No advantage in using computer-assisted-surgical navigation for Total Knee Arthroplasty

CAS TKA 2Advantages of electromagnetic navigation in TKA remain unclear (Healio)

According to researchers, demonstrating the value of using electromagnetic navigation in total knee arthroscopy remains a challenge.

Between July 2007 and August 2010, the researchers selected 200 patients scheduled for total knee arthroplasty (TKA) and randomly assigned them to undergo the procedure with either conventional instrumentation or an electromagnetic computer-assisted surgical technique; 101 patients were assigned to the navigated technique and 97 underwent TKA with the conventional approach. Ninety-two percent of knees from the navigated group and 85% of knees from the conventional group were implanted within 3° of neutral mechanical alignment, according to the researchers. No differences between the two groups were noted with regard to preoperative parameters.

At the 1-year follow-up, a blinded independent assessor evaluated patients, using a hand-held goniometer to determine range of motion, as well as the American Knee Society Score (AKSS) and Oxford Knee Score (OKS) to assess knee-specific measures. Additionally, SF-36 scores were used to measure patients’ general health. Implantation accuracy was determined using postoperative CT scans.

The researchers observed a statistically significant difference between the groups in median tourniquet times, with 80 minutes recorded for the navigation group and 65 minutes recorded for the conventional group. Although there was a small but statistically significant difference in skin incision length of 1 cm, with longer incisions reported in the navigated group, no between-group differences were reported for mean drop in hemoglobin or length of hospital stay.

Between the two groups, researchers found no differences in AKSS and OKS scores, patient satisfaction, quality of life, length of stay, complication events or adverse events. There was only one deep infection in a patient within the conventional group, according to the researchers.  – by Monica Jaramillo

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