Does computer-assisted total knee arthroplasty improve the overall component position and patient function?

Allen, Charlotte; Hooper, Gary J.; Oram, Byron J.; Wells, J. E.

doi:10.1007/s00264-013-1996-0

Cited by 26 publications

(22 citation statements)

References 32 publications

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“…Earlier lack of evidence on post-operative functional improvement has been one of the reasons CAOS did not gain so much popularity. Some studies found no difference in functional outcome between CAOS group and traditional group [ 27 , 28 ]. Outcome assessment factors are gross and not powered enough to detect the statistical difference in most small studies.…”

Section: Methodsmentioning

confidence: 99%

Computer assisted navigation in total knee and hip arthroplasty

Deep

Shankar

Mahendra

2017

SICOT-J

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Introduction: Computer assisted surgery was pioneered in early 1990s. The first computer assisted surgery (CAS) total knee replacement with an imageless system was carried out in 1997. In the past 25 years, CAS has progressed from experimental in vitro studies to established in vivo surgical procedures. Methods: A comprehensive body of evidence establishing the advantages of computer assisted surgery in knee and hip arthroplasty is available. Established benefits have been demonstrated including its role as an excellent research tool. Its advantages include dynamic pre-operative and per-operative assessment, increased accuracy in correction of deformities, kinematics and mechanical axis, a better alignment of components, better survival rates of prostheses and a better functional outcome. Adoption of computer navigation in the hip arthroplasty is still at an early stage compared to knee arthroplasty, though the results are well documented. Evidence suggests improved accuracy in acetabular orientation, positioning, hip offset and leg length correction. Results: Among the orthopaedic surgeons, navigated knee arthroplasty is gaining popularity though slowly. The uptake rates vary from country to country. The Australian joint registry data shows increased navigated knee arthroplasty from 2.4% in 2003 to 28.6% in 2015 and decreased revision rates with navigated knee arthroplasty in comparison with traditional instrumented knee arthroplasty in patient cohort under the age of 55 years. Conclusion: Any new technology has a learning curve and with practice the navigation assisted knee and hip arthroplasty becomes easy. We have actively followed the evidence of CAS in orthopaedics and have successfully adopted it in our routine practice over the last decades. Despite the cautious inertia of orthopaedic surgeons to embrace CAS more readily; we are certain that computer technology has a pivotal role in lower limb arthroplasty. It will evolve to become a standard practice in the future in various forms like navigation or robotics.

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Section: Methodsmentioning

confidence: 99%

Computer assisted navigation in total knee and hip arthroplasty

Deep

Shankar

Mahendra

2017

SICOT-J

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“…Similarly, the use of computer navigated arthroplasty instead of surgeons using simple templates and jigs failed to show any improvement in the literature [ 126 ]. A new development in arthroplasty is the use of patient specific TJR where components are produced to precisely match a preoperative MRI scan of the patient's joint.…”

Section: Joint Registry Datamentioning

confidence: 99%

A Review on the Management of Hip and Knee Osteoarthritis

Wood

Brock

Heil

et al. 2013

International Journal of Chronic Diseases

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Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips. We review the current concepts with regard to the disease process and risk factors for developing hip and knee osteoarthritis. We then explore the nonsurgical management of osteoarthritis as well as the operative management of hip and knee arthritis. We discuss the indications for surgical treatment of hip and knee arthritis, looking in particular at the controversies affecting young and obese patients in both hip and knee replacements. Patient and implant related outcomes along with survivorships are addressed as well as the experiences and controversies described in national joint registries.

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“…In another systematic review, improved coronal plane alignment with fewer radiographic outliers was described but function was not improved [22]. Several other authors have reported no significant advantage in functional outcome at 2-and 5-year follow-up for computer-navigated technique over conventional jig-based technique [23][24][25][26][27]. Despite the positive potential for similar accurate results achieved by novice and experienced users in one study [28], some authors have reported general increased surgical time with navigation-assisted TKR [14,21,22].…”

Section: Discussionmentioning

confidence: 99%