Current Role of Computer Navigation in Total Knee Arthroplasty

Area of Science:

• Orthopedic Surgery
• Medical Technology
• Biomechanical Engineering

Background:

• Total knee arthroplasty (TKA) aims to restore lower limb mechanical alignment.
• Computer-assisted surgical (CAS) navigation has evolved to enhance TKA component positioning accuracy.
• The fundamental question of whether alignment impacts TKA outcomes persists despite technological advancements.

Purpose of the Study:

• To evaluate the effectiveness of CAS navigation in improving TKA component alignment.
• To assess if improved alignment translates to better patient-reported outcomes and long-term survivorship.
• To explore the role of different CAS systems (large-console and handheld) in achieving alignment goals.

Main Methods:

• Review of current literature on CAS navigation in TKA.
• Analysis of studies demonstrating accuracy and precision improvements with CAS systems.
• Examination of evidence regarding patient outcomes and revision rates associated with CAS-guided TKA.

Main Results:

• Both large-console and handheld CAS navigation systems enhance the accuracy and precision of TKA component alignment.
• Conclusive evidence demonstrating long-term clinical superiority (patient outcomes, revision rates) is currently limited.
• Cost remains a significant consideration for large-console CAS systems.

Conclusions:

• CAS navigation effectively improves TKA component alignment accuracy and precision.
• Further research is needed to establish definitive long-term clinical benefits and survivorship advantages.
• Low-cost, handheld CAS systems offer a potential solution to bridge the gap between accuracy and cost-effectiveness.