Revisiting Short-term Outcomes of Conventional and Computer-Assisted Total Knee Arthroplasty: A Population-based
Abdalrahman G Ahmed1, Yao Tian, Mohamed Hasan
1From the Medical College of Wisconsin, Milwaukee, WI (Ahmed); the Department of Surgery (Dr. Tian and Dr. Ghomrawi), Surgical Outcomes and Quality Improvement Center (Dr. Tian), Health Sciences Integrated PhD Program (Dr. Hasan and Harris), Center for Health Services and Outcomes Research (Dr. Ghomrawi), the Department of Medicine (Rheumatology) (Dr. Ghomrawi), the Department of Pediatrics (Dr. Ghomrawi), Feinberg School of Medicine, Northwestern University, Chicago, IL.
Background:
Population-based studies showing the advantage of computer-assisted total knee arthroplasty (CATKA) over conventional total knee arthroplasty (TKA) are outdated. More recent institution-based studies with relatively small sample sizes may hinder wider adoption. This cohort-based study aimed to compare postoperative CATKA and TKA in-hospital complications and 90-day all-cause readmissions using 2017-2018 data.
Methods:
Patients who underwent a primary unilateral CATKA or TKA were identified in the New York Statewide Planning and Research Cooperative System database. In-hospital complications were defined based on the 2020 Centers for Medicare & Medicaid Services total hip arthroplasty and TKA complications measure. Ninety-day readmissions were identified using unique patient identifiers. Logistic regression with a generalized estimating equation was used to assess associations of computer assistance with in-hospital complications and 90-day all-cause readmissions.
Results:
A total of 80,468 TKAs were identified during the study period, of which 7,395 (9.2%) were CATKAs. Significantly fewer complications occurred among patients who had CATKAs compared with conventional TKAs (0.4% of total CATKAs vs 2.6% of total conventional TKAs, P < 0.001); patients who had CATKAs had fewer 90-day all-cause readmissions compared with those who underwent TKAs (363 vs 4,169 revisits, P < 0.01). Computer assistance was associated with significantly lower odds of in-hospital complications (odds ratio, 0.15, 95% confidence interval, 0.09 to 0.24; P < 0.05) but not 90-day all-cause readmissions.
Conclusion:
Patients undergoing CATKAs had markedly lower odds of in-hospital complications, compared with patients having TKAs, which has implications for both patient outcomes and hospital reimbursement. These more recent cohort-based findings encourage wider CATKA adoption.
