Computer-Assisted Surgery in Total Knee Arthroplasty: Our Experience.

Abstract

Total knee arthroplasty (TKA) is a reliable orthopedic procedure for knee osteoarthritis with long-term success rates of 90% after 15years. Computer-assisted surgery (CAS) has been developed to improve the accuracy of the alignment and orientation of the components in TKA. A prospective study involving 103 subjects who underwent CAS-TKA was conducted over a 3-year period. Subjects were assessed for pre- and post-operative varus and valgus deformity, BMI, comorbidities, and Knee Society Score (KSS). Outcome measures of post-operative KSS, post-operative alignment, and hospital stay were examined by Spearman correlation coefficients. Categorical outcomes of complication and secondary procedures were compared by chi-squared test and odds ratio. The study considered 103 TKA patients with a mean ± SD age of 63.7 ± 8.4years (33-88years). Unilateral knee replacement was performed on 56 patients (54.3%) and remaining 47 (45.6%) had simultaneous bilateral TKA. Forty (34.8%) patients were obese, and severe pre-operative deformity (> 15°) was observed in 47 (31.3%) patients. Mean coronal alignment of the knee joint was 91.33° (SD: 90.69° valgus-88.92° varus). The mean post-operative KSS noted in obese and non-obese subjects were 93.43 (84-98) and 94.76 (85-98) respectively. Post-operative KSS for knees with severe deformity was 94.08 (80-98), while it was 95.76 (83-98) in those with mild to moderate deformities. The study confirms that navigation in CAS-TKA consistently achieved coronal alignment of the knee joint within ± 3°, irrespective of the patient BMI and degree of deformity.