Comparison Between Computer Navigation Assisted Surgery and Conventional Surgery in Total Knee Replacement
Abstract
Introduction: Total knee replacement (TKR) is the treatment of choice in the final stages of degenerative joint disease, and its survival depends largely on the alignment, positioning, and stability of the joint. This research aims to compare the mechanical axis of the lower limb measured by telemetry, after a computer navigation-assisted TKR vs. conventional techniques, performed by the same surgeon and using the same prosthesis. Secondly, to evaluate the degree of satisfaction of the patients submitted to this procedure and its possible variation between these two techniques. Materials and Methods: Retrospective, comparative, observational, descriptive study of 200 patients undergoing TKR, divided into two groups: Group A (100 patients), with Columbus® prostheses placed with the OrthoPilot® navigation system; and Group B (100 patients), with the same prosthesis placed with the conventional technique. Postoperative telemetry was performed on all patients to determine and compare the results in both groups. Secondly, the degree of satisfaction with the procedure and body mass index (BMI)—and its possible relationship with the results—were compared. Results: Computer navigation-assisted TKR obtained better outcomes with statistically significant differences both in the postoperative mechanical axis and in the degree of satisfaction with the procedure. Conclusion: Computer navigation-assisted primary TKRs were shown in our study to be more accurate in achieving final limb alignment on a 0 ° +/- 3 ° limb mechanical axis.Downloads
References
Sloan M, Premkumar A, Sheth NP. Projected volume of primary total joint arthroplasty in the U.S., 2014 to 2030. J Bone Joint Surg Am 2018;100(17):1455-60. https://doi.org/10.2106/JBJS.17.01617
Picard F, Deep K, Jenny JY. Current state of the art in total knee arthroplasty computer navigation. Knee Surg Sports Traumatol Arthrosc 2016;24(11):3565–74. https://doi.org/10.1007/s00167-016-4337-1
Selvanayagam R, Kumar V, Malhotra R, Srivastava DN, Digge VK. A prospective randomized study comparing
navigation versus conventional total knee arthroplasty. J Orthop Surg (Hong Kong) 2019;27(2):2309499019848079. https://doi.org/10.1177/2309499019848079
Mathew KK, Marchand KB, Tarazi JM, Salem HS, DeGouveia W, Ehiorobo JO, et al. Computer-assisted navigation in total knee arthroplasty. Surg Technol Int 2020;36:323-30. PMID: 32294224
Dong Z, Li Y, Tian H. [Research progress on comparison of the application effects between personal specific
instrumentation and computer-assisted navigation surgery in total knee arthroplasty]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021;35(11):1492-8. https://doi.org/10.7507/1002-1892.202104048 [En chino]
Shah SM. After 25years of computer-navigated total knee arthroplasty, where do we stand today? Arthroplasty 2021;3(1):41. https://doi.org/10.1186/s42836-021-00100-9
Siddiqi A, Smith T, McPhilemy JJ, Ranawat AS, Sculco PK, Chen AF. Soft-tissue balancing technology for total
knee arthroplasty. JBJS Rev 2020;8(1):e0050. https://doi.org/10.2106/JBJS.RVW.19.00050
Todesca A, Garro L, Penna M, Bejui-Hugues J. Conventional versus computer-navigated TKA: a prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2017;25(6):1778-83. https://doi.org/10.1007/s00167-016-4196-9
Picard F, Deakin AH, Clarke JV, Dillon JM, Gregori A. Using navigation intraoperative measurements narrows
range of outcomes in TKA. Clin Orthop Relat Res 2007;:463:50–7. https://doi.org/10.1097/BLO.0b013e3181468734
Saragaglia D, Picard F, Chaussard C, Montbarbon E, Leitner F, Cinquin P .Computer-assisted knee arthroplasty: comparison with a conventional procedure. Results of 50 cases in a prospective randomized study. Rev Chir Orthop Reparatrice Appar Mot 2001;87(1):18–28. https://doi.org/10.1051/sicotj/2017025
Picard F, Clarke J, Deep K, Gregori A. Computer assisted knee replacement surgery: Is the movement mainstream? Orthop Muscular Syst 2014;3(2):153. https://doi.org/10.4172/2161-0533-3-1000153
Pronk Y, Peters MCWM, Brinkman JM. Is patient satisfaction after total knee arthroplasty predictable using patient characteristics and preoperative patient-reported outcomes? J Arthroplasty 2021;36(7):2458-65.
