Randomized control trial comparing radiographic total knee arthroplasty implant placement using computer navigation...

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Biomechanical Engineering

Background:

• Total knee arthroplasty (TKA) aims to restore function and alignment.
• Conventional surgical techniques for TKA include extramedullary (EM) and intramedullary (IM) guides.
• Variability in implant positioning can affect long-term outcomes.

Purpose of the Study:

• To compare the radiological outcomes of computer-navigated surgery (CAS) versus conventional techniques (EM and IM guides) for TKA.
• To assess the accuracy and consistency of implant placement in TKA using different surgical navigation methods.

Main Methods:

• Prospective randomized study of 90 patients with knee arthritis undergoing TKA.
• Patients were divided into three groups: EM guide, IM guide, and CAS.
• Standardized long leg coronal and sagittal X-rays were evaluated by a blinded assessor.

Main Results:

• Computer-navigated surgery (CAS) demonstrated greater consistency and accuracy in implant placement.
• In the coronal view, 93.3% of CAS cases had better outcomes versus 73.4% (EM) and 60.0% (IM).
• In the sagittal axis, 90.0% of CAS cases showed better outcomes versus 63.3% (EM) and 76.7% (IM).

Conclusions:

• Computer-navigated total knee arthroplasty significantly improves accuracy and reduces outliers in implant positioning.
• CAS offers a more reliable method for achieving optimal implant alignment in TKA.
• This navigation technology enhances radiological outcomes in knee replacement surgery.