Improving outcomes in total knee arthroplasty-do navigation or customized implants have a role?

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Total knee arthroplasty (TKA) effectively treats osteoarthritis pain and disability, with increasing procedure rates.
• Prosthetic component malalignment is a significant cause of TKA dissatisfaction and complications.
• Achieving neutral mechanical axis alignment (within 3°) is crucial for prosthesis survivorship.

Purpose of the Study:

• To review literature on navigation and custom guides for improving prosthetic alignment in TKA.
• To assess if these technologies reduce outliers and enhance patient outcomes.

Main Methods:

• Literature review of studies evaluating navigation systems and custom implant guides in TKA.
• Analysis of data regarding prosthetic alignment, operative times, and patient satisfaction.

Main Results:

• Navigation and custom guides aid in achieving predictable mechanical alignment, reducing outliers.
• These technologies appear cost-effective for improving alignment predictability.
• No significant difference in patient satisfaction was observed between navigation/custom guides and conventional methods.
• Potential for increased operative times with advanced alignment technologies.

Conclusions:

• Navigation and custom guides are effective tools for improving prosthetic alignment in TKA.
• While alignment predictability is enhanced, increased operative times and lack of improved patient satisfaction warrant consideration.
• Further research may be needed to optimize the use of these technologies for better patient outcomes.