Influence of computer navigation on TKA revision rates

Abstract

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.

Pre-operative arthritis severity as a predictor for total knee arthroplasty patients’ satisfaction

“…In our study population we detected a mean cumulative revision rate of 3 % after 2.8 years [19]. Those data are comparable to the well-known arthroplasty registers, e.g.…”

“…Cumulative revision rate averaged 3 % (n=32). As published before, Cox proportional hazard models identified "younger age" (p<0.001) and "conventional jig technique" (p=0.012) as risk factors for revision [19]. Analysis showed that 85.2 % (n=849) of the patients reported "satisfied or neutral" with the implanted knee joint, whereas 14.8 % (n= 147) were dissatisfied with the implanted knee joint.…”

Inconsistencies between navigation data and radiographs in total knee arthroplasty are system-dependent and affect coronal alignment

“…However, this finding is offset by findings of equivalent revision rates in a comparison study of 100 navigated and conventional TKAs 42 as well as a retrospective evaluation of 1121 TKAs that yielded a significantly lower revision rate for navigated TKAs. 43 Although these conflicting findings in the literature raise valid concerns regarding the long-term benefits of navigated TKA, it remains generally accepted that establishing a normal mechanical axis is a fundamental technical objective in TKA and that CAOS-TKA more reliably accomplishes this objective than conventional methods. 44 However, findings from the present study indicate that some CAOS-TKA systems may not be as reliable in providing intraoperative …”

New and evolving technologies for knee arthroplasty—computer navigation and robotics: state of the art

“…Data from the Australian registry of joint replacements show a progressive increase in the use of CAS in TKR from 2.4% in 2003 to 28.6% in 2015 70. The same is happening in some European countries as Norway with values around 20% 71. On the other hand regarding South American surgeons, only 4.5% of them use computer navigation routinely in their practices (Figueroa D, unpublished data).…”