Clinical Outcomes of First 100 Navigated Total Knee Arthroplasties at Duke University Medical Center

Abstract

ABSTRACT Background Total knee arthroplasty (TKA) is one of the most clinically successful and cost-effective interventions in medicine. Implant malalignment can be a cause of early failure following total knee arthroplasty. Computer-assisted surgery has been employed to improve the precision of component alignment. Questions/purpose: We asked (1) What is the average coronal plane alignment of the first 100 patients undergoing computer-assisted total knee arthroplasty at our institution? (2) How do our clinical and radiographic results compare to those values reported in the literature? (3) Was a ‘learning curve’ present as evidenced by improvements in coronal plane alignment over time? Methods We retrospectively reviewed our first 100 patients undergoing computer navigated total knee arthroplasty. We calculated postoperative knee range of motion (ROM), coronal alignment as well as preoperative and postoperative Knee Society Scores. Minimum follow-up was 4.3 years (0.2-8.25 years). Results Of the 100 patients, average postoperative limb alignment was 0.9° varus compared to the mechanical axis. Seventy-nine percent of patients had coronal plane alignment of ±3°. Knee Society Scores improved on average from 60 preoperatively (52-67) to 85 postoperatively (56-97). Conclusion Computer-assisted total knee arthroplasty is potentially a way to improve component alignment and overall patient satisfaction. In our cohort, average coronal alignment was similar to literature reported values for navigated and conventional total knee arthroplasty. The benefit of this technology remains unproven. Level of evidence Level IV Bertrand TE, Bolognesi MP. Clinical Outcomes of First 100 Navigated Total Knee Arthroplasties at Duke University Medical Center. The Duke Orthop J 2014;4(1):13-18.