Computer navigation and total knee arthroplasty.

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Biomechanical Engineering

Background:

• Conventional total knee arthroplasty (TKA) techniques have limitations in achieving optimal mechanical axis alignment.
• Computer-navigated surgery is emerging as an alternative to improve precision in TKA.

Purpose of the Study:

• To compare outliers in mechanical axis and postoperative complications between conventional and computer-navigated TKA.
• To evaluate the efficacy of computer navigation in primary osteoarthritis TKA.

Main Methods:

• A meta-analysis of 15 randomized controlled trials (2002-2012) comparing conventional and computer-navigated TKA.
• Included 2089 patients (1111 computer-navigated, 978 conventional) with primary osteoarthritis.
• Defined outliers as mechanical axis deviation >30°.

Main Results:

• Computer-navigated TKA had a significantly longer mean operative time (+16.9 minutes, P=.046).
• Fewer outliers in mechanical axis were observed with computer-navigated TKA (13.4%) versus conventional (27.4%), but not statistically significant (P=1.000).
• Computer-navigated TKA showed a trend towards fewer postoperative complications (4%) compared to conventional TKA (6.5%).

Conclusions:

• Computer navigation in TKA may reduce mechanical axis outliers and postoperative complications.
• Increased operative time is a consideration for computer-navigated TKA.
• Further research may be needed to achieve statistical significance for axis alignment and complication rates.