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Navigated TKA could represent a better option than
conventional TKA as it significantly reduced the rates of surgery revision in
patients with OA.
Total knee arthroplasty (TKA)
is major surgery and liable to post-operative complications and infection is
one of the worst and most feared issues. It represents an actual challenge to
the orthopaedic surgeon since it
is complicated and lengthy to treat. In navigation-assisted TKA, the bone
cuts were extramedullary-guided and mapped via
navigation and infrared-based systems as per the manufacturer’s instructions. In
case of conventional TKA, the femoral bone cuts (distal and chamber cuts) were
directed by an intramedullary system and guiding instruments.
This study was performed to compare the long-term effects of navigated total knee
arthroplasty with that of conventional TKA. These methods are not so prevalent
and common at present. The long-term survivorship, clinical scores and radiographic outcomes of a matched-pair
group of 350 patients (350 knees) treated with navigated (n = 157) or
conventional (n = 188) TKA for osteoarthritis were reviews over a
period of 11 years.
Mean clinical follow-up was done for ten years. The findings did not
reveal any clinically relevant differences with regards to clinical outcome,
patient satisfaction or pain between the two groups. The navigated group had
coronal leg alignment closer (1.7-3.1°) to the neutral mechanical axis as
compared to conventional group (2.6-4.7°). Revision surgery (p = 0.04) was
performed in 12 knees (6.4%) of the conventional group and 3 knees (1.9%) of
the navigated group. This resulted in an absolute reduction of risk of 4.5% for
revision surgery with the help of navigation. The ten-year year Kaplan-Meier survivorship was 98.1%
and 92.5% in the navigated and conventional groups.
It
can thus be concluded that the navigated TKA enhances the implant survivorship compared with
conventional TKA.
Int Orthop. 2017 May 26
Clinical, radiological and survivorship results after ten years comparing navigated and conventional total knee arthroplasty: a matched-pair analysis
Baier C et al.
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