Does accurate anatomical alignment result in better function and quality of life? Comparing conventional and computer-assisted total knee arthroplasty.
This is a randomized prospective controlled trial comparing the alignment, function, and patient quality-of-life outcomes between patients undergoing conventional (CONV) and computer-assisted (CAS) knee arthroplasty. One hundred and fifteen patients (60 CAS, 55 CONV) underwent cemented total knee arthroplasty. Three patients were lost to follow-up. Eighty-eight percent (CAS) vs 61% (CONV) of knees achieved a mechanical axis within 3 degrees of neutral (P = .003). Aligning femoral rotation with the epicondylar axis was accurately achieved in CAS and CONV with no significant difference. Patients with coronal alignment within 3 degrees of neutral had superior International Knee Society and Short-Form 12 physical scores at 6 weeks, 3 months, 6 months, and 12 months after surgery. Computer-assisted total knee arthroplasty achieves greater accuracy in implant alignment and this correlates with better knee function and improved quality of life.
Department of Orthopaedics, St Vincent's Hospital, University of Melbourne, Melbourne, Victoria, Australia.
Peter F
PF
Choong
Michelle M
MM
Dowsey
James D
JD
Stoney
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D001696:Biomechanical Phenomena; D017760:Bone Malalignment / Q000503:physiopathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology* / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D017755:Prosthesis Fitting / Q000379:methods*; D011788:Quality of Life; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome