-limb mechanical axis was 1.7° ± 2.4° and 1.5° ± 2.8°, respectively; corresponding KOOS values were 82.3 ± 14.3 and 78.6 ± 14.4; KSS-K values were 85.9 ± 11.1 and 85.0 ± 9.7; KSS-F values were 82.2 ± 19.3 and 83.8 ± 18. For these assessments, the differences between the two groups were not statistically significant (p > 0.05). Two CAS (3.8%) and three CI patients (5.7%) were revised. The Kaplan-Meier analysis showed no significant differences between the two groups.


No significant differences were found at long-term follow-up in terms of radiographical-clinical outcomes and of implant survival between TKA operated using CAS or CI.


Total knee arthroplasty Computer-aided surgery Surgical navigation Clinical outcome Long-term follow-up 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryIRCCS Istituto Ortopedico RizzoliBolognaItaly
  2. 2.Movement Analysis LaboratoryIRCCS Istituto Ortopedico RizzoliBolognaItaly
  3. 3.Movement Analysis Laboratory and Functional-Clinical Evaluation of Prostheses, Centro di Ricerca Codivilla-PuttiIstituto Ortopedico RizzoliBolognaItaly

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