Low incidence of complications in computer assisted total knee arthroplasty—A retrospective review of 1596 cases

Khakha, Raghbir; Chowdhry, Madhav; Norris, Mark C.; Kheiran, Amin; Chauhan, Sandeep

doi:10.1016/j.knee.2015.02.009

Cited by 12 publications

(9 citation statements)

References 22 publications

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“…Disadvantages of computer navigation include increased costs, longer operating time, the risk of fractures around pin sites and pin site infection. However, the overall risk of CAS-specific complications has been described as very low [ 17 ]. To date the role of CAS TKA is still under debate [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study

Beyer

Pape

Lützner

et al. 2021

BMC Musculoskelet Disord

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Background Computer-assisted navigation (CAS) was developed to improve the surgical accuracy and precision. Many studies demonstrated better alignment in the coronal plane in CAS TKA compared to conventional technique. The influence on the functional outcome is still unclear. Only few studies report long-term results of CAS TKA. This study was initiated to investigate 10-year patient-reported outcome of CAS and conventional TKA. Methods From initially 80 patients of a randomized study of CAS and conventional TKA a total of 50 patients could be evaluated at the 10-year follow-up. The Knee Society Score and EuroQuol Questionnaire were assessed. For all patients a competing risk analysis for revision was performed. Results The patient-reported outcome measures demonstrated similar values for both groups. The 10-year risk for revision was 2.5% for conventional TKA and 7.5% for CAS TKA (p=0.237). Conclusions There was no difference between CAS and conventional TKA with regard to patient-reported outcome and revision risk ten years after surgery. Trial registration This study was registered at clinicaltrials.gov on 11/30/2009, ID: NCT01022099.

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Section: Introductionmentioning

confidence: 99%

Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study

Beyer

Pape

Lützner

et al. 2021

BMC Musculoskelet Disord

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“…Interestingly, 13 of the 14 total pin‐site complications in this study with a specified location involved a tibial pin site. The increased rate of tibial pin‐site complications may be associated with the use of an additional stab incision for placement of tibial pins, while femoral pins can be placed through the primary operative incision [7]. It is unclear why intraoperative pin‐site fractures in our analysis occurred only in the tibia.…”

Section: Discussionmentioning

confidence: 99%

“…Thus far, the current literature has shown these complications are relatively rare. The overall rate of pin‐site complications following computer navigated and RA‐TKA has ranged between 0.3% to 1.9% [7, 9, 12, 13, 17]. Pin‐site infection is the most commonly reported complication, with rates ranging between 0.3% to 1.2% [7, 12, 13, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

“…While the placement of pins is generally a benign procedure, there remains a risk for pin‐site fracture, pin‐site infections, wound complications, neurovascular injury, and pin breakage in patients undergoing RA‐TKA. The reported rate of pin‐site complications following computer navigated and RA‐TKA has ranged between 0.3% to 1.9% [7, 13, 17, 18]. Interestingly, not all manufacturers of these systems use the same diameter pins, and it has been suggested that the use of larger diameter pins can increase the risk of pin‐site fracture [2, 16].…”

Section: Introductionmentioning

confidence: 99%

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A comparison of pin site complications between large and small pin diameters in robotic‐assisted total knee arthroplasty

et al. 2023

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Purpose Robotic-assisted total knee arthroplasty typically necessitates use of tracking pins, which can vary in diameter. Complications such as infections and fractures at the pin-site have been observed, but clarification of the effect of pin diameter on complication is needed. The aim of this study is to compare the pin-related complication rates following robotic-assisted total knee arthroplasty between 4.5 mm and 3.2 mm diameter pins. Methods In this retrospective cohort study, 90-day pin-site complication rates after robotic-assisted total knee arthroplasty were compared between 4.5 mm diameter and 3.2 mm diameter groups. In total, 367 patients were included: 177 with large pin diameter and 190 with small pin diameter. All four pin sites were evaluated using postoperative radiographs. Cases without orthogonal views or visualization of all four pin tracts were noted. Multivariate logistic regression was used to control for age, which differed between the two cohorts. Results The rate of pin-site complications was 5.6% in the large pin diameter cohort and 2.6% in the small pin diameter cohort, with no statistically significant difference between the groups. The adjusted odds ratio for complications in small compared to large diameter group was 0.48, with a p-value of 0.18. The most common pin-site complication was infection/persistent drainage, found in 1.9% of patients, followed by intraoperative fracture of the second cortex in 1.4%. Intraoperative fracture could not be ruled out in 96 cases due to inadequate radiographic visualization of all pin sites. There was one postoperative pin-site fracture in the large diameter cohort, which required operative fixation. Conclusion This study demonstrates no statistically significant difference in pin-site complication rates after robotic-assisted total knee arthroplasty between 4.5 mm and 3.2 mm pin diameter cohorts, although there was a trend towards increased intraoperative and postoperative pin-site fractures in the 4.5 mm group.

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“…Several authors recommended metaphyseal pin placement to reduce the creation of stress risers in the diaphysis. 4,7,8,14,15 Therefore, it is assumed that pin-site fracture may be reduced by placing the femoral pins through more cancellous bone of the metaphyseal area in the distal femur.…”

Section: Discussionmentioning

confidence: 99%

Distal Femoral Tracker Pin Placement Prevents Delayed Pin Tract-Induced Fracture in Robotic-Assisted Total Knee Arthroplasty: Results of Minimum 1-Year Follow-Up

et al. 2022

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The purpose of this study was to determine the outcomes of the placement of a pin tracker in the distal femur in robotic-assisted total knee arthroplasty (TKA) over a minimum follow-up period of 1 year. A consecutive series of 81 TKAs were performed in 59 patients using a robotic-assisted system (Mako) at our hospital. The mean follow-up period was 1.1 years (range, 1–1.2 years). No periprosthetic fracture at a pin tracker site was reported at a minimum of 1 year of follow-up. No patients reported minor or major complications associated with the distal femoral pins. In addition, unicortical pin-site drilling marks in all patients disappeared on one-postoperative-year follow-up radiographs. Our technique, which used unicortical pin placement in the distal femur in robotic-assisted TKA, demonstrated that it was a safe and reliable method at a minimum follow-up period of 1 year. The level of evidence is IV.

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Low incidence of complications in computer assisted total knee arthroplasty—A retrospective review of 1596 cases

Cited by 12 publications

References 22 publications

Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study

Similar outcomes in computer-assisted and conventional total knee arthroplasty: ten-year results of a prospective randomized study

A comparison of pin site complications between large and small pin diameters in robotic‐assisted total knee arthroplasty

Distal Femoral Tracker Pin Placement Prevents Delayed Pin Tract-Induced Fracture in Robotic-Assisted Total Knee Arthroplasty: Results of Minimum 1-Year Follow-Up

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