https://doi.org/10.1016/j.arth.2021.02.064
Rivière C, Ollivier M, Girerd D, Argenson JN, Parratte S. Does standing limb alignment after total knee arthroplasty predict dynamic alignment and knee loading during gait. Knee 2017;24:627–33. https://doi.org/10.1016/j.knee.2017.03.001
Park JK, Seon JK, Cho KJ, Lee NH, Song EK. Is immediate postoperative mechanical axis associated with the
revision rate of primary total knee arthroplasty? A 10-year follow-up study. Clin Orthop Surg 2018;10(2):167-73.
https://doi.org/10.4055/cios.2018.10.2.167
Young SW, Walker ML, Bayan A, Briant-Evans T, Pavlou P, Farrington B. The Chitranjan S Ranawat Award: no
difference in 2-year functional outcomes using kinematic versus mechanical alignment in TKA: a randomized
controlled clinical trial. Clin Orthop Relat Res 2017;:475:9–20. https://doi.org/10.1007/s11999-016-4844-x
Waterson HB, Clement ND, Eyres KS, Mandalia VI, Toms AD. The early outcome of kinematic versus mechanical alignment in total knee arthroplasty: a prospective randomized control trial. Bone Joint J 2016;98:1360–8. https://doi.org/10.1302/0301-620X.98B10.36862
Takahashi T, Ansari J, Pandit HG. Kinematically aligned total knee arthroplasty or mechanically aligned total knee arthroplasty. J Knee Surg 2018;31(10):999-1006. https://doi.org/10.1055/s-0038-1632378
Koh IJ, Lin CC, Patel NA, Chalmers CE, Maniglio M, Han SB, et al. Kinematically aligned total knee arthroplasty
reproduces more native rollback and laxity than mechanically aligned total knee arthroplasty: A matched pair
cadaveric study. Orthop Traumatol Surg Res 2019;105(4):605-11. https://doi.org/10.1016/j.otsr.2019.03.011
Deep K, Picard F, Clarke JV. Dynamic knee alignment and collateral knee laxity and its variations in normal
humans. Front Surg 2015;2:62. https://doi.org/10.3389/fsurg.2015.00062
Rivière C, Iranpour F, Auvinet E, Howell S, Vendittoli PA, Cobb J, et al. Alignment options for total knee
arthroplasty: A systematic review. Orthop Traumatol Surg Res 2017;103(7):1047–56.
https://doi.org/10.1016/j.otsr.2017.07.010
Kahlenberg CA, Nwachukwu BU, McLawhorn AS, Cross MB, Cornell CN, Padgett DE. Patient satisfaction after
total knee replacement: A systematic review. HSS J 2018;14(2):192-201. https://doi.org/10.1007/s11420-018-9614-8
Almaawi AJH, Hutt JRB, Masse V, Lavigne M, Vendittoli PA. The impact of mechanical and restricted kinematic
alignment on knee anatomy in total knee arthroplasty. J Arthroplasty 2017;32:2133–40.
https://doi.org/10.1016/j.arth.2017.02.028
Hutt JR, LeBlanc MA, Masse V, Lavigne M, Vendittoli PA. Kinematic TKA using navigation: surgical technique
and initial results. Orthop Traumatol Surg Res 2016;102:99–104. https://doi.org/10.1016/j.otsr.2015.11.010
Oussedik S, Abdel MP, Victor J, Pagnano MW, Haddad FS. Alignment in total knee arthroplasty. Bone Joint J
;102-B(3):276-9. https://doi.org/10.1302/0301-620X.102B3.BJJ-2019-1729
Boyce L, Prasad A, Barrett M, Dawson-Bowling S, Millington S, Sammy AH. The outcomes of total knee
arthroplasty in morbidly obese patients: a systematic review of the literature. Arch Orthop Trauma Surg
;139(4):553-60. https://doi.org/10.1007/s00402-019-03127-5
Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.
In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.
It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.
The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.
