Computer-assisted revision total knee arthroplasty does not improve postoperative knee prosthesis alignment compared...

Area of Science:

• Orthopedic surgery
• Surgical technology
• Biomedical engineering

Background:

• Computer-assisted surgery (CAS) is established for primary total knee arthroplasty (TKA) prosthesis alignment.
• Literature on CAS use in revision TKA (rTKA) is limited.
• The impact of CAS on rotational alignment in rTKA remains undescribed.

Purpose of the Study:

• To evaluate the effect of CAS in rTKA.
• To compare coronal, sagittal, and rotational prosthesis alignment between CAS-assisted rTKA and conventional rTKA.
• To assess differences in outlier proportions between the two techniques.

Main Methods:

• Prospective cohort study comparing CAS-rTKA (54 patients/62 knees) with a historical control group (CON-rTKA) (13 patients/23 knees).
• CAS-rTKA utilized imageless CAS between 2012-2017.
• Conventional rTKA (CON-rTKA) used standard techniques between 2002-2012.
• Postoperative alignment assessed via EOS-2D/3D (coronal/sagittal) and CT scans (rotation).

Main Results:

• No significant differences in coronal or sagittal alignment (e.g., mechanical leg angle, distal femoral/proximal tibial angles) between CAS-rTKA and CON-rTKA groups.
• No significant differences in femoral or tibial rotation between the groups.
• The proportion of outliers in coronal, sagittal, and rotational alignment did not differ significantly between the CAS-rTKA and CON-rTKA groups.

Conclusions:

• This study found no evidence that CAS improves coronal, sagittal, or rotational alignment in rTKA.
• No significant difference in outlier rates was observed between CAS-assisted and conventional rTKA.
• Current evidence does not support the routine use of CAS for enhancing prosthesis alignment in revision TKA.