Computer-assisted total knee arthroplasty versus the conventional technique: how precise is navigation in clinical routine?
Restoration of the mechanical leg axis and component positioning are crucial factors affecting long-term results in total knee arthroplasty (TKA). In a prospective study, 1,000 patients were operated on either using a CT-free navigation system or the conventional jig-based technique. Leg alignment and component orientation were determined on postoperative X-rays. The mechanical leg axis was significantly better in the computer-assisted group (95%, within +/-3 degrees varus/valgus) compared to the conventional group (74%, within +/-3 degrees varus/valgus) (P < 0.001). On average, the operating time was increased by 8 min in the computer-assisted group. No significant differences were seen between senior and younger surgeons regarding postoperative leg alignment and operating time. Computer-assisted TKA leads to a more accurate restoration of leg alignment and component orientation compared to the conventional jig-based technique. Potential benefits in long-term outcome and functional improvement require further investigation.
Tingart
Markus
M
Department of Orthopaedic Surgery, University of Regensburg, Asklepios Klinikum, Kaiser Karl V Allee 3, 93077 Bad Abbach, Germany. Markus.Tingart@klinik.uni-regensburg.de
Lüring
Christian
C
Bäthis
Holger
H
Beckmann
Johannes
J
Grifka
Joachim
J
Perlick
Lars
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000592:standards*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000517:prevention & control* / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000379:methods* / Q000592:standards*; D013997:Time Factors; D016896:Treatment Outcome