Clinical Outcomes After Computer-assisted Versus Conventional Total Knee Arthroplasty

Xie, Chunming; Liu, Kai; Xiao, Lei; Tang, Rong

doi:10.3928/01477447-20120426-17

Cited by 34 publications

(26 citation statements)

References 37 publications

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“…While our findings are consistent with those of numerous other authors that CAS results in a mechanical axis closer to neutral, the clinical benefit of this finding has yet to be clearly demonstrated through the use of accepted clinical evaluation tools [17][18][19][20]. Furthermore, using CAS for TKA involves recurring costs and often results in increased operative time.…”

Section: Discussionsupporting

confidence: 87%

Re-learning curve for conventional total knee arthroplasty following 30 consecutive computer-assisted total knee arthroplasties

Nicholson

Trofa

Smith

2013

Computer Aided Surgery

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A learning curve for returning to conventional total knee arthroplasty (TKA) after using computer-assisted (CAS) TKA has not yet been established. In this study, the postoperative mechanical axes of the first 30 consecutive CAS TKAs performed by a single surgeon were compared to his subsequent 120 conventionally performed TKAs. A ''re-learning curve'' of 30 conventional TKAs was necessary to attain an average postoperative mechanical axis statistically indistinguishable from the average CAS mechanical axis (1.99 ). This is a trend of which surgeons should be aware when converting from CAS TKA to conventional TKA. As a secondary goal, the authors identify the first clinical parameter, preoperative deviation from neutral mechanical axis, that may potentially serve as a guide for the selective use of CAS in TKA.

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Section: Discussionsupporting

confidence: 87%

Re-learning curve for conventional total knee arthroplasty following 30 consecutive computer-assisted total knee arthroplasties

Nicholson

Trofa

Smith

2013

Computer Aided Surgery

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“…Also, we contacted experts in the field resulting in one more article eligible for inclusion. As a result, we included 42 SRs 12–14 36–74…”

Section: Resultsmentioning

confidence: 99%

“…Three functional outcomes were compared for TKA 14 45 60 64 67 69 71 72. Knee Society Scores: Two out of eight SRs showed that CA TKA had superior scores,14 60 while six out of eight SRs showed no difference 45 64 67 69 71 72. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): One out of three SRs showed slightly improved scores with the CA TKA,60 while two out of three SRs showed no difference 71 72.…”

Section: Resultsmentioning

confidence: 99%

An umbrella review comparing computer-assisted and conventional total joint arthroplasty: quality assessment and summary of evidence

Hasan

Zhang

Beal

et al. 2020

BMJ Surg Interv Health Technologies

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BackgroundSystematic reviews (SRs) of computer-assisted (CA) total knee arthroplasty (TKA) and total hip arthroplasty (THA) report conflicting evidence on its superiority over conventional surgery. Little is known about the quality of these SRs; variability in their methodological quality may be a contributing factor. We evaluated the methodological quality of all published SRs to date, summarized and examined the consistency of the evidence generated by these SRs.MethodsWe searched four databases through December 31, 2018. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) was applied to assess the methodological quality. Evidence from included meta-analyses on functional, radiological and patient-safety outcomes was summarized. The corrected covered area was calculated to assess the overlap between SRs in including the primary studies.ResultsBased on AMSTAR 2, confidence was critically low in 39 of the 42 included SRs and low in 3 SRs. Low rating was mainly due to failure in developing a review protocol (90.5%); providing a list of excluded studies (81%); accounting for risk of bias when discussing the results (67%); using a comprehensive search strategy (50%); and investigating publication bias (50%). Despite inconsistency between SR findings comparing functional, radiological and patient safety outcomes for CA and conventional procedures, most TKA meta-analyses favored CA TKA, whereas most THA meta-analyses showed no difference. Moderate overlap was observed among TKA SRs and high overlap among THA SRs.ConclusionsDespite conclusions of meta-analyses favoring CA arthroplasty, decision makers adopting this technology should be aware of the low confidence in the results of the included SRs. To improve confidence in future SRs, journals should consider using a methodological assessment tool to evaluate the SRs prior to making a publication decision.

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“…In CAS the cost, operating time, chances of periprosthetic fractures are very high. 3,4,5 The need to overcome these limitations led to the development of hand held navigation system. It has showed promising results for achieving accurate tibial and femoral resection and alignment as with the same degree of accuracy as with large console CAS systems, while preventing the above mentioned concern.…”

Section: Introductionmentioning

confidence: 99%

“…It has showed promising results for achieving accurate tibial and femoral resection and alignment as with the same degree of accuracy as with large console CAS systems, while preventing the above mentioned concern. 5 It also does not depend on assumptions based on the axes of the femur and tibia like in conventional method. 6 I am doing this study, as not many studies have been done on the radiological outcome or the effective component alignment using portable accelerometer-based hand held navigation system in TKA.…”

Section: Introductionmentioning

confidence: 99%

A study on radiological outcomes of accelerometer based hand held navigation system in total knee arthroplasty

2020

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Background: The goal of obtaining more accurate component alignment in total knee arthroplasty (TKA) has led to the development of techniques like portable accelerometer-based handheld navigation system, computer assisted system, patient specific instrumentation. Among which hand held navigation has showed promising results for achieving accurate resection and alignment and only few studies were done to assess radiological outcome or the effective component alignment using portable accelerometer-based hand held navigation system in TKA.Methods: TKA using portable accelerometer-based hand held navigation system (Smith and Nephew- knee align) was done on 25 knees with primary osteoarthritis. Preoperative and post-operative mechanical axis and component alignments were measured using hip-to-ankle radiographs.Results: Among the femoral components, 92.0% were placed within 90°±2° to the femoral mechanical axis in the coronal and 96.0% of the tibial components were placed within 90°±2° to the mechanical axis in the coronal plane, 94.3% of the TKAs had an overall lower extremity alignment within 3° of neutral to the mechanical axis, based on postoperative hip-to-ankle radiographs.Conclusions: The degree of accuracy in positioning the femoral and tibial component in TKA using portable accelerometer-based hand held navigation system (knee align) is very much promising and is an effective intraoperative tool for reducing the proportion of outliers for component placement and thus decreasing the chances of instability and early wear and tear of the components in TKA.

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Clinical Outcomes After Computer-assisted Versus Conventional Total Knee Arthroplasty

Cited by 34 publications

References 37 publications

Re-learning curve for conventional total knee arthroplasty following 30 consecutive computer-assisted total knee arthroplasties

Re-learning curve for conventional total knee arthroplasty following 30 consecutive computer-assisted total knee arthroplasties

An umbrella review comparing computer-assisted and conventional total joint arthroplasty: quality assessment and summary of evidence

A study on radiological outcomes of accelerometer based hand held navigation system in total knee arthroplasty

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