title: Comparison of radiographic alignment of imageless computer-assisted surgery vs conventional instrumentation in primary total knee arthroplasty.
abstract: A total of 208 patients were enrolled in a multicenter, prospective randomized, institutional review board-approved study that compared preoperative surgical plan to postoperative 2-dimensional radiographic alignment measured by a blinded reviewer for primary total knee arthroplasty (TKA) implanted using computer-assisted surgery (CAS) compared with conventional TKA instrumentation. The results demonstrated a statistically significant improvement in the coronal tibial component alignment (P < .03) and failed to demonstrate a statistically significant improvement in the mechanical axis, femoral coronal/sagittal, and tibial sagittal alignment. Knee Society Score knee and function scores and 6-minute walk test were equivalent between the 2 treatment groups at all postoperative intervals. There was a statistically significant increase in the skin-skin time (P < .0001) and the time until first bone cut (P < .0001) for the CAS knees compared with those implanted with conventional instrumentation. The use of CAS in this randomized clinical trial conducted at high-volume centers did not offer a clinically meaningful improvement in postoperative alignment, clinical, functional, or safety outcomes compared with conventional TKA.
authors: Valley Orthopedic Associates, Seattle, Washington 98055-5791, USA.
authors: William P
authors: WP
authors: Barrett
authors: J Bohannon
authors: JB
authors: Mason
authors: Joseph T
authors: JT
authors: Moskal
authors: David F
authors: DF
authors: Dalury
authors: Ali
authors: A
authors: Oliashirazi
authors: David A
authors: DA
authors: Fisher
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D017760:Bone Malalignment / Q000000981:diagnostic imaging* / Q000517:prevention & control; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000502:physiology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery*; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016037:Single-Blind Method; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000379:methods*; D013977:Tibia / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology