Comparison of total knee arthroplasty using computer-assisted navigation versus conventional guiding systems: a...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Surgical Navigation Systems

Background:

• Total knee arthroplasty (TKA) aims to restore knee joint function and alignment.
• Accurate implant positioning is crucial for TKA success and longevity.
• Conventional guiding systems may have limitations in achieving precise alignment.

Purpose of the Study:

• To compare the accuracy of knee alignment in TKA using computer-assisted navigation (CAN) versus conventional guiding systems.
• To evaluate the impact of CAN on coronal and sagittal plane alignment.
• To assess the achievement of the mechanical axis in TKA procedures.

Main Methods:

• A comparative study involving 70 patients (5 men, 49 women) with primary knee osteoarthritis and varus deformity.
• 35 TKAs were performed using CAN, and 35 TKAs used conventional extramedullary tibial and intramedullary femoral guides.
• Postoperative alignment was assessed by comparing the mechanical axis, coronal tibial/femoral angles, and sagittal tibial/femoral angles between the two groups.

Main Results:

• TKAs performed with CAN demonstrated more optimal sagittal tibial and femoral angles.
• 94% of TKAs using CAN achieved a postoperative mechanical axis within 3 degrees of neutral (varus/valgus).
• 74% of TKAs using conventional guides achieved a postoperative mechanical axis within 3 degrees of neutral.

Conclusions:

• Computer-assisted navigation provides more consistent alignment correction in TKA.
• CAN effectively reduces outliers in implant positioning compared to conventional methods.
• CAN may lead to improved outcomes in total knee arthroplasty due to enhanced alignment accuracy.