Comparison Between Computer Navigation Assisted Surgery and Conventional Surgery in Total Knee Replacement
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Published:
Jun 25, 2022
Keywords:
Computer-assisted surgery, navigation, knee arthroplasty, kinematics
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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.
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.
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How to Cite
Pace, A., Estrada, M., & Ruggieri, E. A. (2022). Comparison Between Computer Navigation Assisted Surgery and Conventional Surgery in Total Knee Replacement. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(3), 325-334. https://doi.org/10.15417/issn.1852-7434.2022.87.3.1463
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Clinical Research
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13. 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
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18. 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
19. 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
20. 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
21. 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
22. 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
23. 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
24. Oussedik S, Abdel MP, Victor J, Pagnano MW, Haddad FS. Alignment in total knee arthroplasty. Bone Joint J
2020;102-B(3):276-9. https://doi.org/10.1302/0301-620X.102B3.BJJ-2019-1729
25. 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
2019;139(4):553-60. https://doi.org/10.1007/s00402-019-03127-5
2. 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
3. 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
4. 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
5. 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]
6. 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
7. 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
8. 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
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
10. 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
11. 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
12. 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
13. 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
14. 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
15. 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
16. 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
17. 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
18. 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
19. 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
20. 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
21. 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
22. 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
23. 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
24. Oussedik S, Abdel MP, Victor J, Pagnano MW, Haddad FS. Alignment in total knee arthroplasty. Bone Joint J
2020;102-B(3):276-9. https://doi.org/10.1302/0301-620X.102B3.BJJ-2019-1729
25. 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
2019;139(4):553-60. https://doi.org/10.1007/s00402-019-03127-5