Clinical and radiologic outcomes of contemporary 3 techniques of TKA.
This report compares the radiologic and early clinical results of total knee arthroplasty (TKA) performed by the same surgeon using 3 techniques. In this prospective study, 75 knees were randomized to conventional technique (25 knees), image-free navigation system (25 knees), or minimally invasive surgery (MIS) (25 knees). Age range of the 43 women (65 knees) and 5 men (10 knees) was 58 to 81 years. Posterior stabilized knee prosthesis was used in all patients. Data was collected according to Knee Society System for radiologic evaluation of x-rays. Knee Society clinical (KS-C) and functional knee scores were measured preoperatively and at 6 weeks, 3 months, 6 months, 1 year, and 2 years. The postoperative KS-C was not statistically better in the MIS group (mean, 88 ± 11.5; range, 70-100) than the conventional (mean, 85.9 ± 7.8; range, 74-94) (P=.68) or navigation group (mean, 85 ± 11; range, 63-100) (P=.59). Mean postoperative delta (mechanical axis) angle was significantly different (P=.014): 2.38° in the conventional group (SD=2.88°; 95% CI, 1.19°-3.57°; range, -1.59° to 6.86°), 0.61° in the navigation group (SD=2.07°; 95% CI, -0.24° to 1.46°; range, -2.07° to 4.25°), and 4.25° in the MIS group (SD=6.52°; 95% CI, 1.56°-6.94°; range, -6.72° to 15.60°). Significant difference could be elicited between navigation-assisted and MIS groups, with navigation-assisted surgery providing more accurate alignment of the mechanical axis (P=.014). Of the three techniques, navigation-assisted surgery gives superior prosthesis alignment and promising longevity of TKA.
Department of Orthopedic Surgery, Seoul Veterans Hospital, Seoul, Korea.
Jae-Hyuk
JH
Yang
Jung-Ro
JR
Yoon
Dilbans S
DS
Pandher
Kwang-Jun
KJ
Oh
D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010329:Patella / Q000000981:diagnostic imaging; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D011859:Radiography; D025321:Surgery, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data*; D013977:Tibia / Q000601:surgery; D016896:Treatment Outcome