A prospective study comparing the functional outcome of computer-assisted and conventional total knee replacement

Area of Science:

• Orthopedic surgery
• Medical technology

Background:

• Total knee replacement (TKR) is a common procedure for knee osteoarthritis.
• Optimizing clinical outcomes and surgical techniques in TKR is an ongoing area of research.

Purpose of the Study:

• To compare the clinical outcomes of computer-navigated total knee replacement (TKR) versus conventional TKR.
• To investigate if navigated TKR provides superior results over a five-year period.

Main Methods:

• Prospective, single-centre study involving 195 patients undergoing TKR.
• Patients were alternately assigned to either conventional instrumentation (97 knees) or a computer navigation system (98 knees).
• Clinical outcomes were assessed over five years, with 62% of patients providing complete scores.

Main Results:

• Navigated TKR showed a significantly better mean Knee Society score compared to conventional TKR (p = 0.008).
• The difference in scores between groups varied over time, indicating different patient responses to surgery.
• No significant difference in malalignment frequency was observed between the navigated and conventional groups.

Conclusions:

• Computer navigation in TKR surgery leads to improved functional outcomes at the five-year mark.
• Rotational alignment, rather than mechanical alignment, may be a more sensitive indicator of clinical outcome differences in navigated TKR.
• Further research into rotational alignment could enhance the understanding of navigated TKR efficacy.