A prospective randomized study comparing navigation versus conventional total knee arthroplasty

Abstract

Background: Navigation is associated with improved accuracy in alignment. However, its influence on clinical outcome is inconclusive. The aim of this study was to compare the component alignment and functional outcome in patients undergoing navigation-assisted and conventional total knee replacement (TKR). Materials and method: A prospective randomized study consisting of two groups (group A and group B) was carried out. Group A consisted of patients undergoing TKR using conventional jig-based method, whereas group B consisted of patients undergoing TKR using computer navigation-assisted method. We measured and compared the coronal and sagittal plane alignment in X-ray and rotational alignment in computed tomography scan between both groups. Functional outcome was analysed using Knee Society Score (KSS) and Western Ontario and McMaster University scale (WOMAC) score. Results: A total of 50 patients were randomized into two groups A and B each with 25 patients. Navigation was associated with more accuracy in mechanical axis alignment (p ¼ 0.011) and femoral component rotation (p ¼ 0.033). The mean follow-up was 4.6 years (range 48-62 months). There was no statistically significant difference between the groups with respect to KSS and WOMAC score at the minimum follow-up of 4 years. Conclusion: We concluded that even though navigation-assisted system is associated with better accuracy, there was no difference in clinical outcome at an average follow-up of 4.6 years.

Accelerometer-Based Navigation Versus Conventional Technique in Total Knee Replacement. A Prospective Study in a Tertiary Care Medium Volume Setup in India.

“…While Harvie et al reported no difference in functional outcome (Knee society, SF 36, WOMAC scale and patient satisfaction score) with navigated and conventional TKA at ve years follow up. (27) similar result reported by Rajkumar Selvanagayam et al by comparing functional outcome (knee society, WOMAC scale) at follow up of minimum 4 years, even though better accuracy was (18) associated with navigation-assisted system. Kim YH et al showed that no differences in components alignment, clinical function and components survival between the computer navigational TKR knees and conventional TKR knees.…”

New technology‐based assistive techniques in total knee arthroplasty: A Bayesian network meta‐analysis and systematic review

“…Twenty‐one of the included studies compared clinical outcomes between CAS‐ and CON‐TKA 8,31–40,42–51 . Most of these studies reported no significant differences in all clinical outcome measures, including KSS knee and function scores, WOMAC scores, HSS scores, and ROM, regardless of the follow‐up time 8,31,32,34,36,37,39,43–47,49–51 . However, the results of six studies suggested that CAS‐TKA could improve post‐operative clinical outcomes 33,35,38,40,42,48 .…”

“…As a passive system, CAS shows the position of surgical tools and the prosthesis within a patient's fixed reference system, enabling the surgeon to navigate through virtual pictures on a screen while handling these components 4 . Several comparative studies have demonstrated that CAS can provide better precision in bone cutting, mechanical alignment restoration and prosthesis positioning in TKA when compared with conventional instrumentation 5–11 …”

“…4 Several comparative studies have demonstrated that CAS can provide better precision in bone cutting, mechanical alignment restoration and prosthesis positioning in TKA when compared with conventional instrumentation. [5][6][7][8][9][10][11] Nevertheless, RAS is considered as an active system, where the patient-specific model and corresponding surgical plan are all constructed offline prior to the commencement of surgery. 12 The surgeon can position the robot through a referencing procedure and then supervises the reaming process, without modifying the procedure online.…”

The iAssist Navigation System Demonstrated Superior Radiological Outcomes in Restoring Mechanical Alignment and Component Sagittal Positioning in Total Knee Arthroplasty

“…Considering the growing demand for technical accuracy and precision, computerassisted system (CAS) has rapidly developed and been well applied. A number of comparative research has demonstrated that CAS was able to minimize cases of outliers in MA and component position in comparison with conventional instrumentations [7][8][9]. Nevertheless, utilizing CAS would take longer surgery time and is related to higher cost [4].…”