The higher preoperative scores in the PSI group limits the ability to draw definitive conclusions from the raw postoperative scores, but analyzing the changes in scores revealed that PSI was associated with a statistically significant improvement in Knee Society Functional score at 6-month post-TKA as compared to CAS or manual TKA. This may be attributable to improvements in component rotation and positioning, improved component size accuracy, or other factors that are not discernible on plain radiograph.
The purpose of this study was to determine whether differences in clinical, functional, or radiographic outcomes existed at 5-year follow-up between patients who underwent computer-assisted or manual total knee arthroplasty (TKA). Seventy-eight consecutive TKAs were performed by a single surgeon who had extensive experience performing computer-assisted and manual TKA. The manual group (n=40) and computer-assisted group (n=38) were similar with regard to age, sex, diagnosis, body mass index, surgical technique, implants, perioperative management, Knee Society scores, and anteroposterior mechanical axis. Sixty-three (manual group, n=34; computer-assisted group, n=29) patients were available for final follow-up. At 5-year follow-up, no statistically significant differences were found in Knee Society knee score (P=.289), function score (P=.272), range of motion (P=.284), pain score (P=.432), or UCLA activity score (P=.109) between the 2 groups. Postoperative radiographs showed a significant difference in the mechanical axis (P=.004) between the 2 groups; however, both groups achieved a neutral mechanical axis of ±3° (computer-assisted group mean, 2.0°; manual group mean, -0.24°).When TKA was performed by an experienced surgeon, no significant difference was identified at 5-year follow-up between patients who underwent computer-assisted vs manual TKA.
In this study, the surgeon's final component selection was more likely to be in accordance with the PSG rather than the CAN sizing algorithm. This study suggests that intraoperative surface registration may not be as accurate as preoperative three-dimensional magnetic resonance imaging reconstructions for establishing optimal femoral component sizing.
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