Clinical outcome using a ligament referencing technique in CAS versus conventional technique

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Biomechanical Engineering

Background:

• Computer-assisted surgery (CAS) is increasingly utilized in total knee arthroplasty (TKA).
• Existing studies often use bone referencing techniques, with mixed clinical outcome results despite improved alignment.
• The impact of CAS on TKA using strict ligamentous referencing requires further investigation.

Purpose of the Study:

• To evaluate the clinical outcomes of computer-assisted total knee arthroplasty (CAS TKA) compared to conventional TKA when employing a ligament referencing technique.
• To determine if CAS offers enhanced clinical benefits over conventional methods in TKA procedures focused on ligamentous balancing.

Main Methods:

• A prospective cohort study comparing navigated TKA (43 patients) with conventional TKA (122 patients).
• Patients were assessed preoperatively and at 2 and 12 months postoperatively.
• Validated patient-reported outcome tools and clinical examinations were used by an independent assessor.

Main Results:

• No significant differences were observed between groups at the 2-month follow-up.
• At 12 months, CAS TKA demonstrated significantly reduced pain and stiffness during rest and daily activities.
• Overall patient satisfaction was notably higher in the CAS TKA group compared to the conventional TKA group.

Conclusions:

• Computer-navigated TKA, utilizing a ligament referencing technique, significantly enhances patient-reported outcomes, including WOMAC and Knee Society scores, one year post-surgery.
• A substantial majority (91%) of patients in the CAS TKA group reported being extremely or very satisfied, versus 70% in the conventional TKA group.
• These findings suggest that CAS, when combined with ligament referencing, offers superior clinical results and patient satisfaction in TKA.