Bilateral Total Knee Arthroplasties Performed With and Without Computer Navigation: Prospective 11-Year Postoperative...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Medical Technology

Background:

• Computer navigation is increasingly used in total knee arthroplasty (TKA) to enhance component alignment and patient outcomes.
• Direct comparative studies between computer navigation and traditional instrumentation within the same patient are limited.

Purpose of the Study:

• To prospectively compare the efficacy of computer navigation versus traditional instrumentation in TKA.
• To evaluate differences in component alignment, reoperation rates, and clinical outcomes between the two methods.

Main Methods:

• Bilateral TKAs were performed, with one knee using computer navigation and the contralateral knee using traditional instrumentation.
• Patients were followed prospectively for reoperations and adverse events.
• Statistical analyses compared outcomes between the computer navigation and traditional instrumentation groups.

Main Results:

• No significant differences were observed in postoperative component alignment (femoral/tibial angles, posterior tibial slope) or clinical outcomes (range of motion, Knee Society Scores) between the two groups.
• Computer navigation showed a statistically significant reduction in posterior tibial slope outliers (1 vs. 8, P=0.018).
• Reoperation rates and adverse events did not differ significantly between the computer navigation and traditional instrumentation groups at a mean 11.8-year follow-up.

Conclusions:

• While computer navigation may reduce posterior tibial slope outliers in TKA, this did not lead to improved clinical outcomes at long-term follow-up.
• In the hands of experienced surgeons, traditional instrumentation may yield comparable clinical results to computer navigation in TKA.