title: A randomized controlled clinical and radiological trial about outcomes of navigation-assisted TKA compared to conventional TKA: long-term follow-up.
abstract: OBJECTIVE
  Well balanced knees with good alignment are essential for a well-functioning TKA with long survival of its implants. This prospective randomized study comparing navigation-assisted TKA and conventional TKA reported the clinical and radiological outcomes at a follow-up of 9 years. The purpose of this study was to compare the clinical and radiological outcomes for patients who underwent navigation-assisted TKA or conventional TKA after long-term follow-up.
  
  
  METHODS
  A total of 80 patients (88 knees) were available for physical and radiological examination 9 years after TKA. Clinical outcomes were evaluated using HSS, WOMAC, and KS function and pain scores. And radiological outcomes of the component loosening and its survivorship during 9-year follow-up were also evaluated.
  
  
  RESULTS
  There were no significant differences in the field of clinical outcomes between the two groups. In terms of radiological outcomes, the navigation group had fewer alignment outliers (7.3 vs 20 %, p = 0.006). Although the clinical outcomes showed no differences between the two groups, the survival rate was slightly better in the navigation group than in the conventional group without statistical significance (best-case scenario 100 vs 95.3 %, n.s., worst-case scenario 95.6 vs 88.4 %, n.s.).
  
  
  CONCLUSIONS
  Navigation-assisted TKA produced better alignment outcomes and better survival rates than conventional instruments although some of the differences were not statistically significant.
  
  
  METHODS
  I.
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, 160Ilsimri, Hwasun-eup, Hwasun-gun, Jeollanamdo, 519-809, South Korea.
authors.forename: E K
authors.initials: EK
authors.lastname: Song
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, 160Ilsimri, Hwasun-eup, Hwasun-gun, Jeollanamdo, 519-809, South Korea.
authors.forename: Pranav R
authors.initials: PR
authors.lastname: Agrawal
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: H Y
authors.initials: HY
authors.lastname: Seo
authors.affiliation: Department of Orthopedic Surgery, Center for Joint Disease, Chonnam National University Hwasun Hospital, 160Ilsimri, Hwasun-eup, Hwasun-gun, Jeollanamdo, 519-809, South Korea. seonbell@yahoo.co.kr.
authors.forename: J K
authors.initials: JK
authors.lastname: Seon
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D019736:Prostheses and Implants; D011859:Radiography; D000072177:Radiologists; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D016896:Treatment Outcome
keywords: Arthroplasty; Conventional; Knee; Navigation
references.citation: J Arthroplasty. 2014 Sep;29(9):1795-802
references.pmid: 24906519
references.citation: J Bone Joint Surg Am. 2007 Feb;89(2):261-9
references.pmid: 17272438
references.citation: Knee. 2013 Aug;20(4):242-9
references.pmid: 22892197
references.citation: Knee Surg Sports Traumatol Arthrosc. 2011 Jul;19(7):1107-12
references.pmid: 21234541
references.citation: Knee Surg Sports Traumatol Arthrosc. 2015 Jun;23(6):1660-8
references.pmid: 24929659
references.citation: J Bone Joint Surg Br. 1991 Sep;73(5):709-14
references.pmid: 1894655
references.citation: Comput Aided Surg. 2007 May;12 (3):189-93
references.pmid: 17538792
references.citation: Knee. 2008 Mar;15(2):75-9
references.pmid: 18234498
references.citation: J Bone Joint Surg Br. 2004 Apr;86(3):372-7
references.pmid: 15125124
references.citation: J Arthroplasty. 2009 Jun;24(4):570-8
references.pmid: 18534396
references.citation: Clin Orthop Relat Res. 1989 Nov;(248):9-12
references.pmid: 2805502
references.citation: Clin Orthop Relat Res. 2004 Nov;(428):131-9
references.pmid: 15534533
references.citation: J Arthroplasty. 2007 Dec;22(8):1097-106
references.pmid: 18078876
references.citation: Clin Orthop Relat Res. 1994 Feb;(299):31-43
references.pmid: 8119035
references.citation: J Bone Joint Surg Am. 2012 Nov 21;94(22):2017-24
references.pmid: 23052635
references.citation: Clin Orthop Relat Res. 2001 Nov;(392):38-45
references.pmid: 11716411
references.citation: J Arthroplasty. 2006 Sep;21(6):777-82
references.pmid: 16950026
references.citation: Orthopedics. 2008 Oct;31(10 Suppl 1):null
references.pmid: 19298036
references.citation: Orthopedics. 2005 Oct;28(10 Suppl):s1259-62
references.pmid: 16235451
references.citation: Clin Orthop Relat Res. 1995 Sep;(318):176-81
references.pmid: 7671514
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10):2241-7
references.pmid: 23851969
references.citation: Knee Surg Sports Traumatol Arthrosc. 2013 Oct;21(10 ):2206-12
references.pmid: 23928929
references.citation: Clin Orthop Relat Res. 1994 Feb;(299):153-6
references.pmid: 8119010
references.citation: J Bone Joint Surg Br. 2008 Sep;90(9):1121-7
references.pmid: 18757949
references.citation: Clin Orthop Relat Res. 2002 Nov;(404):7-13
references.pmid: 12439231
references.citation: Knee Surg Sports Traumatol Arthrosc. 2014 Dec;22(12 ):2954-61
references.pmid: 25331655
references.citation: Clin Orthop Relat Res. 2001 Nov;(392):315-8
references.pmid: 11716402
references.citation: Bone Joint J. 2013 Jul;95-B(7):906-10
references.pmid: 23814241
references.citation: J Bone Joint Surg Br. 2007 Apr;89(4):477-80
references.pmid: 17463115
references.citation: J Arthroplasty. 2012 May;27(5):667-72.e1
references.pmid: 21958937
references.citation: J Arthroplasty. 2009 Jun;24(4):560-9
references.pmid: 18534397
references.citation: J Bone Joint Surg Am. 2011 Jul 6;93(13):1190-6
references.pmid: 21776571