Can Computer Assistance Improve the Clinical and Functional Scores in Total Knee Arthroplasty?

Hernández-Vaquero, Daniel; Suárez-Vázquez, A.; Iglesias-Fernandez, S

doi:10.1007/s11999-011-2044-2

Cited by 59 publications

(46 citation statements)

References 22 publications

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“…To date, few publications report midterm results of navigated versus conventional TKAs: most focus on postoperative function, involve less than 100 patients [16,17], and provide no revision rates. Other studies report revision rates of navigated TKAs: Hernández-Vaquero et al assessed 100 patients with a follow-up of eight years and detected similar revision rates between conventional and navigated techniques [18]. Harvie et al evaluated 71 patients and found no revisions after five years [19], Pang et al 140 patients and no revisions after two years [20], and Ishida 54 patients and one revision in each group after five years [21].…”

Section: Discussionmentioning

confidence: 97%

Influence of computer navigation on TKA revision rates

Schnurr

Güdden

Eysel

et al. 2012

International Orthopaedics (SICOT)

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Purpose We performed this study to determine whether the use of imageless navigation reduces revision rates after total knee arthroplasty (TKA). Methods Data of 1,121 consecutive primary TKA with a follow-up of one to six years were retrospectively analysed. Following the conversion of the standard technique from conventional to navigated procedures, these data included the last 342 conventional and first 779 navigated procedures performed in our clinic. Demographic and perioperative covariates were recorded. All patients were asked by post to report instances of revisions. Results Data of 1,054 patients (94 %) were complete. Mean follow-up was 3.9 years for conventional and 2.4 years for navigated operations. Cumulative revision rate averaged 4.7 % for conventional and 2.3 % for navigated procedures. Cox's proportional hazard model was used to assess the effect of covariates on survival, resulting in significantly lower revision rates for older patients (p<0.001) and for the navigated technique (p00.012). The reduced revision rate for navigated operations was mainly caused by a significantly reduced rate of aseptic implant loosening (1.9 % vs. 0.1 %, p00.024). Conclusions Our study showed lower revision rates when computer navigation was used. However, due to the retrospective uncontrolled design, further prospective trials will be necessary to further evaluate this effect.

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Section: Discussionmentioning

confidence: 97%

Influence of computer navigation on TKA revision rates

Schnurr

Güdden

Eysel

et al. 2012

International Orthopaedics (SICOT)

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“…Choong et al 23 concluded that the use of computer-navigated total knee arthroplasty resulted in greater accuracy of implant alignment, better knee function, and improved quality of life than that achieved with conventional total knee arthroplasty. By contrast, studies comparing the clinical and functional results of total knee arthroplasty performed with or without computer navigation have found no differences, even in the short term [24][25][26][27][28][29] . In the current study, Knee Society scores (knee and functional scores) and WOMAC scores were not significantly different between the two groups at 10.8 years after the operation.…”

Section: Discussionmentioning

confidence: 99%

“…Our study, along with other reports, suggests that the relationship between the postoperative mechanical axis and implant survival is marginal 21,22 . Although the neutral mechanical axis is a valuable intraoperative target, its achievement does not necessarily confer satisfactory kinematics and implant survival 29,37 .…”

Section: Discussionmentioning

confidence: 99%

Computer-Navigated Versus Conventional Total Knee Arthroplasty

Kim

Park

Kim

2012

The Journal of Bone and Joint Surgery-American Volume

126

128

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“…Axial alignment of the limb with restoration of the mechanical axis is a determinant of the outcome [2]. A number of studies [3][4][5] have suggested that alignment errors of >3°a re associated with more rapid failure and less satisfactory functional results.…”

Section: Introductionmentioning

confidence: 99%

Are MRI-based, patient matched cutting jigs as accurate as the tibial guides?

Conteduca¹,

Iorio²,

Mazza³

et al. 2012

International Orthopaedics (SICOT)

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Purpose The aim of this study is to evaluate the accuracy of VISIONAIRE (Smith & Nephew Inc., Memphis, TN, USA) Patient Matched cutting tibial jigs in comparison with extramedullary (EM) tibial instrumentation by analysing data as detected by intra-operative use of VectorVision knee navigation software from BrainLAB (Redwood City, CA, USA). Methods Twelve patients were selected for unilateral total knee replacement (TKR). They underwent a full-length weight-bearing anteroposterior (AP) radiograph and magnetic resonance imaging (MRI). During surgery, once the EM guides were placed and fixed on the tibia, the orientation in the coronal and sagittal planes was checked by the navigator and then compared with the data obtained by measuring the orientation of VISIONAIRE Patient Matched cutting tibial jigs. An unsatisfactory result was considered an error ≥2°in both coronal and sagittal planes for the tibial component as a possible error of 4°could result. Results In the coronal plane the mean deviation of the EM tibial guides from the ideal alignment (0°) was 0.7±0.39°a nd of the VISIONAIRE was 129±1.55°(P00.22). In the sagittal plane the mean deviation of the EM tibial guides from 3°of posterior slope was −1.62±1.78°and of the VISIONAIRE was +1.16±4.29°(P<0.05). Negative values indicate a more posterior slope from the ideal and positive values an anterior slope. Conclusions This preliminary study documented only a fair accuracy of the method with a consistent risk of error of more of 3°especially in the sagittal plane. We could speculate that the problem in the sagittal plane was due to the fact that the pre-operative protocol does not include a lateral X-ray projection of the knee and only includes an AP standing X-ray of the straight leg and MRI.

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Can Computer Assistance Improve the Clinical and Functional Scores in Total Knee Arthroplasty?

Abstract: Level II, therapeutic study. See the Guidelines online for a complete description of levels of evidence.

Cited by 59 publications

References 22 publications

Influence of computer navigation on TKA revision rates

Influence of computer navigation on TKA revision rates

Computer-Navigated Versus Conventional Total Knee Arthroplasty

Are MRI-based, patient matched cutting jigs as accurate as the tibial guides?

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