Conventional versus computer-assisted surgery in total knee arthroplasty: comparison at ten years follow-up
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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.
KeywordsTotal 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.
- 2.Saragaglia D, Rubens-Duval B, Gaillot J, Lateur G, Pailhe R (2018) Total knee arthroplasties from the origin to navigation: history, rationale, indications. Int Orthop. https://doi.org/10.1007/s00264-018-3913-z
- 4.Hamelynck KJ (2006) The history of mobile-bearing total knee replacement systems. Orthopedics 29(9 Suppl):S7–S12Google Scholar
- 6.Baier C, Wolfsteiner J, Otto F, Zeman F, Renkawitz T, Springorum HR, Maderbacher G, Grifka J (2017) Clinical, radiological and survivorship results after ten years comparing navigated and conventional total knee arthroplasty: a matched-pair analysis. Int Orthop 41(10):2037–2044. https://doi.org/10.1007/s00264-017-3509-z CrossRefGoogle Scholar
- 10.Thiengwittayaporn S, Fusakul Y, Kangkano N, Jarupongprapa C, Charoenphandhu N (2016) Hand-held navigation may improve accuracy in minimally invasive total knee arthroplasty: a prospective randomized controlled trial. Int Orthop 40(1):51–57. https://doi.org/10.1007/s00264-015-2848-x CrossRefGoogle Scholar
- 11.Saragaglia D, Sigwalt L, Gaillot J, Morin V, Rubens-Duval B, Pailhe R (2018) Results with eight and a half years average follow-up on two hundred and eight e-Motion FP (R) knee prostheses, fitted using computer navigation for knee osteoarthritis in patients with over ten degrees genu varum. Int Orthop 42(4):799–804. https://doi.org/10.1007/s00264-017-3618-8 CrossRefGoogle Scholar
- 17.Ensini A, Catani F, Leardini A, Romagnoli M, Giannini S (2007) Alignments and clinical results in conventional and navigated total knee arthroplasty. Clin Orthop Relat Res 457:156–162Google Scholar
- 18.Ewald FC (1989) The Knee Society total knee arthroplasty roentgenographic evaluation and scoring system. Clin Orthop Relat Res (248):9–12Google Scholar
- 20.Belvedere C, Ensini A, Leardini A, Dedda V, Feliciangeli A, Cenni F, Timoncini A, Barbadoro P, Giannini S (2014) Tibio-femoral and patello-femoral joint kinematics during navigated total knee arthroplasty with patellar resurfacing. Knee Surg Sports Traumatol Arthrosc 22(8):1719–1727CrossRefGoogle Scholar
- 21.Insall JN, Dorr LD, Scott RD, Scott WN (1989) Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res (248):13-14Google Scholar
- 26.Cip J, Obwegeser F, Benesch T, Bach C, Ruckenstuhl P, Martin A (2017) Twelve-year follow-up of navigated computer-assisted versus conventional total knee arthroplasty: a prospective randomized comparative trial. J Arthroplast. https://doi.org/10.1016/j.arth.2017.12.012
- 29.Eckhoff DG, Bach JM, Spitzer VM, Reinig KD, Bagur MM, Baldini TH, Flannery NM (2005) Three-dimensional mechanics, kinematics, and morphology of the knee viewed in virtual reality. J Bone Joint Surg Am 87(Suppl 2):71–80Google Scholar
- 32.Lee HJ, Park YB, Song MK, Kwak YH, Kim SH (2018) Comparison of the outcomes of navigation-assisted revision of unicompartmental knee arthroplasty to total knee arthroplasty versus navigation-assisted primary TKA. Int Orthop. https://doi.org/10.1007/s00264-018-4028-2